Early rehabilitation with lumbar-type hybrid assistive limb for acute stroke patients: a pilot study and clinical review.

Only 15 patients took part, at one hospital, so the results could easily have arisen by chance and may not apply to other settings. Training lasted two weeks. There is no follow-up, so nothing is known about whether any balance gain lasted or affected daily life later. The people in the HAL group started with much lower balance scores than the conventional group (18.7 versus 29.0), so having more room to improve may explain part of the larger change. Patients with severe paralysis, impaired consciousness or communication difficulties were excluded, so the findings do not speak to those patients. The paper does not list who was excluded from the study, so it is not clear how many people were screened and turned down. Both groups improved on most measures, which makes it hard to separate the effect of the device from the usual rehabilitation everyone received. The authors note that maintaining the device is expensive, which limits how widely it could be used.

The work was funded by a Japanese KAKENHI Grant-in-Aid for Scientific Research (23K10509). The authors state that they have no commercial or financial relationships that could be seen as a conflict of interest.

Do not read this as evidence that lumbar-type HAL improves walking or independence. The only measure that differed between the two groups was balance, and the HAL group began with much lower balance scores than the other group (18.7 versus 29.0, on a scale where 14 tasks are each scored 0 to 4), so part of the larger change may simply reflect where they started.