Immediate effects of a single session of robot-assisted gait training using Hybrid Assistive Limb (HAL) for cerebral palsy.
Mayumi Matsuda, Yuki Mataki, Hirotaka Mutsuzaki and 8 others
PMID 29545679WHAT IT FOUND
In 12 patients with cerebral palsy, one HAL gait session did not improve walking speed, stride length, or cadence immediately after.
It increased single-leg support and stance-phase hip and knee extension angles, but walking during HAL was slower and shorter.
Key findings
01Immediately after HAL, gait speed, stride length, and cadence were not significantly different from before.
02During HAL, gait speed, stride length, and cadence significantly decreased compared with before.
03Immediately after HAL, single-leg support phase and hip and knee extension angles in stance increased, while knee flexion angle in mid-swing decreased.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 12 patients were studied, and the paper used no control group, so it cannot show whether HAL caused the changes. The participants had a range of walking abilities, from independent walking to needing parallel bars, so the result cannot be applied to all people with cerebral palsy. The main walking outcomes did not improve after the session; the positive changes were in single-leg support and joint angles. A single session was tested, so this says nothing about repeated training, long-term function, or reduced walking support. Walking during HAL required a harness and two therapists, so it was not independent walking.
The easy way to misread this
Do not conclude that one HAL session improves walking ability in cerebral palsy. Walking speed, stride length, and cadence were not better immediately after, and they were lower during HAL. The study was small and uncontrolled, and HAL walking needed a harness and two therapists.