Improvement and sustainability of walking ability with hybrid assistive limb training in a patient with cerebral palsy after puberty: a case report.
Shogo Nakagawa, Hirotaka Mutsuzaki, Yuki Mataki and 3 others
PMID 31528000WHAT IT FOUND
In one post-pubertal patient with cerebral palsy, hybrid assistive limb training plus daily physical therapy was reported to improve walking and sustain changes to 7 months.
This is one case, and the robot suit alone cannot be credited.
Key findings
01HAL training was performed thrice weekly for 4 weeks, total 12 sessions, along with concurrent daily physical therapy.
02Bilateral step lengths were greater from the first post-intervention month and remained so until the last follow-up visit at 7 months.
03The knee flexion angle during the late stance phase was reduced immediately following the intervention and persisted until 7 months for both knees.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so it cannot show that HAL training works for other patients with cerebral palsy. HAL training was given together with daily physical therapy, so the contribution of HAL alone cannot be separated. The gait speed reporting is inconsistent: the text says speed was higher at all post-intervention assessments, but Table 1 lists immediate post-training speed as lower than pre-training. The patient was assessed while using a walker and ankle-foot orthoses, so the paper does not show how he would walk without these supports. The authors state the scope is limited and call for large prospective studies.
Declared interests
This work was supported by a Grant-in-Aid for Project Research from the Ibaraki Prefectural University of Health Sciences. The authors declare that there is no conflict of interest.
The easy way to misread this
Do not conclude that HAL training alone improves walking in cerebral palsy. This is one case report, and HAL was given with concurrent daily physical therapy, so the contribution of HAL alone cannot be separated.