Newly developed hybrid assistive limb for pediatric patients with cerebral palsy: a case report.
Shogo Nakagawa, Hirotaka Mutsuzaki, Yuki Mataki and 5 others
PMID 31528013WHAT IT FOUND
After one 20-minute session that included standard physical therapy, a smaller walking assist device, a harness, orthoses, and crutches, an 11-year-old with cerebral palsy walked faster, from 0.92 to 1.10 m/sec.
The contribution of the device alone cannot be separated.
Key findings
01Immediately after a session that included standard physical therapy, the smaller HAL, a harness, ankle-foot orthoses, and crutches, the child's 10-m walking speed, stride length, and cadence were higher; the contribution of HAL alone cannot be separated.
02The authors reported no severe adverse event and said vital signs remained almost unchanged after training, with Borg fatigue rated 13 (somewhat hard).
03The post-training gait video showed increased left hip flexion during swing and increased right knee extension during stance, and integrated EMG signals in several measured muscles were lower after training.
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 describes what happened to one child and cannot show that the device works for other children. The measurements were taken immediately after one session, so it does not show whether the changes lasted. The session included standard physical therapy, the HAL, a harness, orthoses, and crutches, so the contribution of the HAL alone cannot be separated. The child was 11 years old, walked with crutches and orthoses, and had GMFCS level III and full-scale IQ 67, so the result may not apply to younger children or those with different walking ability or understanding. The authors inferred muscle normalization and improved symmetry from kinematics and EMG; those are explanations, not outcomes that were tested against a comparison.
Declared interests
The authors declared no conflict of interest. The work was supported by a Grant-in-Aid for Project Research (1655) from Ibaraki Prefectural University of Health Sciences.
The easy way to misread this
Do not conclude that the smaller walking assist device improves walking in children with cerebral palsy. This was one child, one session, measured immediately after training, and the session also included standard physical therapy, a harness, orthoses, and crutches, so the device alone cannot be shown to have caused the change.