Context: We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury.
Findings: A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient’s manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees.
Conclusion/clinical relevance: Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury. 相似文献
Acute transverse myelitis (ATM) is a neurologic condition that presents with bilateral lower extremity weakness and sensory loss associated with bowel and bladder dysfunction. Whereas the time of onset may be hours to days, the time to either partial or complete recovery may require months. The etiology is varied and may be idiopathic. Laboratory and radiographic evaluation may be nonrevealing. Corticosteriods have been used for treatment, but their efficacy is controversial. As illustrated by this case report, the essential aspect of the initial management of ATM is the elimination of potentially treatable causes. 相似文献
Epidural abscess is a well-recognised but rare complication of epidural catheter placement. We have found only five previous reports of epidural abscess from noncatheter-related administration of steroids and/or local anaesthetic. We describe a further case which led to critical illness and emphasise the association between diabetes mellitus and epidural infection. 相似文献
Hereditary spastic paraplegia (HSP) is a group of clinically and genetically heterogeneous neurodegenerative disorders characterized
by slowly progressive spasticity and weakness of the lower extremities. Among eight loci linked with autosomal-dominant (AD)-HSP,
the SPG4 locus on chromosome 2p22 accounts for about 40% of all patients. Recently, mutations in a new member of the AAA protein family,
called spastin, have been identified as responsible for SPG4-linked AD-HSP. Here, we describe a novel missense mutation (c.1031T>A; I344K) in exon 7 of the SPG4 gene identified in a Korean family with typical clinical features of pure AD-HSP. The mutation affects the third amino acid
of the highly conserved AAA cassette domain, which is the most fore part of the domain altered by a missense mutation reported
so far. Clinical presentations of affected individuals carrying the I344K mutation were not different from those of pure AD-HSP
with SPG4 mutations reported previously. However, it is noteworthy that neither urinary dysfunction nor involvement of upper extremities
was noticed in this family. To our knowledge, this is the first report of genetically confirmed AD-HSP in Korea.
Received: February 20, 2002 / Accepted: May 21, 2002 相似文献