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Gait training using a hybrid assistive limb after botulinum toxin treatment for cerebral palsy: a case report
Authors:Mayumi Matsuda Kuroda  Hirotaka Mutsuzaki  Kenichi Yoshikawa  Haruka Ohguro  Iwasaki Nobuaki
Affiliation:1) Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences: 4669-2 Ami, Ami-machi, Ibaraki 300-0394, Japan;2) Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Japan;3) Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Japan;4) Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, Japan
Abstract:
[Purpose] Hybrid Assistive Limb® (HAL; Cyberdyne, Tsukuba, Japan) is a wearable robot that assists patients based on their voluntary movements. We report gait training with HAL after botulinum toxin treatment for spasticity of the lower limb in cerebral palsy (CP). [Participant and Methods] The participant was a 36 year-old male with spastic diplegia due to periventricular leukomalacia, with Gross Motor Function Classification System (GMFCS) level II. HAL training was performed in 20-minute sessions (3 sessions/week for 4 weeks). The outcome measures were range of motion, spasticity, walking ability, muscle strength, gross motor function measure (GMFM), Canadian Occupational Performance Measure (COPM), and Pediatric Evaluation of Disability Inventory measured before, immediately after, and one, two, and three months after HAL training. [Results] No adverse events were observed during training. After the HAL intervention, gait speed, step length, cadence, 6-min walking distance (6MD), knee extension strength, GMFM, and COPM increased, and Physiological Cost Index declined. Three months post-intervention, gait speed, step length, cadence, 6MD, and GMFM remained higher than those observed within the first two months. [Conclusion] Gait training with HAL can be a safe and feasible method for patients with CP who undergo botulinum toxin treatment to improve walking ability and motor function.
Keywords:Robotics   Robot assisted gait training   Botulinum toxin
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