Training with Hybrid Assistive Limb for walking function after total knee arthroplasty

被引:39
作者
Yoshikawa, Kenichi [1 ]
Mutsuzaki, Hirotaka [2 ]
Sano, Ayumu [1 ]
Koseki, Kazunori [1 ]
Fukaya, Takashi [3 ]
Mizukami, Masafumi [4 ]
Yamazaki, Masashi [5 ]
机构
[1] Ibaraki Prefectural Univ, Hlth Sci Hosp, Dept Phys Therapy, 4773 Ami, Ami, Ibaraki 3000331, Japan
[2] Ibaraki Prefectural Univ Hlth Sci, Dept Orthopaed Surg, 4669-2 Ami, Ami, Ibaraki 3000394, Japan
[3] Tsukuba Int Univ, Fac Hlth Sci, Dept Phys Therapy, 6-8-33 Manabe, Tsuchiura, Ibaraki 3000051, Japan
[4] Ibaraki Prefectural Univ Hlth Sci, Dept Phys Therapy, 4669-2 Ami, Ami, Ibaraki 3000394, Japan
[5] Univ Tsukuba, Fac Med, Dept Orthopaed Surg, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan
关键词
Total knee arthroplasty; Osteoarthritis; Rheumatoid arthritis; Robot assisted training; Hybrid assistive limb; QUADRICEPS STRENGTH; STROKE PATIENTS; GAIT; RECOVERY; OUTCOMES; PEOPLE; REHABILITATION; IMPROVEMENT; REDUCTIONS; SPEED;
D O I
10.1186/s13018-018-0875-1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: The Hybrid Assistive Limb (HAL, CYBERDYNE) is a wearable robot that provides assistance to patients while walking, standing, and performing leg movements based on the intended movement of the wearer. We aimed to assess the effect of HAL training on the walking ability, range of motion (ROM), and muscle strength of patients after total knee arthroplasty (TKA) for osteoarthritis and rheumatoid arthritis, and to compare the functional status after HAL training to the conventional training methods after surgery. Methods: Nine patients (10 knees) underwent HAL training (mean age 74.1 +/- 5.7 years, height 150.4 +/- 6.5 cm; weight 61.2 +/- 8.9 kg), whereas 10 patients (11 knees) underwent conventional rehabilitation (mean age 78.4 +/- 8.0 years, height 150.5 +/- 10.0 cm, weight 59.1 +/- 9.8 kg). Patients underwent HAL training during 10 to 12 (average 14.4 min a session) sessions over a 4-week period, 1 week after TKA. There was no significant difference in the total physical therapy time including HAL training between the HAL and control groups. Gait speed, step length, ROM, and muscle strength were evaluated. Results: The nine patients completed the HAL training sessions without adverse events. The walking speed and step length in the self-selected walking speed condition, and the walking speed in the maximum walking speed condition were greater in the HAL group than in the control group at 4 and 8 weeks (P < 0.05). The step length in the maximum walking speed condition was greater in the HAL group than in the control group at 2, 4, and 8 weeks (P < 0.05). The extension lag and knee pain were lower in the HAL group than in the control group at 2 weeks (P < 0.05). The muscle strength of knee extension in the HAL group was greater than that in the control group at 8 weeks (P < 0.05). Conclusion: HAL training after TKA can improve the walking ability, ROM, and muscle strength compared to conventional physical therapy for up to 8 weeks after TKA. Since the recovery of walking ability was earlier in the HAL group than in the control group and adverse events were not observed in this pilot study, HAL training after TKA can be considered a safe and effective rehabilitation intervention.
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页数:10
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