PURPOSE Gait parameters and gross motor function improve after 12 sessions of small-sized Hybrid Assistive Limb® (S-HAL) training in adult cerebral palsy (CP) patients. However, there are no reports on repetitive robot-assisted gait training using the newly developed very small-sized HAL (2S-HAL). This study aimed to examine the effect of using 2S-HAL on a pediatric CP patient. METHODS The subject was an 11-year-old boy (height = 138 cm, weight = 30 kg) with spastic quadriplegia due to periventricular leukomalacia, with Gross Motor Function Classification System level IV. HAL training was performed for 2-4 sessions/week for 20 min/session (i.e., 4-week period with 12 sessions). Outcome measures were walking ability, gross motor function, Canadian Occupational Performance Measure (COPM), and Pediatric Evaluation of Disability Inventory measured before, after, and at 1, 2, and 3 months after HAL-assisted gait training. RESULTS After HAL intervention, gait speed, step length, cadence, 6-min walking distance (6MD), Gross Motor Function Measure (GMFM), and COPM increased and physiological cost index (PCI) declined compared to those before intervention. The peaks of gait speed, step length, and cadence were 2 month, 1 month, and 3 month, respectively. 6MD, PCI, and GMFM at 1-3 months post-intervention were maintained. COPM peaked at 1 month post-intervention but remained higher than that before intervention. CONCLUSION This is the first report of repetitive intervention using 2S-HAL in a pediatric CP patient. Gait training using 2S-HAL may be effective in CP patients as it improves post-training walking ability and gross motor function.

中文翻译：

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机器人辅助步态训练使用超小型 Hybrid Assistive Limb® 治疗小儿脑瘫：病例报告

目的 在成人脑瘫 (CP) 患者中进行 12 次小型混合辅助肢体® (S-HAL) 训练后，步态参数和粗大运动功能得到改善。然而，没有关于使用新开发的超小型 HAL (2S-HAL) 进行重复机器人辅助步态训练的报道。本研究旨在检查使用 2S-HAL 对儿科 CP 患者的影响。方法 受试者为一名 11 岁男孩（身高 = 138 cm，体重 = 30 kg），因脑室周围白质软化导致痉挛性四肢瘫痪，大运动功能分类系统 IV 级。HAL 培训进行了 2-4 节/周，每次 20 分钟（即 4 周，12 节）。结果测量为步行能力、粗大运动功能、加拿大职业绩效测量 (COPM)、在 HAL 辅助步态训练之前、之后和之后 1、2 和 3 个月测量的残疾清单的儿科评估。结果与干预前相比，HAL 干预后步速、步长、步频、6 分钟步行距离（6MD）、粗大运动功能测量（GMFM）和 COPM 增加，生理成本指数（PCI）下降。步速、步长和步频的峰值分别为2个月、1个月和3个月。维持干预后 1-3 个月的 6MD、PCI 和 GMFM。COPM 在干预后 1 个月达到峰值，但仍高于干预前。结论 这是对儿科 CP 患者使用 2S-HAL 进行重复干预的第一份报告。