ABSTRACT

The Hybrid Assistive Limb (HAL) was developed as an exoskeleton robot that supports gait training. The purpose of this study was to assess the usefulness of training using the HAL after total hip arthroplasty (THA). We targeted 16 consecutive patients who underwent THA via the posterior approach. We randomized patients to the HAL group (8 hips), in which the HAL was used as part of physical therapy, or the control group (8 hips), in which only typical physical therapy was performed. Gait analysis was performed before and after surgery, and comparisons were made between the two groups. We evaluated the single support time (%), double support time (%), cadence (steps/min), velocity (cm/s), stride length (cm), and anteroposterior and lateral variability, and assessed the hip and knee joint range of motion in the sagittal plane. The results showed improvements in the hip extension angle and other gait parameters in the HAL group. Among gait-related problems after THA, a decreased peak hip extension angle is reported to be a significant factor that affects gait disability. This study revealed that HAL usage after THA seems to be a useful method to obtain sufficient extension angle.

摘要

混合辅助肢体 (HAL) 是作为支持步态训练的外骨骼机器人开发的。本研究的目的是评估在全髋关节置换术 (THA) 后使用 HAL 进行训练的有效性。我们针对 16 名通过后路接受 THA 的连续患者。我们将患者随机分为 HAL 组（8 髋），其中 HAL 被用作物理治疗的一部分，或对照组（8 髋），其中仅进行典型的物理治疗。术前、术后进行步态分析，比较两组。我们评估了单支撑时间 (%)、双支撑时间 (%)、节奏 (steps/min)、速度 (cm/s)、步幅 (cm) 以及前后和横向可变性，并评估了髋关节和膝关节矢状面的运动范围。结果显示 HAL 组的髋关节伸展角度和其他步态参数有所改善。在 THA 后的步态相关问题中，据报道，髋关节伸展角峰值降低是影响步态残疾的重要因素。这项研究表明，在 THA 后使用 HAL 似乎是获得足够延伸角的有用方法。