Background:Aiming to establish an effective tool in new cardiac rehabilitation programs, we investigated the use of a lumbar-type hybrid assistive limb (HAL) in patients with heart failure (HF) who had difficulty in walking at the usual speed of healthy subjects (≈80 m/min).

Methods and Results:We randomly assigned 28 HF patients (age, 73.1±13.8 years) to perform a sit-to-stand exercise with or without HAL. The sit-to-stand exercise was repeated as many times as possible as cardiac rehabilitation therapy over a period of 6–10 days. We measured 5 parameters before and after the completion of cardiac rehabilitation: B-type natriuretic peptide, Short Physical Performance Battery (SPPB), 6-min walking distance (6MWD), 30-s chair-stand test (CS-30), and isometric knee extensor muscle strength. The SPPB and 6MWD were significantly improved, and the CS-30 score was somewhat improved, after the exercise therapy in both the HAL and non-HAL groups. The knee extensor muscle strength improved significantly in the HAL group (0.29±0.11 to 0.35±0.11 kgf/kg, P<0.01), but showed no change in the non-HAL group (0.35±0.11 to 0.35±0.13 kgf/kg, P=0.40).

Conclusions:The improved knee extensor muscle strength in the HAL group suggests that the lumbar-type HAL may be an effective tool for cardiac rehabilitation in HF patients with frailty, which is a predictor of poor prognosis in HF.

背景：为了在新的心脏康复计划中建立一个有效的工具，我们调查了在以健康受试者的通常速度行走有困难的心力衰竭（HF）患者中使用腰椎型混合辅助肢体（HAL）的情况。 ≈80 米/分钟）。

方法和结果：我们随机分配了 28 名 HF 患者（年龄 73.1±13.8 岁）进行有或没有 HAL 的坐站运动。在 6-10 天的时间内，尽可能多地重复坐站运动作为心脏康复治疗。我们测量了心脏康复完成前后的5个参数：B型利钠肽、短体能电池（SPPB）、6分钟步行距离（6MWD）、30秒椅立试验（CS-30）和等距膝伸肌力量。HAL组和非HAL组在运动治疗后SPPB和6MWD均有明显改善，CS-30评分有所改善。HAL 组膝伸肌力量显着提高（0.29±0.11 至 0.35±0.11 kgf/kg，P<0.01），但非 HAL 组无变化（0.35±0.11 至 0.35±0.13 kgf/kg， P = 0.40）。

结论： HAL 组膝伸肌力量的改善提示腰椎型 HAL 可能是心衰合并虚弱患者心脏康复的有效工具，是心衰预后不良的预测因素。