Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report
Disorders of the central nervous system sometimes cause severe sensory motor paralysis accompanied by gait impairment. Recently, there are several reports on the effectiveness of robot-assisted gait training for patients experiencing these issues. The purpose of this case report was to assess the ne...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00102/full |
| _version_ | 1818500086681829376 |
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| author | Hideki Kadone Hideki Kadone Shigeki Kubota Tetsuya Abe Hiroshi Noguchi Kousei Miura Kousei Miura Masao Koda Yukiyo Shimizu Yasushi Hada Yoshiyuki Sankai Kenji Suzuki Masashi Yamazaki |
| author_facet | Hideki Kadone Hideki Kadone Shigeki Kubota Tetsuya Abe Hiroshi Noguchi Kousei Miura Kousei Miura Masao Koda Yukiyo Shimizu Yasushi Hada Yoshiyuki Sankai Kenji Suzuki Masashi Yamazaki |
| author_sort | Hideki Kadone |
| collection | DOAJ |
| description | Disorders of the central nervous system sometimes cause severe sensory motor paralysis accompanied by gait impairment. Recently, there are several reports on the effectiveness of robot-assisted gait training for patients experiencing these issues. The purpose of this case report was to assess the neuromechanical effect of a wearable robot suit HAL (Hybrid Assistive Limb) during post-operative gait training in a patient with gait impairment due to compressive myelopathy caused by ossification of the posterior longitudinal ligament (OPLL). For this purpose, we compared lower limb muscular activities while the patient was walking with and without the robot through a course of treatment sessions by (i) gait phase-dependent muscle usage analysis, (ii) muscle synergy analysis, and (iii) muscle network analysis. The results show (i) enhanced activity of the extensor muscles for weight-bearing in the initial sessions by using HAL and reduced knee extensor and increased hip extensor activations for achieving larger steps and faster gait in the later sessions; (ii) involvement of a greater number of synergies during walking with HAL than without HAL; and (iii) modulated muscle network property during walking with HAL remaining until the next HAL session. The patient's gait was improved after completing HAL sessions, acquiring close to normal joint profile with greater range of joint movement, faster walking speed, and larger step length. We discuss that the muscular activity modulation during walking with HAL suggests altered control of the muscles by the central nervous system during post-operative walking. Activity-dependent sensorimotor augmentation by HAL is discussed in the context of recovery of gait control by the central nervous system. The relationship between the altered control and the achieved gait recovery requires further investigation. |
| first_indexed | 2024-12-10T20:38:13Z |
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| id | doaj.art-9c236e5c8118485b8aa0fea3d70c21c1 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T20:38:13Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-9c236e5c8118485b8aa0fea3d70c21c12022-12-22T01:34:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-03-011110.3389/fneur.2020.00102504511Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case ReportHideki Kadone0Hideki Kadone1Shigeki Kubota2Tetsuya Abe3Hiroshi Noguchi4Kousei Miura5Kousei Miura6Masao Koda7Yukiyo Shimizu8Yasushi Hada9Yoshiyuki Sankai10Kenji Suzuki11Masashi Yamazaki12Center for Innovative Medicine and Engineering, University of Tsukuba Hospital, Tsukuba, JapanCenter for Cybernics Research, University of Tsukuba, Tsukuba, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanDepartment of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanDepartment of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, JapanDepartment of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, JapanCenter for Cybernics Research, University of Tsukuba, Tsukuba, JapanCenter for Cybernics Research, University of Tsukuba, Tsukuba, JapanDepartment of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanDisorders of the central nervous system sometimes cause severe sensory motor paralysis accompanied by gait impairment. Recently, there are several reports on the effectiveness of robot-assisted gait training for patients experiencing these issues. The purpose of this case report was to assess the neuromechanical effect of a wearable robot suit HAL (Hybrid Assistive Limb) during post-operative gait training in a patient with gait impairment due to compressive myelopathy caused by ossification of the posterior longitudinal ligament (OPLL). For this purpose, we compared lower limb muscular activities while the patient was walking with and without the robot through a course of treatment sessions by (i) gait phase-dependent muscle usage analysis, (ii) muscle synergy analysis, and (iii) muscle network analysis. The results show (i) enhanced activity of the extensor muscles for weight-bearing in the initial sessions by using HAL and reduced knee extensor and increased hip extensor activations for achieving larger steps and faster gait in the later sessions; (ii) involvement of a greater number of synergies during walking with HAL than without HAL; and (iii) modulated muscle network property during walking with HAL remaining until the next HAL session. The patient's gait was improved after completing HAL sessions, acquiring close to normal joint profile with greater range of joint movement, faster walking speed, and larger step length. We discuss that the muscular activity modulation during walking with HAL suggests altered control of the muscles by the central nervous system during post-operative walking. Activity-dependent sensorimotor augmentation by HAL is discussed in the context of recovery of gait control by the central nervous system. The relationship between the altered control and the achieved gait recovery requires further investigation.https://www.frontiersin.org/article/10.3389/fneur.2020.00102/fullmyelopathygait recoveryHybrid Assistive Limb (HAL)ossification of posterior longitudinal ligament (OPLL)muscle activity analysissynergy analysis |
| spellingShingle | Hideki Kadone Hideki Kadone Shigeki Kubota Tetsuya Abe Hiroshi Noguchi Kousei Miura Kousei Miura Masao Koda Yukiyo Shimizu Yasushi Hada Yoshiyuki Sankai Kenji Suzuki Masashi Yamazaki Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report Frontiers in Neurology myelopathy gait recovery Hybrid Assistive Limb (HAL) ossification of posterior longitudinal ligament (OPLL) muscle activity analysis synergy analysis |
| title | Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report |
| title_full | Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report |
| title_fullStr | Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report |
| title_full_unstemmed | Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report |
| title_short | Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report |
| title_sort | muscular activity modulation during post operative walking with hybrid assistive limb hal in a patient with thoracic myelopathy due to ossification of posterior longitudinal ligament a case report |
| topic | myelopathy gait recovery Hybrid Assistive Limb (HAL) ossification of posterior longitudinal ligament (OPLL) muscle activity analysis synergy analysis |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00102/full |
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