Impact of hybrid assistive limb on gait ability and quality of life in patients with amyotrophic lateral sclerosis

Abstract

Objective Hybrid Assistive Limb (HAL) is a cyborg-type wearable robot that supports gait training based on the wearer’s intended motion. This study aimed to evaluate the effects of HAL treatment on gait ability and quality of life (QoL) in patients with amyotrophic lateral sclerosis (ALS). Methods Patients with an unsteady gait with the ability to walk ≥10 m with assistance from a caregiver and/or walker were included in this study. Patients underwent nine HAL treatment sessions (20–40 min per session), with no more than one session per day, over a period of at least 4 weeks. Gait ability was evaluated using the distance of the 2-min walk test (2MWT), and the speed (m/s), step length (m/step), and cadence (step/s) of the 10-m walk test. Both tests were performed without HAL assistance. QoL was evaluated using the 36-Item Short Form Health Survey. Results We evaluated 30 patients who completed one course of treatment. To evaluate the effectiveness of HAL, a paired t- test was used for the results of one course. With one course of treatment, the 2MWT improved from 92.27 m (40.46) at baseline to 104.16 m (41.73) (p < 0.001). Regarding QoL, the mental component summary score was 55.35 (8.27) before HAL treatment, indicating relatively preserved mental QoL. There were no significant changes in QoL before and after treatment. Conclusion Although no curative treatment exists for ALS, HAL treatment may provide short-term improvement in gait ability in patients with ALS. However, no significant changes in QoL were observed after one course of treatment.