Cargando…

Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors

Sensory ataxia due to posterior cord syndrome is a relevant, disabling condition in nontraumatic spinal cord dysfunction. Ataxic gait is a common symptom of sensory ataxia that restricts activities of daily living. A 70-year-old woman with severe sensory disturbance was diagnosed with intradural ext...

Descripción completa

Detalles Bibliográficos
Autores principales: Soma, Yuichiro, Kubota, Shigeki, Kadone, Hideki, Shimizu, Yukiyo, Hada, Yasushi, Koda, Masao, Sankai, Yoshiyuki, Yamazaki, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782825/
https://www.ncbi.nlm.nih.gov/pubmed/36557027
http://dx.doi.org/10.3390/medicina58121825
_version_ 1784857430614605824
author Soma, Yuichiro
Kubota, Shigeki
Kadone, Hideki
Shimizu, Yukiyo
Hada, Yasushi
Koda, Masao
Sankai, Yoshiyuki
Yamazaki, Masashi
author_facet Soma, Yuichiro
Kubota, Shigeki
Kadone, Hideki
Shimizu, Yukiyo
Hada, Yasushi
Koda, Masao
Sankai, Yoshiyuki
Yamazaki, Masashi
author_sort Soma, Yuichiro
collection PubMed
description Sensory ataxia due to posterior cord syndrome is a relevant, disabling condition in nontraumatic spinal cord dysfunction. Ataxic gait is a common symptom of sensory ataxia that restricts activities of daily living. A 70-year-old woman with severe sensory disturbance was diagnosed with intradural extramedullary spinal cord tumors found in the thoracic spine region (T8). Surgical management of the tumors was performed. The patient received gait training 20 days after surgery (postoperative acute phase) using a hybrid assistive limb (HAL). HAL is a wearable exoskeleton cyborg that provides real-time assistance to an individual for walking and limb movements through actuators mounted on the bilateral hip and knee joints. Walking ability was assessed using the 10 m walking test, which included evaluating walking speed, step length, and cadence in every session. To evaluate the immediate effects of HAL training, walking speed and step length were measured before and after the training in each session. During the 10 m walking test, gait kinematics and lower muscle activity were recorded using a motion capture system and wireless surface electromyography before the first session and after completion of all HAL sessions. After the HAL training sessions, improvement in the patient’s gait performance was observed in the gait joint angles and muscle activity of the lower limb. After 10 training sessions, we observed the following changes from baseline: walking speed (from 0.16 m/s to 0.3 m/s), step length (from 0.19 m to 0.37 m), and cadence (from 50.9 steps/min to 49.1 steps/min). The average standard deviations of the knee (from right, 7.31; left, 6.75; to right, 2.93; p < 0.01, left, 2.63; p < 0.01) and ankle joints (from right, 6.98; left, 5.40; to right, 2.39; p < 0.01, left, 2.18; p < 0.01) were significantly decreased. Additionally, walking speed and step length improved immediately after completing all the HAL training sessions. This suggests that HAL gait training might be a suitable physical rehabilitation program for patients with sensory ataxia causing dysfunctional movement of the lower limb.
format Online
Article
Text
id pubmed-9782825
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-97828252022-12-24 Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors Soma, Yuichiro Kubota, Shigeki Kadone, Hideki Shimizu, Yukiyo Hada, Yasushi Koda, Masao Sankai, Yoshiyuki Yamazaki, Masashi Medicina (Kaunas) Case Report Sensory ataxia due to posterior cord syndrome is a relevant, disabling condition in nontraumatic spinal cord dysfunction. Ataxic gait is a common symptom of sensory ataxia that restricts activities of daily living. A 70-year-old woman with severe sensory disturbance was diagnosed with intradural extramedullary spinal cord tumors found in the thoracic spine region (T8). Surgical management of the tumors was performed. The patient received gait training 20 days after surgery (postoperative acute phase) using a hybrid assistive limb (HAL). HAL is a wearable exoskeleton cyborg that provides real-time assistance to an individual for walking and limb movements through actuators mounted on the bilateral hip and knee joints. Walking ability was assessed using the 10 m walking test, which included evaluating walking speed, step length, and cadence in every session. To evaluate the immediate effects of HAL training, walking speed and step length were measured before and after the training in each session. During the 10 m walking test, gait kinematics and lower muscle activity were recorded using a motion capture system and wireless surface electromyography before the first session and after completion of all HAL sessions. After the HAL training sessions, improvement in the patient’s gait performance was observed in the gait joint angles and muscle activity of the lower limb. After 10 training sessions, we observed the following changes from baseline: walking speed (from 0.16 m/s to 0.3 m/s), step length (from 0.19 m to 0.37 m), and cadence (from 50.9 steps/min to 49.1 steps/min). The average standard deviations of the knee (from right, 7.31; left, 6.75; to right, 2.93; p < 0.01, left, 2.63; p < 0.01) and ankle joints (from right, 6.98; left, 5.40; to right, 2.39; p < 0.01, left, 2.18; p < 0.01) were significantly decreased. Additionally, walking speed and step length improved immediately after completing all the HAL training sessions. This suggests that HAL gait training might be a suitable physical rehabilitation program for patients with sensory ataxia causing dysfunctional movement of the lower limb. MDPI 2022-12-12 /pmc/articles/PMC9782825/ /pubmed/36557027 http://dx.doi.org/10.3390/medicina58121825 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Soma, Yuichiro
Kubota, Shigeki
Kadone, Hideki
Shimizu, Yukiyo
Hada, Yasushi
Koda, Masao
Sankai, Yoshiyuki
Yamazaki, Masashi
Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors
title Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors
title_full Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors
title_fullStr Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors
title_full_unstemmed Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors
title_short Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors
title_sort postoperative acute-phase gait training using hybrid assistive limb improves gait ataxia in a patient with intradural spinal cord compression due to spinal tumors
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782825/
https://www.ncbi.nlm.nih.gov/pubmed/36557027
http://dx.doi.org/10.3390/medicina58121825
work_keys_str_mv AT somayuichiro postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors
AT kubotashigeki postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors
AT kadonehideki postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors
AT shimizuyukiyo postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors
AT hadayasushi postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors
AT kodamasao postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors
AT sankaiyoshiyuki postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors
AT yamazakimasashi postoperativeacutephasegaittrainingusinghybridassistivelimbimprovesgaitataxiainapatientwithintraduralspinalcordcompressionduetospinaltumors