A wearable, robotic device designed to support movement preserved, and in some cases improved, gait ability in patients with amyotrophic lateral sclerosis (ALS), according to a small study published in the Journal of Clinical Neuroscience.

“The Hybrid Assistive Limb (HAL, Cyberdyne Inc., Japan) is a unique wearable exoskeleton robot device that provides physical gait assistance according to bioelectrical signals of neuromuscular activity on the surface of the skin caused by voluntary intention,” explained researchers from Toho University in Tokyo.

The single-arm, single-center observational study tested the effect of HAL-based training in 11 patients diagnosed with ALS in 2019. Participants underwent 20- to 40-minute sessions of HAL training 2 to 3 days a week, over at least 4 weeks but no more than 5 weeks in accordance with the patient’s condition. No participants dropped out or experienced adverse events during the course of the study.

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According to the findings, gait function improved after HAL training. Mean distance on the 2-minute walk test increased from 73.87 meters at baseline to 89.9 meters after the full course of HAL training. On the 10-meter walk test, cadence significantly improved. Gait speed and step length on the 10-meter walk did not improve significantly, but researchers said the trend improved or was maintained in most patients after HAL training.

Activities of daily living measures did not change significantly with HAL training. A tendency toward improvement on both the Barthel Index (BI) and Functional Independence Measures (FIM) was observed, however: total BI scores slightly increased in 6 and remained stable in 4 patients, and total FIM scores increased in five and remained stable in four patients.

“In conclusion, we report the possibility that the use of the HAL system for ALS patients is effective when used for gait training in rehabilitation settings. It can bring about temporary amelioration and preservation of gait ability,” researchers wrote. “Although HAL is not a curative treatment for ALS, our data suggest that such training may improve gait function in patients with ALS.”

References

Morioka H, Hirayama T, Sugisawa T, et al. Robot-assisted training using hybrid assistive limb ameliorates gait ability in patients with amyotrophic lateral sclerosis. J Clin Neurosci. Published online March 10, 2022. doi: 10.1016/j.jocn.2022.02.032

Hybrid Assistive Limb (HAL) improves gait ability in patients with ALS. News release. Toho University. March 17, 2022. Accessed April 26, 2022.