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Neural Prostheses for Locomotion

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Front. Neurosci. | doi: 10.3389/fnins.2018.00099

Reshaping of Gait Coordination by Robotic Therapy in Myelopathy Patients After Surgery

 Sandra Puentes1, 2*,  Hideki Kadone2, Shigeki Kubota3, Tetsuya Abe3,  Yukiyo Shimizu4, Aiki Marushima5, Masashi Yamazaki3, Yoshiyuki Sankai6 and  Kenji Suzuki6
  • 1Department of Intelligent Interaction Technologies, University of Tsukuba, Japan
  • 2Center for Innovating Medicine and Engineering (CIME), University of Tsukuba Hospital, Japan
  • 3Department of Orthopaedic Surgery, University of Tsukuba Hospital, Japan
  • 4Department of Rehabilitation Medicine, University of Tsukuba Hospital, Japan
  • 5Department of Neurosurgery, University of Tsukuba Hospital, Japan
  • 6Center for Cybernics Research, University of Tsukuba, Japan

The Ossification of the Posterior Longitudinal Ligament (OPLL) is an idiopathic degenerative spinal disease which may cause motor deficit. For patients presenting myelopathy or severe stenosis, surgical decompression is the treatment of choice; however, despite adequate decompression residual motor impairment is found in some cases. After surgery, there is no therapeutic approach available for this population.
The Hybrid Assistive Limb® (HAL) robot suit is a unique powered exoskeleton designed to predict, support and enhance the lower extremities performance of patients using their own bioelectric signals. This approach has been used for spinal cord injury and stroke patients where the walking performance improved. However, there is no available data about gait kinematics evaluation after HAL therapy. Here we analyze the effect of HAL therapy in OPLL patients in acute and chronic stages after decompression surgery. We found that HAL therapy improved the walking performance for both groups. Interestingly, kinematics evaluation by the analysis of the elevation angles of the thigh, shank and foot by using a principal component analysis showed that planar covariation, plane orientation and movement range evaluation improved for acute patients suggesting an improvement in gait coordination. Being the first study performing kinematics analysis after HAL therapy, our results suggest that HAL improved the gait coordination of acute patients by supporting the relearning process and therefore reshaping their gait pattern.

Keywords: Myelopathy, Motor deficit, Gait coordination, kinematics, Robotic therapy, gait reshaping

Received: 31 Aug 2017; Accepted: 08 Feb 2018.

Edited by:

Yury Ivanenko, Fondazione Santa Lucia (IRCCS), Italy

Reviewed by:

Michael J. MacLellan, Louisiana State University, United States
Thomas Hoellinger, Laboratory of Neurophysiology and Movement Biomechanics - Université Libre de Bruxelles, Belgium  

Copyright: © 2018 Puentes, Kadone, Kubota, Abe, Shimizu, Marushima, Yamazaki, Sankai and Suzuki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. Sandra Puentes, University of Tsukuba, Department of Intelligent Interaction Technologies, Tennodai 1-1-1, Tsukuba, 305-8573, Ibaraki, Japan, sandra@ccr.tsukuba.ac.jp