TY - JOUR
T1 - Gait training using a hybrid assistive limb (HAL) attenuates head drop
T2 - A case report
AU - Miura, Kousei
AU - Koda, Masao
AU - Kadone, Hideki
AU - Kubota, Shigeki
AU - Shimizu, Yukiyo
AU - Kumagai, Hiroshi
AU - Nagashima, Katsuya
AU - Mataki, Kentaro
AU - Fujii, Kengo
AU - Noguchi, Hiroshi
AU - Funayama, Toru
AU - Abe, Tetsuya
AU - Sankai, Yoshiyuki
AU - Yamazaki, Masashi
N1 - Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/6
Y1 - 2018/6
N2 - Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, which can severely interfere with forward vision and impair activities of daily living. A standardized treatment strategy for DHS has not been established. To our knowledge, this is the first case report describing the efficacy of gait training using a hybrid assistive limb (HAL) for DHS. A 75-year-old man showed apparent head drop in a standing position, resulting in passively reducible chin-on-chest deformity. A radiograph image showed apparent cervical kyphosis. Center of gravity of the head (CGH)–C7 SVA was +115 mm, CL was −40° and T1S 39°. The patient underwent a treatment program using HAL, in which gait training was mainly performed, 60 min a day, 5 days a week for 2 weeks (10 sessions). After 2–3 sessions, dropped head started to attenuate. At the end of 10 sessions, the patient was able to walk with normal posture and radiograph images showed cervical kyphosis dramatically decreased because of HAL training. CGH–C7 SVA was 42 mm, CL was −1.7° and T1S was 30°. Three months’ outpatient follow-up revealed a slight deterioration of cervical alignment. However, the patient was able to maintain a better cervical alignment than before HAL training and keep walking with forward vision. There were no complications in any HAL treatment session. In conclusion, gait training using HAL is an option for treatment of DHS in addition to previously reported neck extensor muscle training.
AB - Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, which can severely interfere with forward vision and impair activities of daily living. A standardized treatment strategy for DHS has not been established. To our knowledge, this is the first case report describing the efficacy of gait training using a hybrid assistive limb (HAL) for DHS. A 75-year-old man showed apparent head drop in a standing position, resulting in passively reducible chin-on-chest deformity. A radiograph image showed apparent cervical kyphosis. Center of gravity of the head (CGH)–C7 SVA was +115 mm, CL was −40° and T1S 39°. The patient underwent a treatment program using HAL, in which gait training was mainly performed, 60 min a day, 5 days a week for 2 weeks (10 sessions). After 2–3 sessions, dropped head started to attenuate. At the end of 10 sessions, the patient was able to walk with normal posture and radiograph images showed cervical kyphosis dramatically decreased because of HAL training. CGH–C7 SVA was 42 mm, CL was −1.7° and T1S was 30°. Three months’ outpatient follow-up revealed a slight deterioration of cervical alignment. However, the patient was able to maintain a better cervical alignment than before HAL training and keep walking with forward vision. There were no complications in any HAL treatment session. In conclusion, gait training using HAL is an option for treatment of DHS in addition to previously reported neck extensor muscle training.
KW - Dropped head syndrome
KW - The hybrid assistive limb (HAL)
KW - Wearable robot
UR - http://www.scopus.com/inward/record.url?scp=85047010680&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2018.03.010
DO - 10.1016/j.jocn.2018.03.010
M3 - Article
C2 - 29615290
AN - SCOPUS:85047010680
SN - 0967-5868
VL - 52
SP - 141
EP - 144
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
ER -