More Sense in Neurorehabilitation

HAL Lower Limb (HAL-ML05)

HAL Lower Limb Type is cleared as a medical device, obtaining CE Marking [CE 0197], in the EU for patients of Musculoskeletal Ambulation Disability Symptom Complex [= MADS], such as spinal cord injuries, traumatic brain injuries, cerebrovascular diseases, and other diseases of the brain and neuromuscular systems

Improve and regenerate physical functions

HAL Lower Limb (HAL-ML05), a neurological device helps the patients regain the natural movement of their paretic or paralyzed legs based on their intention. It is to improve locomotor activity in spinal cord injury, stroke and other several types of neuromuscular disease patients even in the chronic stage of them.

The clinician has an array of customizable settings that can be used to help the patient carry out the movement they intended, or to present a challenge for the patient to overcome. Overtime with repetitive physiotherapy using HAL, the signals gradually improve in quality and quantity, leading to improved lower limb function.

Cybernics Therapy using HAL-ML05 guides and temporarily enforces an impaired neural loop, and restores physical ability.

Indication of use

Spinal cord injury at levels T8 to L5 (ASIA A/B/C/D) and levels C2 to T7 (ASIA C/D)
Paralysis after cerebrovascular disease (CVD)
Progressive intractable neuromuscular diseases: Spinal Muscular Atrophy (SMA), Spinal Bulbar Muscular Atrophy (SBMA), Amyotrophic Lateral Sclerosis (ALS), Muscular Dystrophy (MD), Inclusion Body Myositis (iBM), Charcot-Marie-Tooth Disease (CMT), congenital Myopathy, distal Myopathy

HAL-Lower Limb (HAL-ML) obtained CE Marking (CE 0197) for the first time as a robotic medical device. HAL for Medical Use was certified its conformity to the requirements of Medical Device Directives in EU. Prescription and medical professional supervision are required on usage of HAL system.

Functional improvement and regeneration

Reduced need for assistive devices

Increased walking speed and walking distance

Development of musculature

Prolong a high-quality of life

HAL Monitor for Better Care Wirelessly display the neurological signal on a tablet screen in real time.

HAL Monitor provides numeral and visual information and feedbacks, in real time, on physical and neurological of wearers. Patients and therapists can choose 4 different views such as summary view, graph view, foot view, and model view. These views offer a powerful tool to understand where patients need to work on.
HAL Lower Limb has four sets of sensors with each set detecting signals from the flexor and extensor muscles around a specific joint. The four joints assisted by HAL include the hip and knee joints of each leg. Those neurological signals are displayed on a tablet device in real time, allowing therapists to analyze individual joint activity as well as the overall interactions between joints, and to modify HAL’s settings for the best results.

Sciences

Progressive rare neuromuscular diseases

HAL is a new treatment device for walking exercise, proven to be more effective than the conventional method in patients with incurable neuromuscular diseases.

"Cybernic treatment with wearable cyborg Hybrid Assistive Limb (HAL) improves ambulatory function in patients with slowly progressive rare neuromuscular diseases: a multicentre, randomised, controlled crossover trial for efficacy and safety (NCY-3001) "

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Spinal Cord Injury

Use of HAL Lower Limb for 55 chronic spinal cord injury patients for 12 weeks (5 times/week) resulted in significant improvement in walking speed, distance and level of dependence on walking aids without wearing the device.

"Against the odds: what to expect in rehabilitation of chronic spinal cord injury with a neurologically controlled Hybrid Assistive Limb exoskeleton. A subgroup analysis of 55 patients according to age and lesion level"

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Subacute Stroke Recovery

16 sub-acute stage stroke patients who reached plateau with traditional rehabilitation were split into experimental group with HAL intervention and control group with conventional physiotherapy for at least 20 sessions and the result showed the HAL group significantly improved walking speed.

"Subacute Stroke Recovery Gait Training With Hybrid Assistive Limb Enhances the Gait Functions in Subacute Stroke Patients: A Pilot Study"

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Cerebral Palsy Movement Research

This report concluded that: “HAL intervention and surgery with improvement of contractures of the knee and ankle can enhance improvement in walking ability for the patient with cerebral palsy. Improvement in walking ability leads to improved lower limb function, improved standing ability, and reduced need for assistance.” This has profound effects on what is possible for patients with cerebral palsy.

"Use of Hybrid Assistive Limb (HAL®) for a postoperative patient with cerebral palsy: a case report"

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Knee Arthroplasty Recovery

This report concluded that: “HAL training after TKA can improve the walking ability, ROM, and muscle strength compared to conventional physical therapy for up to 8 weeks after TKA.” Researchers have new recovery methods available to them with wearables in several different facets of post-surgery therapy.

"Training with Hybrid Assistive Limb for walking function after total knee arthroplasty"

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Gait Training with Bionics

The study concluded that: “This review identified consistent evidence that the use of the HAL system is feasible when used for gait training in hospital and rehabilitation settings. Data suggest that such training may have beneficial effects on gait function and independence in walking after stroke and after spinal cord injury.” Re-learning to walk is a difficult endeavor for both patient and physical therapist. Wearable technology may be one key to easing the difficulty and researchers will be at the forefront of this.

"Clinical application of the Hybrid Assistive Limb (HAL) for gait training—a systematic review"

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