Newly developed hybrid assistive limb for pediatric patients with cerebral palsy: a case report

[Purpose] The effect of fitness training on improving walking ability in cerebral palsy is controversial. However, gait training with a wearable robot (hybrid assistive limb) has been reported to improve gait ability in patients with cerebral palsy. For pediatric patients, a smaller, lighter-weight hybrid assistive limb has been newly developed. We describe the immediate effect of this newly developed smaller hybrid assistive limb on the gait ability of a pediatric patient with cerebral palsy and examine its safety and feasibility. [Participant and Methods] An 11-year-old male with spastic cerebral palsy (height, 130 cm; weight, 29.0 kg) who could ambulate using an elbow crutch participated in this study. A single session of hybrid assistive limb training comprising pre-exercise of the hip and knee joints and walking for 20 minutes was conducted. [Results] The intervention immediately improved his gait speed, stride length, and cadence according to the 10-m walking test. Co-contraction of agonist/antagonist muscles during walking improved, and the flexion angle of the right hip during the swing phase increased, which resulted in symmetry of movement of both legs. [Conclusion] Gait training using the new, smaller hybrid assistive limb for a pediatric patient was safe and feasible, and the newly developed hybrid assistive limb has the potential to immediately improve walking ability even among young children with cerebral palsy.