Gait Training for Becker's Muscular Dystrophy Using Robot Suit Hybrid Assistive Limb

Becker's muscular dystrophy (BMD) is an X-linked recessive inherited disorder characterized by a slow and degenerative muscle weakness of the legs and pelvis. The patients eventually use walking aids or are wheelchairbound in daily life because of the progression of disability. The robot suit hybrid assistive limb (HAL) is a new robot suit designed to assist voluntary control of lower limb motion by detecting extremely weak bioelectric signals on the skin surface. Here we report how HAL gait training can be adapted for a wheelchairbound patient with BMD. A 25-year-old patient with BMD participated in HAL gait training.Gait training consisted of three phases: phase 1, adaptation of HAL for the patient; phase 2 (1 year), treadmill training with the body-weight supported walker (BWSW); and phase 3 (2 years), gait training on the floor with the BWSW. The subject completed 2 h of HAL gait training once a week (from August 2011 to August 2014). Although there are no standard exercises for patients with BMD, his gait ability and fitness improved, following HAL gait training. This result indicates that HAL gait training can be both feasible and safe when used as a part of a regular rehabilitation program for patients with BMD. Harness use seems to be essential for safety and feasibility of HAL gait for patients with BMD. The combined use of the HAL gait training and BWSW may be an effective rehabilitation tool for patients with BMD.