Gait training using a hybrid assistive limb (HAL) attenuates head drop: A case report

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Dropped head syndrome (DHS) presents as a chin-on-chest deformity, significantly impacting vision and daily activities.
• Currently, no standardized treatment exists for DHS, necessitating exploration of novel therapeutic strategies.

Observation:

• A 75-year-old male patient exhibited severe head drop and cervical kyphosis, with significant postural deviation.
• Radiographic measurements indicated substantial cervical kyphosis (CGH-C7 SVA +115 mm, CL -40°, T1S 39°).

Findings:

• The patient underwent gait training using a hybrid assistive limb (HAL) for 2 weeks (10 sessions).
• Significant improvements were observed after 2-3 sessions, with marked reduction in head drop and cervical kyphosis (CGH-C7 SVA 42 mm, CL -1.7°, T1S 30°).
• The patient regained normal posture and improved forward vision, maintaining functional gains at 3-month follow-up.

Implications:

• Gait training with HAL presents a viable therapeutic option for managing dropped head syndrome.
• This approach complements existing treatments like neck extensor muscle training.
• Further research into HAL-based interventions for DHS is warranted to establish efficacy and optimize treatment protocols.