ArticleJournal of neuroengineering and rehabilitation2015
HAL® exoskeleton training improves walking parameters and normalizes cortical excitability in primary somatosensory cortex in spinal cord injury patients.
Article in Journal of neuroengineering and rehabilitation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Effects of an exoskeleton robot on motor function in patients with spinal cord injuries: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Occurrence and Type of Adverse Events During the Use of Stationary Gait Robots-A Systematic Literature Review.Frontiers in robotics and AI · 2020Pooled it
- Robotic assisted gait as a tool for rehabilitation of individuals with spinal cord injury: a systematic review.Journal of neuroengineering and rehabilitation · 2017Pooled it
- Trial
- Exoskeletal-Assisted Walking During Acute Inpatient Rehabilitation Enhances Recovery for Persons with Spinal Cord Injury-A Pilot Randomized Controlled Trial.Journal of neurotrauma · 2024Trial
- Feasibility, safety, and functional outcomes using the neurological controlled Hybrid Assistive Limb exoskeleton (HAL®) following acute incomplete and complete spinal cord injury - Results of 50 patients.The journal of spinal cord medicine · 2023Trial
- Use of Robot-Assisted Gait Training in Pediatric Patients with Cerebral Palsy in an Inpatient Setting-A Randomized Controlled Trial.Sensors (Basel, Switzerland) · 2022Trial
- Rehabilitation during early postoperative period following total knee arthroplasty using single-joint hybrid assistive limb as new therapy device: a randomized, controlled clinical pilot study.Archives of orthopaedic and trauma surgery · 2022Trial
- Trial
- Hybrid assistive limb (HAL) treatment for patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in the postoperative acute/subacute phase: A clinical trial.The journal of spinal cord medicine · 2019Trial
- Hybrid Assistive Limb in orthopaedic rehabilitation: cybernic treatment developed in Japan for neuromotor functional restoration.International orthopaedics · 2026Review
- Wearable powered overground exoskeleton reduces dose-dependently the spasticity in individuals with spinal cord injury.Spinal cord · 2026Article
- Robotic Rehabilitation in Spinal Cord Injury: Neurophysiological Basis and Severity-Based Clinical Framework.Brain sciences · 2026Review
- Robotic-Assisted Rehabilitation and Spinal Neuromodulation After Spinal Cord Injury: From Mechanisms to Trial-Informed Practice.Journal of clinical medicine · 2026Review
- Priming with transcutaneous spinal direct current stimulation followed by robotic exoskeleton gait training in individuals with spinal cord injury: A case series.The journal of spinal cord medicine · 2025Article
- Hybrid Assistive Limb Treatment for the Shoulder and Elbow Joints Enabled Recovery from Chronic-Phase Severe C5 Palsy Following Cervical Spine Surgery.Journal of clinical medicine · 2025Article
- State-of-the-Art in Robotic Rehabilitation for Spinal Cord Injury Patients: A Literature Review.Korean journal of neurotrauma · 2025Review
- Novel Gait Training with a Hybrid Assistive Limb Improved Delayed Progressive Spastic Paraplegia After a Lightning Strike.Journal of clinical medicine · 2025Article
- Article
- Physiotherapy-assisted overground exoskeleton use: mixed methods feasibility study protocol quantifying the user experience, as well as functional, neural, and muscular outcomes in children with mobility impairments.Frontiers in neuroscience · 2024Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReorganization in the sensorimotor cortex accompanied by increased excitability and enlarged body representations is a consequence of spinal cord injury (SCI). Robotic-assisted bodyweight supported treadmill training (BWSTT) was hypothesized to induce reorganization and improve walking function.
objectiveTo assess whether BWSTT with hybrid assistive limb® (HAL®) exoskeleton affects cortical excitability in the primary somatosensory cortex (S1) in SCI patients, as measured by paired-pulse somatosensory evoked potentials (ppSEP) stimulated above the level of injury.
methodsEleven SCI patients took part in HAL® assisted BWSTT for 3 months. PpSEP were conducted before and after this training period, where the amplitude ratios (SEP amplitude following double pulses - SEP amplitude following single pulses) were assessed and compared to eleven healthy control subjects. To assess improvement in walking function, we used the 10-m walk test, timed-up-and-go test, the 6-min walk test, and the lower extremity motor score.
resultsPpSEPs were significantly increased in SCI patients as compared to controls at baseline. Following training, ppSEPs were increased from baseline and no longer significantly differed from controls. Walking parameters also showed significant improvements, yet there was no significant correlation between ppSEP measures and walking parameters.
conclusionsThe findings suggest that robotic-assisted BWSTT with HAL® in SCI patients is capable of inducing cortical plasticity following highly repetitive, active locomotive use of paretic legs. While there was no significant correlation of excitability with walking parameters, brain areas other than S1 might reflect improvement of walking functions. EEG and neuroimaging studies may provide further information about supraspinal plastic processes and foci in SCI rehabilitation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.