April 2022


Amyotrophic lateral sclerosis (ALS) is a fatal progressive neurodegenerative disease that presents with various symptoms, such as muscle weakness, dysphagia, dysarthria, and respiratory failure, leading to death in 3–5 years. As ALS remains incurable, patient care including rehabilitation is important for maintaining the physical function and quality of life during the rapid progression of the disease.

The Hybrid Assistive Limb (HAL; CYBERDYNE Inc., Japan) is a cyborg-type wearable robot that supports gait training based on the wearer’s intended motion. HAL is based on a technology called ‘cybernics’, in which the machine and human are connected and share information in real time, allowing the machine to support the voluntary movement of the wearer. HAL detects bioelectrical signals on the skin surface and provides support to the wearer’s voluntary drive.

Professor Kano Osamu, MD, PhD, and his colleagues conducted a study to evaluate the effect of HAL-based training in ALS patients. Patients who were diagnosed with ALS at Toho University Omori Medical Center, Tokyo, between January and December 2019 and had an unsteady gait with the ability to walk for >10 m with assistance from caregivers and/or a walker were included. The gait training program consisted of 1 session per day (20–40 minutes per session), 2–3 days a week for at least 4 weeks. As a result, the distance of the 2-minute walk test (2MWT) improved, on average, from 73.87m to 89.94m after 1 course of training. Other outcome measures also showed some improvement or preservation.

“Our results show that cybernic therapy improves gait ability in ALS patients in a short period,” said Kano. “This also suggests that continuous cybernic therapy may be able to suppress the progression of ALS and maintain [quality of life].”

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