The effects of hybrid assistive limb (HAL) application on locomotor function and balance parameters in individuals with multiple sclerosis

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dc.contributor.authorAcar, Gorkem
dc.contributor.authorBaser, Miray
dc.contributor.authorOzkeskin, Mehmet
dc.contributor.authorOzden, Fatih
dc.contributor.authorSeyhan, Sinan
dc.contributor.authorKavak, Muhammed Fatih
dc.contributor.authorAkturk, Adem
dc.date.accessioned2026-09-26T19:20:02Z
dc.date.available2026-09-26T19:20:02Z
dc.date.issued2026
dc.departmentEge Üniversitesi
dc.description.abstractBackground: Multiple Sclerosis (MS) often causes walking and balance impairments, limiting daily independence. Hybrid Assistive Limb (HAL), a wearable robotic exoskeleton, may assist in improving these functions. Objective: To investigate the effect of HAL-assisted rehabilitation on locomotor function, balance performance, and functional mobility in individuals with MS. Methods: Thirteen individuals with MS were included in this single-group pre-post quasi-experimental study. This study did not include a control group. Participants underwent gait rehabilitation using a lower-limb HAL device for 1 h per day, 5 days a week, for 2 months. Locomotor function and balance were assessed using the 10-Meter Walk Test (10MWT), the Timed Up and Go (TUG) test, and the 6-Minute Walk Test (6MWT). Spatiotemporal parameters of the gait were analyzed using the Tecnobody Walker View system. Static balance was evaluated using the Tecnobody D-Wall system. Results: Thirteen adults with MS (mean age 46.2 f 7.5 years) completed the 2-month HAL-assisted rehabilitation program. Significant improvements were observed in locomotor function and functional mobility: TUG time decreased from 18.85 f 12.20 s to 14.04 f 11.04 s (p < 0.001), 10MWT time decreased from 25.64 f 21.54 s to 21.05 f 21.08 s (p = 0.001), and 6MWT distance increased from 174.62 f 58.68 m to 261.54 f 95.03 m (p = 0.001). EDSS scores showed a decrease from 4.62 f 1.33 to 2.62 f 1.85 (p = 0.002). Static balance improved under both eyes-open and eyes-closed conditions, and step length increased significantly bilaterally. Cadence and hip/lumbar ROM showed no significant changes, while left knee ROM improved significantly (p = 0.008). These findings should be interpreted as preliminary, given the absence of a control group. Conclusions: HAL-assisted rehabilitation may be a feasible and promising approach for improving walking performance, balance, and functional mobility in individuals with MS. However, these preliminary findings from a single-group pre-post design without a control group should be interpreted with caution, and further randomized controlled trials are needed to confirm these results.
dc.identifier.doi10.1016/j.msard.2026.107225
dc.identifier.issn2211-0348
dc.identifier.issn2211-0356
dc.identifier.pmid42119269
dc.identifier.scopus2-s2.0-105038758825
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1016/j.msard.2026.107225
dc.identifier.urihttps://hdl.handle.net/11454/135600
dc.identifier.volume111
dc.identifier.wosWOS:001769448700001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Sci Ltd
dc.relation.ispartofMultiple Sclerosis and Related Disorders
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20260922
dc.subjectMultiple Sclerosis
dc.subjectExoskeleton Device
dc.subjectGait
dc.subjectBalance
dc.subjectHybrid Assistive Limb
dc.titleThe effects of hybrid assistive limb (HAL) application on locomotor function and balance parameters in individuals with multiple sclerosis
dc.typeArticle

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