# Hybrid Assistive Limb Single Joint Type (HAL-SJ) Training for Knee Osteoarthritis: A Case Series

**Authors:** Mao Tanaka, Yuichiro Soma, Yukiyo Shimizu, Naoya Kikuchi, Hideki Kadone, Masashi Yamazaki, Hajime Mishima, Yasushi Hada

PMC · DOI: 10.7759/cureus.102019 · 2026-01-21

## TL;DR

This case series explores the use of a robotic device called HAL-SJ to help patients with moderate knee osteoarthritis improve mobility and reduce pain.

## Contribution

The study demonstrates the feasibility and safety of HAL-SJ training for knee osteoarthritis patients.

## Key findings

- Three patients with moderate knee OA completed 10 HAL-SJ training sessions without serious adverse events.
- Knee pain decreased in two patients and remained stable in one, suggesting potential clinical benefits.
- HAL-SJ training was well tolerated and did not cause symptom deterioration.

## Abstract

Knee osteoarthritis (OA) is a common degenerative joint condition in older adults, and pain often limits engagement in conventional exercise therapy. We report three cases of patients with Kellgren-Lawrence (KL) grade 3 KO who underwent rehabilitation using the Hybrid Assistive Limb Single Joint Type (HAL-SJ), a wearable robotic device that supports voluntary knee movement based on bioelectrical signals from muscle activity. All patients completed 10 training sessions over five weeks with no serious adverse events. The intervention was well tolerated, and no clinically significant deterioration in symptoms was observed during the training period. Knee pain decreased in two cases and remained unchanged in one case. These cases suggest that HAL-assisted knee training is feasible and safe for patients with moderate knee OA and may offer potential clinical benefits.

## Full-text entities

- **Diseases:** Pain (MESH:D010146), extension (MESH:D000079822), degenerative (MESH:D019636), inflammatory (MESH:D007249), cardiopulmonary or neurological disorders (MESH:D006323), fatigue (MESH:D005221), stroke (MESH:D020521), Knee pain (MESH:D046788), OA (MESH:D010003), spinal cord injury (MESH:D013119), Knee Injury and Osteoarthritis (MESH:D020370), HAL (MESH:D015456), muscle soreness (MESH:D063806), musculoskeletal disorders (MESH:D009140), chronic pain (MESH:D059350), movement impairments (MESH:D009069), neuromuscular diseases (MESH:D009468)
- **Chemicals:** oxygen (MESH:D010100), HAL (-)
- **Species:** Hypotrichida sp. AL (species) [taxon 196105], Homo sapiens (human, species) [taxon 9606]

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12923294/full.md

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Source: https://tomesphere.com/paper/PMC12923294