Robot-Assisted Gait Training in a Patient with Adult Polyglucosan Body Disease: A Case Report.

Background/

Objectives

Adult Polyglucosan Body Disease (APBD) is a rare neurodegenerative glycogen storage disorder characterized by progressive gait disturbance, sensory impairment, and balance dysfunction. Although rehabilitation is recommended for functional maintenance, evidence regarding robot-assisted gait training (RAGT) in APBD remains extremely limited.

Methods

A 58-year-old man with progressive lower extremity sensory and motor symptoms was diagnosed with APBD in 2026. Neurological examination revealed severe proprioceptive impairment in both great toes, generalized sensory deficits, gait instability, and impaired balance. Functional assessment demonstrated mild balance impairment with generally preserved muscle strength except for mild weakness in the lower extremities. RAGT was initiated and performed for 19 sessions over approximately 6 weeks in combination with conventional rehabilitation therapy, including gait and balance training with visual feedback.

Results

Following the combined rehabilitation program, improvements were observed in balance function, postural stability and proprioceptive function.

Conclusions

This case suggests that RAGT combined with conventional rehabilitation may improve balance and gait-related function in patients with APBD. Repetitive task-specific gait training with enhanced sensory feedback may be particularly beneficial in APBD, where proprioceptive impairment and sensory ataxia are major contributors to gait dysfunction; however, this remains a hypothesis that requires validation in future studies. This report highlights the feasibility and potential applicability of RAGT in rare neurodegenerative disorders such as APBD.