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Lokomat

Lokomat combines a robotic gait orthosis and an advanced body weight support system with a treadmill. The robotic arms move paralyzed hips and knees at an adjustable speed. The robotic device according to a preprogrammed gait pattern guides patient’s legs; the process of gait training is automated.LK1

The patient is suspended in a harness over a treadmill, and an exoskeleton robotic frame, attached by straps to the outside of the legs, moves the legs in a natural walking pattern. A computer controls the pace of walking and measures the body’s response to the movement. The pediatric model also has an interactive gaming interface which, through cartoon characters and challenges, motivates children and provides them instruction.

Lokomat can control timing and shape of desired gait pattern very accurately.

Augmented Performance FeedBack Feature
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  • Designed to increase patients motivation.

  • Designed to evoke active participation in the lokomat training

  • Patients have to perform interactive tasks in virtual environments, similarly to computer games

  • First product that provides a motivating software to support robot-assisted gait therapy

  • Force sensors drives quantify the patients gait activity

  • Simulated turning in the virtual environment is controlled by attempts to change stride length

  • Simulated walking speed can be controlled by patients’ gait activity, i.e biofeedback

  • Sensitivity can be adjusted to the patient individual abilities.

Lokomat®Pro with Pediatric Orthoses


  • Longer and more intensive training sessions for faster progress

  • Controllable, more physiological gait pattern

  • Physical strain relieved from therapists

  • Functional biofeedback – Motivation ↑↑

  • Sensation/Emotion of walking - Motivation↑↑

  • Advanced patient assessment

  • Training progress measurable

Spinal cord Injury Patient During Lokomat Training

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 Spinal cord Injury patient at 2 weeks of Lokomat Training

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Spinal cord Injury patient at 12 weeks of Lokomat Training

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Questions and Answers About Lokomat Walking Therapy

What is robot-assisted walking therapy?

Robot-assisted walking therapy is a form of physical therapy that uses a robotic device to help a person whose ability to walk has been impaired as a result of stroke, spinal cord or brain injury, neurological or orthopedic condition, learn to walk again.

How does the robotic device work?

The person is suspended in a harness over a treadmill and the frame of the robot, attached by straps to the outside of the legs, moves the legs in a natural walking pattern. A computer controls the pace of walking and measures the body’s response to the movement.

How does robot-assisted walking therapy help a person re-learn to walk?

The exact mechanism for walking is still not clear, but it is believed that the repetitive walking pattern helps the brain and spinal cord work together to re-route signals that were interrupted by injury or illness. Currently, this type of therapy is done with the aid of two or more physical therapists that manually move the patient’s legs in a walking pattern. However, the labor-intensive, strenuous nature and variability of the manual method can limit the frequency and duration of the therapy. With robot-assisted walking therapy, the robotic device does most of the heavy work, the pattern and pace are consistent throughout the session, and the exercise can be sustained over longer periods of time.

Are there other benefits to robot-assisted walking therapy?
In addition to training the brain and spinal cord, robot-assisted walking therapy may help strengthen muscles and improve circulation. Also, the weight bearing nature of the exercise may help strengthen bones at risk for osteoporosis (the loss of calcium from bones that makes them fragile and easy to break) due to lack of use.

Who would benefit from robot-assisted walking therapy?

The primary goal of robot-assisted walking therapy is to regain or improve the ability to walk, so it may be most appropriate for people whose ability to walk has been impaired by brain injury, including stroke, incomplete spinal cord injury, or some other neurological or orthopedic condition, such as multiple sclerosis or hip replacement. Among other criteria for participation in robot-assisted walking therapy, a person must have some sensation or movement in at least one major muscle group in the leg. An evaluation by an RIC physician would be required for a course of treatment to be prescribed.

Who should not participate in robot-assisted walking therapy?

As with any form of physical exercise, a person should have a complete physical evaluation to determine if robot-assisted walking therapy is right for them. However, people with certain conditions would generally not be considered good candidates for robot-assisted walking therapy. These conditions include cardiopulmonary disease, high blood pressure or blood pressure that changes dramatically when standing up or walking, seizures, diabetes, unhealed incisions or pressure sores, severe osteoporosis, swelling or contracture of the legs and other conditions that would make independent walking unsafe. An evaluation by a RIC physician would be required for a course of treatment to be prescribed.

How often does a person need to participate in robot-assisted walking therapy?

The effectiveness of robot-assisted walking therapy varies from person to person, so patients should be able to commit to a minimum of 60 minutes of therapy per day, three days per week, for four to eight weeks. Periodic evaluations will be conducted to determine if more sessions would be helpful in achieving the maximum benefit.

Are the results of robot-assisted walking therapy guaranteed?

No, the results of robot-assisted walking therapy or any other type of therapy are not guaranteed. However, during the course of therapy, periodic evaluations will be conducted to measure improvement and determine if more sessions may help to achieve the maximum benefit.


Pediatric Lokomat® Walking Therapy
We been examining and tracking the effects of this therapy for adults for years and continues to focus on new research and clinical trials that provide more data on this treatment. In an early study conducted in Europe examining the use of Lokomat therapy for children with CP, results indicated an improvement in walking speed and in gross-motor function. The therapy was also rated “excellent” in providing motivation for carrying out therapy among a majority of children, while there was also a very high level of approval from the therapy team and parents.

Questions

What are the criteria for using the Pediatric Lokomat?

All patients must undergo an evaluation by an RIC physician and physical therapist before being recommended for the Lokomat.

The following information can be used as a guideline for patients and family members interested in RIC’s services:

•             Age: Minimum age typically 4 years; Lokomat is available for older children and adults
•             Diagnoses:  Central gait impairment secondary to cerebral palsy or malformations, spinal cord injury, stroke, traumatic brain injury or Guillain-Barre’ Syndrome
•             Over Ground Walking:  Achieving over ground walking ability; presents some stepping pattern in supported gait
•             Cognition:  Ability to follow single step commands and to signal fear, pain or discomfort
•             Femur Length:  Femur length must be 21 centimeters

Contraindications

Are there conditions that would prevent a patient from using the Lokomat

The following issues may prevent a patient from being eligible for services in the Lokomat:

•             Spasticity:  Severe spasticity requires a trial test Lokomat session
•             Cardiovascular issues:  Cardiovascular instability or thromboembolic disease are contraindications
•             Bone Issues:  Fractures, osseous instabilities, osteoporosis, scoliosis greater than 20 degrees are contraindications
•             Skin: Unhealed skin lesions in the trunk or lower extremities are contraindications
•             Musculoskeletal issues:  Weight-bearing restrictions are a contraindication
•             Neurological comorbidities: Acute or progressive neurological disorders are a contraindication
•             Ventilators: Ventilator dependency is a contraindication
•             Intravenous Drip: Intravenous drip is a contraindication
•             Behavior: Aggressive or self harming behavior is a contraindication

How often does a person need to participate in robot-assisted walking therapy?

The effectiveness of robot-assisted walking therapy varies from person to person, so patients should be able to commit to a minimum of 60 minutes of therapy per day, three days per week, for four weeks. Periodic evaluations will be conducted to determine if more sessions would be helpful in achieving the maximum benefit.

Are the results of robot-assisted walking therapy guaranteed?
No, the results of robot-assisted walking therapy or any other type of therapy are not guaranteed. However, during the course of therapy, periodic evaluations will be conducted to measure improvement and determine if more sessions may help to achieve the maximum benefit.