The Utilization of the Lokomat Robotic Gait Training

Table of Contents Objectives What is the Lokomat? How is it used? Indications Contraindications What are the Advantages? Things to Remember References

Objectives By the end of this presentation you will be able to: Describe how the Lokomat fundamentally functions Decide which patients would benefit from using the Lokomat Understand the advantages seen in robotic assisted walking

What is a Lokomat? The Lokomat is a robotic assistive device used on patients in need of neurological rehabilitation in order to restore movement and functionality in affected parts.

What is it Used for? Robot-assisted walking therapy A form of therapy which utilizes robotic assistance in order to enhance a patients gait pattern The device allows this patient to walk in a consistent gait pattern in hopes that they will one day be able to continue this pattern without mechanical assistance. The photo above shows the basic gait pattern patients in recovery strive to emulate.

How is the Lokomat Used? First, the patient is placed in a harness on top of a treadmill. The robotic Lokomat attaches to the lower extremities by straps and moves the legs in a consistent gait pattern A computer controls the pace of walking and measures the body’s response to the movement. A physical therapist stands by in order to instruct the patient and to analyze their gait pattern.

Indications A patient may consider this modality if they are currently recovering from the following: Stroke Multiple sclerosis (MS) Cerebral palsy (CP) Parkinson’s disease Paraplegia Traumatic brain injury (TBI) Endoprosthesis (eg. Total hip endoprosthesis) Hemiplegic patients Degenerative joint diseases of the lower limbs (eg. osteoarthritis of the knee) Spinal muscular atrophy Muscle weakness due to lack of mobility

Contraindications Do not consider using the Lokomat on a patient in they are experiencing and of the following: Severely fixed contractures Non-consolidated fractures, unstable spinal column Severe osteoporosis Open skin lesions in the area of the lower limbs and torso Circulatory problems Cardiac contraindications Extremely disproportionate growth of the legs and/or spinal column (eg. Bone or cartilage dysplasia) Severe vascular disorders of the lower limbs Osteomyelitis or other inflammatory/infectious disorders Surgically fused hip, knee, ankle joints

What are the advantages? Normally, locomotion therapy is performed using only a treadmill. The patient supports as much weight as they can while they walk as the physical therapist carries the remaining weight.

What are the Advantages? By using a Lokomotor device, rather than a conventional physical therapist: The physical therapist would not need to undergo the strain of holding someone up as they walk and could instead focus on simply observing the progress in the patient’s gait pattern. The robotic device would be able to move the patient’s legs for longer periods of time and at a more consistent pace compared to the manual movement provided by the physical therapist. The Lokomat computer software would give constant feedback on the patients improvement. Robot-assisted walking therapy may help strengthen muscles and improve circulation.

Things to Remember Hocoma has worked as a leading Lokomotor manufacturing company in order to improve the overall treatment of patients recovering from neurological impairments. The results seen by using a Lokomat, however, vary from patient to patient; there is no guarantee of a full recovery. Further research is necessary to better understand the long-term effects of the Lokomat The Lokomat does, however, show promising potential in the NeuroRehabilitation field as well as an encouraging integration of technology into the world of physical therapy.

Sources Rehabilitation Institute of Chicago((2013).Lokomat Assisted Walking Therapy. Retrieved From: http://www.ric.org/conditions/specialized-services/lokomat-assisted-therapy/ HOCOMA(2015). Lokomat-Functional Robotic Gait Therapy. Retreived from: http://www.hocoma.com/en/products/lokomat/ University of Maryland Rehabilitation &Orthopaedic Institute(Feb. 10,2015). Lokomat- Robotic Treadmill. Retrieved from: http://www.umrehabortho.org/programs/outpatient/services/lokomat MossRehab Einstein Healthcare Network.(2012) The Lokomat. Retrieved from: http://www.mossrehab.com/Innovative-Technology/advanced-technology-the-lokomatr.html Journal of Rehabilitation Research and Development(September 2006). Tools for Understanding and Optomizing Robotic Gait Training. Retrieved from :http://escholarship.org/uc/item/9jm0g42v#page-1 Journal of NeuroEngineering and Rehabilitation(2012). Towards more Effective Gait Training for Stroke Rehabilitation: A Review. Retrieved from: http://www.biomedcentral.com/content/pdf/1743- 0003-9-65.pdf Royal College of Surgeons in Ireland Student Medical Journal (2010).Photograph. Retrieved from:: http://www.rcsismj.com/2009-2010-issue/wii-habilitation/#sthash.UWIDQvHk.dpuf Royal College of Surgeons in Ireland Student Medical Journal (2010).Photograph. Retrieved from::http://www.rcsismj.com/2009-2010-issue/wii-habilitation/