II.

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Objective: To examine the impact on gait velocity and spatiotemporal symmetry using three different modes of locomotor therapy: an end effector robot (G-EOä); a robotic exoskeleton (Lokomat Ò ) and manual assisted partial-body weight supported treadmill training (PBWSTT) in patients with traumatic brain injury (TBI). Design: Randomized, prospective, pilot study. Setting: Tertiary rehabilitation hospital. Participants: 22 TBI participants able to walk with or without assistance at velocities between 0.2 and 0.6 m/s. Interventions: 45 minutes of selected training for a total of 18 sessions. Main Outcome Measures: Overground walking self-selected velocity (SSV); maximal velocity (MV) and spatiotemporal symmetry. Results: Mean age was similar for the three groups. 50% of the participants were men. Right hemiparesis was more common in the G-EO and PBWSTT groups; paretic side was evenly distributed in the Lokomat group. Post training elicited a statistically significant median increase in SSV compared to pre-training, (G-EO, P ¼.028; Lokomat, P ¼.035 and PBWSTT, P ¼.018) and MV excluding the G-EO group (G-EO, P ¼ .150; Lokomat, P ¼ .036 and PBWSTT, P ¼.027). No pre-post significant differences in SSV or MV swing time, stance time and step length symmetry ratios. Mean rank in the change of SSV and MV were not statistically significantly different between groups, P ¼ .744, .658. Mean rank in the change of SSV and MV swing time, stance time and step length symmetry ratios were not statistically significantly different between groups (SSV: P ¼.552; 0.139 and 0.574; MV: P ¼.492; 0.483 and 0.131). Conclusions: Locomotor therapy in the TBI population using G-EO, Lokomat or PBWSTT produced equivalent increases in SSV and MV without significant changes in symmetry. A larger study may further define changes in gait symmetry and group differences.

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