Most gait training systems are designed for acute and subacute neurological inpatients. Many systems are used for relearning gait movements (nonfunctional training) or gait cycle training (functional gait training). Each system presents its own advantages and disadvantages in terms of functional outcomes. However, training gait cycle movements is not sufficient for the rehabilitation of ambulation. There is a need for new solutions to overcome the limitations of existing systems in order to ensure individually tailored training conditions for each of the potential users, no matter the complexity of his or her condition. There is also a need for a new, integrative approach in gait rehabilitation, one that encompasses and addresses all aspects of physical as well as psychological aspects of ambulation in real-life multitasking situations. In this respect, a multidisciplinary multinational team performed an overview of the current technology for gait rehabilitation and reviewed the principles of ambulation training.
Abstract-Creating the best solution in terms of a rehabilitation technique, device or system design for rehabilitation medicine interventions or assistance is not enough. The new solution has to be effective. And, in order to be effective, it has to be used therefore, the solution has to be accepted by the user as a solution for his/her functional need. The solution must convince the physical therapist, all the other members of the medical team, as well as the patient and his/her family, of its utility, before use and during its use. The degree of usability of the solution will be cultural specific and very personal. A model for Rehabilitation Technology Acceptance and Usability (RTAU) has been developed in order to become a base for rehabilitation technology usability prediction. The model presented in this paper is a world-wide premiere, considering the patient centered approach.
Given the large variability of pathological gait and the high specificity of gait phenotypes, it is very difficult to design a gait rehabilitation system able to adapt to the functional requirements of every person with ambulation disabilities, in every stage of the complex process of gait rehabilitation. Another approach is that of ambiental gait rehabilitation, with focus on adaptability, not on adaptation, on synthetical training, not on analytical training, on integrative training, not on step by step training. Our focus is not on controlling the movement itself, but on controlling the environment that shapes human functionality and assuring the appropriate level of support, resistance and persuasion, with consequent stimulation of the explorative behavior and the active involvement of the person in gait training. A mechatronic system designed for such a therapeutical approach has specific functional requirements.
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