Effects of body weight support and guidance force settings on muscle synergy during Lokomat walking

Cherni, Yosra; Hajizadeh, Maryam; Maso, Fabien Dal; Turpin, Nicolas A.

doi:10.1007/s00421-021-04762-w

Cited by 16 publications

(19 citation statements)

References 63 publications

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“…These results are also in agreement with previous studies showing that high levels of BWS, as well as low Guidance, result in typically low muscle activation as well as an alteration of lower limb muscle coordination (Cherni et al, 2021;Kammen et al, 2014).…”

Section: Discussionsupporting

confidence: 93%

Effects of Robotic-Assisted Gait at Different Levels of Guidance and Body Weight Support on Lower Limb Joint Angles, Angular Velocity, and Inter-Joint Coordination

Cherni

Blache

Begon³

et al. 2022

Preprint

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The Lokomat provides task-oriented therapy for patients with gait disorders. This robotic technology drives the lower limbs in the sagittal plane. However, unconstrained gait involves motions also in the coronal and transverse planes. This study aimed to compare the Lokomat with Treadmill gait through 3D-joint kinematics and inter-joint coordination. Lower limb kinematics was recorded in 18 healthy participants who walked at 3 km/h on a Treadmill or in a Lokomat with nine combinations of Guidance (30, 50, 70%) and body-weight-support (30, 50,70%). Compared to Treadmill, the Lokomat altered pelvis rotation, decreased pelvis obliquity and hip adduction, and increased ankle rotation. Moreover, the Lokomat resulted in a significantly slower velocity at the hip, knee, and ankle flexion compared to the treadmill condition. Moderate to strong correlations were observed between the Treadmill and Lokomat conditions in terms of inter-joint coordination between hip-knee (r=0.67-0.91), hip-ankle (r=0.66-0.85), and knee-ankle (r=0.90-0.95). In conclusion, this study showed that some gait determinants such as pelvis obliquity and rotation, and hip adduction are altered when walking with Lokomat in comparison to Treadmill. Kinematic deviations induced by the Lokomat were most prominent at high levels of body-weight-support. Interestingly, different levels of Guidance did not affect gait kinematics.

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Section: Discussionsupporting

confidence: 93%

Effects of Robotic-Assisted Gait at Different Levels of Guidance and Body Weight Support on Lower Limb Joint Angles, Angular Velocity, and Inter-Joint Coordination

Cherni

Blache

Begon³

et al. 2022

Preprint

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“…However, a reduction of the Guidance Force can increase the muscle activation [ 63 , 64 , 104 ]. Cherni et al found a non-trivial influence of Guidance Force on muscle activations, partially attenuated previous results [ 105 ]. A pilot study could also show that during learning a trajectory tracking task in the Lokomat with a low Guidance Force , muscle activation could be increased and tracking errors could be reduced [ 106 ].…”

Section: Discussionmentioning

confidence: 73%

“…Current evidence on the body weight support suggests that a decrease in the body weight support can increase the metabolic costs [ 103 ] and can elicit higher heart rates [ 62 ]. This is related to the fact that a reduction in body weight support elicits a higher muscle activation [ 63 , 64 , 104 , 105 ]. However, the muscle synergies were found to be robust across different levels of body weight support [ 105 ] .…”

Section: Discussionmentioning

confidence: 99%

“…This is related to the fact that a reduction in body weight support elicits a higher muscle activation [ 63 , 64 , 104 , 105 ]. However, the muscle synergies were found to be robust across different levels of body weight support [ 105 ] . Besides these direct effects, there is some evidence that the body weight support interacts with the effects of other therapy parameters.…”

Section: Discussionmentioning

confidence: 99%

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Settings matter: a scoping review on parameters in robot-assisted gait therapy identifies the importance of reporting standards

Dellen

Labruyère

2022

J NeuroEngineering Rehabil

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Background Lokomat therapy for gait rehabilitation has become increasingly popular. Most evidence suggests that Lokomat therapy is equally effective as but not superior to standard therapy approaches. One reason might be that the Lokomat parameters to personalize therapy, such as gait speed, body weight support and Guidance Force, are not optimally used. However, there is little evidence available about the influence of Lokomat parameters on the effectiveness of the therapy. Nevertheless, an appropriate reporting of the applied therapy parameters is key to the successful clinical transfer of study results. The aim of this scoping review was therefore to evaluate how the currently available clinical studies report Lokomat parameter settings and map the current literature on Lokomat therapy parameters. Methods and results A systematic literature search was performed in three databases: Pubmed, Scopus and Embase. All primary research articles performing therapy with the Lokomat in neurologic populations in English or German were included. The quality of reporting of all clinical studies was assessed with a framework developed for this particular purpose. We identified 208 studies investigating Lokomat therapy in patients with neurologic diseases. The reporting quality was generally poor. Less than a third of the studies indicate which parameter settings have been applied. The usability of the reporting for a clinical transfer of promising results is therefore limited. Conclusion Although the currently available evidence on Lokomat parameters suggests that therapy parameters might have an influence on the effectiveness, there is currently not enough evidence available to provide detailed recommendations. Nevertheless, clinicians should pay close attention to the reported therapy parameters when translating research findings to their own clinical practice. To this end, we propose that the quality of reporting should be improved and we provide a reporting framework for authors as a quality control before submitting a Lokomat-related article.

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“…Regarding the progression in training settings, it has been suggested that in order to get closer to normative gait patterns, very low speeds and high levels of BWS should be avoided when possible [36,37]. Depending on the study, initial BWS levels were adjusted between by 30 and 50%.…”

Section: Anti-gravity Training: Protocols and Settingsmentioning

confidence: 99%

Lower-Body Positive Pressure Treadmill Training for Pediatric Gait Disorders: A Scoping Review

et al. 2021

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The purpose of this scoping review was to examine the literature on the use of anti-gravity treadmills and its effects on lower-limb motor functions in children and adolescents with locomotor impairments. Method: Four databases (MEDLINE, CINAHL, Embase, Web of Science) were searched for articles from inception to August 2021. Inclusion criteria were: (1) experimental or quasi-experimental studies using anti-gravity training as the primary intervention; (2) studies conducted in pediatric participants; (3) articles reporting outcomes related to lower-limb functions; and (4) studies published in French or English. Results: Fifteen articles were included in the review. Studies included children and adolescents aged 4–18 years with locomotor impairments. Intervention duration ranged from 2 to 12 weeks, with 2–5 sessions per week. Included studies reported that anti-gravity training induces improvements in muscle strength, balance, spatiotemporal gait parameters, and walking endurance in children with locomotor impairments. Conclusion: This review provides relevant information about interventions, outcomes and limits associated with anti-gravity training in pediatrics. Overall, anti-gravity treadmill training could be viewed as a valuable training modality, specifically for children with cerebral palsy. However, a more precise and comprehensive description of anti-gravity training protocols would be useful.

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Effects of body weight support and guidance force settings on muscle synergy during Lokomat walking

Cited by 16 publications

References 63 publications

Effects of Robotic-Assisted Gait at Different Levels of Guidance and Body Weight Support on Lower Limb Joint Angles, Angular Velocity, and Inter-Joint Coordination

Effects of Robotic-Assisted Gait at Different Levels of Guidance and Body Weight Support on Lower Limb Joint Angles, Angular Velocity, and Inter-Joint Coordination

Settings matter: a scoping review on parameters in robot-assisted gait therapy identifies the importance of reporting standards

Lower-Body Positive Pressure Treadmill Training for Pediatric Gait Disorders: A Scoping Review

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