Technology of the Robotic Gait Orthosis Lokomat

Riener, Robert

doi:10.1007/978-1-4471-2277-7_13

Cited by 18 publications

(6 citation statements)

References 19 publications

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“…Instruments: The RAGT used is a robotic device set up as an exoskeleton on the lower limbs of the patient (Lokomat ® , Hocoma) [ 28 ]. The system uses a dynamic body weight-support system to support the participant above a motorized treadmill that is synchronized with the gait orthosis in a virtual reality environment with constant audio and visual feedback used to perform various tasks.…”

Section: Methodsmentioning

confidence: 99%

Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

et al. 2021

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Background and Objectives: Gait disorders represent one of the most disabling aspects in multiple sclerosis (MS) that strongly influence patient quality of life. The improvement of walking ability is a primary goal for rehabilitation treatment. The aim of this study is to evaluate the effectiveness of robot-assisted gait training (RAGT) in association with physiotherapy treatment in patients affected by MS in comparison with ground conventional gait training. Study design: Randomized controlled crossover trial. Materials and Methods: Twenty-seven participants affected by MS with EDSS scores between 3.5 and 7 were enrolled, of whom seventeen completed the study. They received five training sessions per week over five weeks of conventional gait training with (experimental group) or without (control group) the inclusion of RAGT. The patients were prospectively evaluated before and after the first treatment session and, after the crossover phase, before and after the second treatment session. The evaluation was based on the 25-foot walk test (25FW, main outcome), 6 min walk test (6MWT), Tinetti Test, Modified Ashworth Scale, and modified Motricity Index for lower limbs. We also measured disability parameters using Functional Independence Measure and Quality of Life Index, and instrumental kinematic and gait parameters: knee extensor strength, double-time support, step length ratio; 17 patients reached the final evaluation. Results: Both groups significantly improved on gait parameters, motor abilities, and autonomy recovery in daily living activities with generally better results of RAGT over control treatment. In particular, the RAGT group improved more than control group in the 25FW (p = 0.004) and the 6MWT (p = 0.022). Conclusions: RAGT is a valid treatment option that in association with physiotherapy could induce positive effects in MS-correlated gait disorders. Our results showed greater effectiveness in recovering gait speed and resistance than conventional gait training.

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Section: Methodsmentioning

confidence: 99%

Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

et al. 2021

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“…The development of robot-assisted gait devices offered great potential for modern neurorehabilitation based on principles of exercise-related neuroplasticity [9]. So far, robot-assisted gait therapy has been tested successfully in patients with stroke [10][11][12][13] and is recommended in addition to multidisciplinary rehabilitation [14,15]. Even though intensity, measured as time spent in rehabilitation activities, seems to be relevant for optimising functional recovery [1,16], scarce evidence is available on the role of robot-assisted gait training (RAGT) dose for functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

Is robot-assisted gait training intensity a determinant of functional recovery early after stroke? A pragmatic observational study of clinical care

Lissom

Lamberti

Lavezzi

et al. 2022

International Journal of Rehabilitation Research

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Gait rehabilitation is a critical factor in functional recovery after a stroke. The aim of this pragmatic observational study was to identify the optimal dose and timing of robot-assisted gait training (RAGT) that can lead to a favourable outcome in a sample of subacute stroke survivors. Subacute patients with stroke who underwent a RAGT within a multidisciplinary rehabilitation program were enrolled. A set of clinical (i.e. age, type of stroke and time since stroke) and rehabilitation stay outcomes (length of stay and RAGT number of sessions) were recorded to evaluate their impact on functional outcome measures by functional independence measure (FIM) or functional ambulation category (FAC). We included 236 patients (62.73 ± 11.82 year old); 38.44% were females, and 59.32% were ischaemic stroke patients. Patients that received at least 14 RAGT sessions, had 15.83% more chance to be responders compared to those that receive less sessions (P = 0.006). Similarly, younger patients (≤60 years) were more prone to be responders (+15.1%). Lastly, an early rehabilitation (<6 weeks) was found to be more efficient (+21.09%) in determining responsiveness (P < 0.001). Becoming newly independent for gait, that refers to a FAC score ≥4, was related with age and RAGT sessions (P = 0.001). In conclusion, a younger age (≤60 years), an early rehabilitation (<6 weeks since stroke) and a higher RAGT dose (at least 14 sessions) were related to a favourable outcome in patients with subacute stroke.

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“…The Lokomat is a full leg exoskeleton, with only the hip and knee joints actuated, that measure joint angles of the user with the L-ROM (lower limb-RoM) tool [ 36 , 37 ]. In the studies we included, however, the sensors used for this purpose were not precisely defined, but are simply referred to as “position sensors” [ 86 ]. Since the human as well as the technical joints and segments lie on one line, the developer of the L-ROM Tool assume that the joint angles measured by the exoskeleton also correspond to the human angles [ 86 ].…”

Section: Resultsmentioning

confidence: 99%

“…In the studies we included, however, the sensors used for this purpose were not precisely defined, but are simply referred to as “position sensors” [ 86 ]. Since the human as well as the technical joints and segments lie on one line, the developer of the L-ROM Tool assume that the joint angles measured by the exoskeleton also correspond to the human angles [ 86 ]. The built-in tool moves the limb up to a predefined torque threshold, and then determines the maximum and minimum joint angles.…”

Section: Resultsmentioning

confidence: 99%

Use of Lower Limb Exoskeletons as an Assessment Tool for Human Motor Performance: A Systematic Review

Moeller

Moehler

Krell‐Roesch

et al. 2023

Sensors

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Exoskeletons are a promising tool to support individuals with a decreased level of motor performance. Due to their built-in sensors, exoskeletons offer the possibility of continuously recording and assessing user data, for example, related to motor performance. The aim of this article is to provide an overview of studies that rely on using exoskeletons to measure motor performance. Therefore, we conducted a systematic literature review, following the PRISMA Statement guidelines. A total of 49 studies using lower limb exoskeletons for the assessment of human motor performance were included. Of these, 19 studies were validity studies, and six were reliability studies. We found 33 different exoskeletons; seven can be considered stationary, and 26 were mobile exoskeletons. The majority of the studies measured parameters such as range of motion, muscle strength, gait parameters, spasticity, and proprioception. We conclude that exoskeletons can be used to measure a wide range of motor performance parameters through built-in sensors, and seem to be more objective and specific than manual test procedures. However, since these parameters are usually estimated from built-in sensor data, the quality and specificity of an exoskeleton to assess certain motor performance parameters must be examined before an exoskeleton can be used, for example, in a research or clinical setting.

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Technology of the Robotic Gait Orthosis Lokomat

Cited by 18 publications

References 19 publications

Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

Is robot-assisted gait training intensity a determinant of functional recovery early after stroke? A pragmatic observational study of clinical care

Use of Lower Limb Exoskeletons as an Assessment Tool for Human Motor Performance: A Systematic Review

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