LOKOMAT (Robotic Gait Assisted Walking) Gait Training
For the past 15-years bodyweight supported treadmill training (BWSTT) has become a prominent gait rehabilitation method in leading rehabilitation centers throughout the world.
Experiments conducted on spinalized cats demonstrate that spinal circuitry (reflex generators) below the level of injury remains active and functional neuronal properties can respond to peripheral input from below the level of injury. Treadmill cats can be ‘trained to sit, stand and walk’
Lack of appropriate stimulation induces functional incapacity called the ‘learning non-use’. Simply stated if you teach the remaining active spinal circuits to sit they will sit! Motor cortex centers in the brain re-allocate functional capacity lost through spinal cord injury – it is imperative to keep this ‘window open’. Body Weight Support Treadmill Training (BWSTT) and more recent studies on LOKOMAT (Robotic Gait Assisted Walking) demonstrate the potential of functional neuroplasticity - the ability to re-learn and re-organize function.
This type of locomotor training has many functional benefits but the labor costs are considerable. To reduce therapist effort, Robotically Gait Assisted BWSTT (LOKOMAT) has been shown to be more accurate and financially feasible, compared to the other BWSTT modalities. Currently 45+ LOKOMAT systems are in use in large Neurorehabilitation hospitals in the USA and approximately 150 LOKOMAT systems found in 31 Countries.
Internationally LOKOMAT (Robotic Gait Assisted Walking) and Body Weight Support Treadmill Training programs are payable under Third Party Insurance for spinal cord injury and a range of neurodegenerative and neurodevelopment gait disorders including Multiple Sclerosis.
HyperMED/LOKOMAT - Australian Experience HyperMED NeuroRecovery.pdf
HyperMED Clinical Research/Clinical_Report_LS_UT LOKOMAT Southwestern_en_0904_small_en.pdf
HyperMED Clinical Research/Clinical_Report_LS_ LOKOMAT Spaulding_en_0905_small_en.pdf
HyperMED Clinical Research/Lokomat_Clinical_Report_ LOKOMAT Shepherd_0706_en_small_en.pdf
LOKOMAT (Robotic Gait Assisted Walking) Gait Training
Patients receiving LOKOMAT (Robotic Gait Assisted Walking) are scheduled daily; initially 1-hour session and then as the patient builds we recommend up to 2-hours each day attending.
LOKOMAT is NOT passive involvement. The LOKOMAT is constantly adjusted to best assist the functional responses of the patient. Patients commence with passive assistance however as the patient compliancy builds the LOKOMAT settings and various programs are tailored to the patient performance and capabilities. Some patients have high level spasticity and others a complete loss of tone. Each patient's presentation is different - LOKOMAT provides excellent opportunity to 'best-fit' the patients specific capabilities and capacity to re-train function. And this is replicable on every separate training session!
In addition the support harness treadmill system are utilized independent of the LOKOMAT to promote functional changes. Functional changes being driven by 'man and machine' are then put to the test with the patient then able to implement strategies being focused on during each LOKOMAT session.
This combination effect is both unique and significant towards each neurologic patient developing a sense of supportive assistance whilst focusing on improving functional independence.
Walking requires a 'fluid like connection between spinal reflex generators and higher brain centers'. The combined approach is invaluable to promote functional changes - neuroplasticity (the ability to salvage back what has been damaged).
Restoration of Walking in Multiple Sclerosis Using Treadmill Training
Gait impairment is a major cause of ongoing disability in patients with multiple sclerosis (MS). New treadmills that provide body weight support and even robotic assistance to the lower limbs have recently been developed and are now commercially available. These treadmills allow the subject to execute the integrated process of walking in a task-specific manner that is repetitively reinforced in a normal pattern. Data from studies using these body-weight supported treadmills (BWSTT) in spinal cord injury and stroke patients suggest that intensive task-specific gait rehabilitative training may help to restore a normative gait pattern, improve overground walking and enhance quality of life in multiple sclerosis patients with neurological gait impairment.
In this study, we propose a series of prospective longitudinal clinical studies to collect pilot data on the use of task-specific BWSTT +/- LOKOMAT on improving ambulation, motor function and quality of life for MS patients with mild to moderate gait difficulty. Pilot data will also be collected for the effect conventional rehabilitation has on ambulation and motor outcomes as well as how these outcomes change during usual care. Our clinical research goals are to capture the initial pilot data (mean changes and variances in ambulation, motor, fatigue and quality of life outcomes) to facilitate the design of a larger clinical trial to test efficacy if these preliminary data are promising. The planned studies will study the effect of two forms of task specific training (BWSTT alone and BWSTT combined with LOKOMAT) compared to conventional gait rehabilitative methods and usual care