Lokomat: Automated electromechanical gait training in neurological patients

Neurological disorders such as stroke and (incomplete) spinal cord injury (SCI) usually lead to difficulties in performing locomotor activities, such as walking or climbing stairs. Therefore, an important part of rehabilitation programs is aimed at restoration of gait function. To improve walking ability it seems important to include task-specific repetitive training with focus on higher intensities of walking practice. These concepts have lead to the development of various automated electromechanical gait-training devices, such as the Lokomat, which assist walking practice. Although it is claimed that such devices may be highly beneficial owing to the intense practice possible in non-ambulatory patients, scientific evidence which could justify their relatively high cost is scarce. Recently, within our research institute in collaboration with the Rehabilitation Centre Amsterdam, we have started a randomized controlled clinical trial investigating the effectiveness of Lokomat-training in patients after stroke and SCI on gait performance, quality of life and neuromuscular and cardiovascular properties. This lecture will give an overview on the existing literature concerning the efficacy of electromechanical assisted training for walking and the concepts which would favor the use of these devices will be discussed. In addition, developments and preliminary results from our study will be presented and discussed.