HYPERMED - CLINICAL RESEARCH - LOKOMAT

HyperMED Clinical Research  provides links with all current publications on Hyperbaric Oxygenation, LOKOMAT (Robotic Gait Assisted Walking) and other break-through we believe relevant to the objective of NeuroRecovery.

Clinical Research:  LOKOMAT

 

Functional and Physiological Responses to Lokomat Therapy (Pilot Study)

Individuals with neurological deficiencies such as those who have spinal cord injury, stroke, traumatic brain injury, Parkinson's disease, and multiple sclerosis often lose their ability to ambulate over ground. Loss of functional mobility not only impedes everyday life, but may also affect many systems and organs in the body. The investigators are interested in obtaining a wide variety of data in order to obtain a better understanding of changes that occur as a result of receiving Lokomat therapy. The investigators will be studying body composition, cardiac, pulmonary, endocrine, metabolic, and molecular changes after a 12-week clinical therapy program.

 

Immediate effects of electrical stimulation combined with passive locomotion-like movement on gait velocity and spasticity in persons with hemiparetic stroke: a randomized controlled study.

The Effect of Locomotor Training on Children With Incomplete Spinal Cord Injuries

McGill University : Rick Hansen Foundation : Shriners Hospitals for Children 2011. The purpose of this study is to address how well children with incomplete spinal cord injuries of greater than 12 months duration who remain non-functional ambulators improve through body weight assisted treadmill training (BWATT).

 

Comparison of Lokomat and Aquatic Exercise for Individuals With Chronic Incomplete Spinal Cord Injury (July 2011)

Participants will need to commit to a total of seven months. Included in this time is: testing, then the 3 months of exercise, testing, 2 week break, then the second 3 months of exercise, and a final testing. Half of the group will start with the Lokomat training and half will start wtih aquatic exercise. Each group will then switch to the other exercise condition. Exercise sessions will occur three times per week and last approximately 45-55 minutes. A physical therapist will provide personal direction for each of the exercise groups. Walking ability and cardiovascular fitness, as well as muscle strength will be assessed before starting exercise, at the three-month point and then at the six month point.

 

http://www.ncbi.nlm.nih.gov/pubmed?term=lokomat

HyperMED/LOKOMAT - Australian Experience HyperMED NeuroRecovery.pdf

HyperMED Clinical Research/Clinical_Report_LS_UTSouthwestern_en_0904_small_en.pdf

HyperMED Clinical Research/Clinical_Report_LS_Spaulding_en_0905_small_en.pdf

HyperMED Clinical Research/LOKOMAT_Clinical_Report_Shepherd_0706_en_small_en.pdf

 

Controlling Patient Participation During Robot Assisted Training - Stroke Recovery

The overall goal of this paper was to investigate approaches to controlling active participation in stroke patients during robot-assisted gait therapy. Although active physical participation during gait rehabilitation after stroke was shown to improve therapy outcome, some patients can behave passively during rehabilitation, not maximally benefiting from the gait training. Up to now, there has not been an effective method for forcing patient activity to the desired level that would most benefit stroke patients with a broad variety of cognitive and biomechanical impairments.

 

Robotic Locomotor Experience Applied to Parkinson's Disease (ROLEP)

Gait rehabilitation with treadmill has been reported to be useful in patients with Parkinson's disease. In the last years, interest in robotic devices for gait training has grew up for patients with different neurological disorders, since they minimize demands on physical therapists and may provide a more reliable and constant treatment.

The aim of this study is to evaluate if robotic gait training with LOKOMAT can improve walking more than conventional gait training with treadmill in patients affected by Parkinson's disease.

 

Robotic Gait Training in an Adult With Cerebral Palsy: A Case Report

Improved treatments and rehabilitation for cerebral palsy (CP) have led to an increased number of children with CP surviving into adulthood. Adults with CP show an increased prevalence of pain, fatigue, and musculoskeletal dysfunction, leading to a decrease in ambulatory function. Recent work has demonstrated the potential benefits of intensive task-specific gait training, including the use of robotic-driven gait orthoses, on motor recovery in children with CP []. In contrast, reports of interventions aimed at improving motor function in adults with CP are lacking. This case study reports on the outcomes of a 6-week intervention of robotic-assisted gait training administered to a 52-year-old woman with right hemiplegia attributable to CP. Improvements were noted in balance, walking speed, and time to negotiate stairs at posttraining and follow-up. Gait analysis showed an increase in step length and a reduction in the period of double support. In conclusion, robotic-assisted gait training may be beneficial in enhancing locomotor function in adults with CP.

 

Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy.

Children's Hospital, University of Munich, Germany. Eur J Paediatr Neurol. 2010 Feb 5. [Epub ahead of print]

Abstract : Task-specific body-weight-supported treadmill therapy improves walking performance in children with central gait impairment. The aim of the study was to investigate the effect of robotic-assisted treadmill therapy on standing and walking performance in children and adolescents with cerebral palsy and to determine parameters influencing outcome. METHODS: 20 Patients (mean age 11.0+/-5.1, 10 males and 10 females) with cerebral palsy underwent 12 sessions of robotic-assisted treadmill therapy using the driven gait orthosis LOKOMAT. Outcome measures were the dimensions D (standing) and E (walking) of the Gross Motor Function Measure (GMFM). RESULTS: Significant improvements in dimension D by 5.9% (+/-5.2, p=0.001) and dimension E by 5.3% (+/-5.6, p<0.001) of the GMFM were achieved. Improvements in the GMFM D and E were significantly greater in the mildly affected cohort (GMFCS I and II) compared to the more severely affected cohort (GMFCS III and IV). Improvement of the dimension E but not of D correlated positively with the total distance and time walked during the trial (r(s)=0.748, p<0.001). CONCLUSIONS: Children and adolescents with bilateral spastic cerebral palsy showed improvements in the functional tasks of standing and walking after a 3-week trial of robotic-assisted treadmill therapy. The severity of motor impairment affects the amount of the achieved improvement. Copyright © 2010 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved

 

Improvement of Gross Motor Function in Children with Cerebral Palsy after LOKOMAT (Robotic Gait Training)

Ambulatory children with a diagnosis of spastic diplegia due to CP, GMFCS level II to III were enrolled in the study. 21 children aged 6-14 (mean 12.13) with a diagnosis of spastic diplegia due to cerebral palsy (CP) GMFCS level II to III They were randomly allocated to either intervention or control group. were divided into 2 groups. Intervention group (n=12) participated in a 4-week robotic-assisted walking gait training involving max. 3-5 sessions of 45min per week. 20 sessions (45min per session)

Transfer of scientific concepts to clinical practice: recent robot-assisted training studies.

Waldner A, Tomelleri C, Hesse S. Funct Neurol. 2009 Oct-Dec;24(4):173-7.

Abstract: Restoration of motor function is a priority of post-stroke rehabilitation, the aim being to facilitate the patient's reintegration into society. Innovative technologies for neurological rehabilitation must be easy to use and offer patients real benefits, and the treatments they provide must be efficacious and efficient. All these aspects must be carefully evaluated in their development. To achieve restoration of motor function after stroke, task-specific repetitive robot-assisted training of the upper and the lower extremity is currently the most promising approach. The results of clinical trials of robotic devices for upper limb (MIT-Manus, MIME, NeReBot, BiManuTrack, ARMin, ARMOR) and lower limb (LokoHelp, GangTrainer GT1, Haptic Walker, G-EO-Systems, LOKOMAT) training are here presented with the aim of highlighting the possible gains in motor function due to robotic therapy. Patients who receive robot-assisted training in combination with physiotherapy after stroke are more likely to achieve better motor function than patients trained without these devices, or only with these devices.

 

Olfactory mucosal autografts and rehabilitation for chronic traumatic spinal cord injury.

Participants included paraplegics and well as tetraplegics ranging in age from 19-37 years and with an average of 49 months since the injury. Before surgery, all participants underwent high intensity rehabilitation consisting of range of motion and strengthening exercises, balance training for posture, standing, transfers and gait and pre gait activities for approximately 4 months. The gait activities were either carried out using a LOKOMAT, which is a robotic-assisted body weight supported treadmill training, or BIONT which is described as assisted over ground walking training. The participants’ own olfactory mucosa was transplanted into the injury site after partial scar removal. There was no control group, with all participants receiving transplants. The intense rehabilitation regimes were continued postoperatively.

 

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

 

Effectiveness of robotic-assisted walking (LOKOMAT) on quality of life, gait, activity level, and balance in patients with multiple sclerosis

Enhancing Walking in People With Incomplete Spinal Cord Injury: a Pilot Study

The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients: a randomized controlled trial.

Spinal decompression sickness presenting as partial Brown-Sequard syndrome and treated with robotic-assisted body-weight support treadmill training.

Pilot study of LOKOMAT versus manual-assisted treadmill training for locomotor recovery post-stroke.

Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy.

Safety of robotic-assisted treadmill therapy in children and adolescents with gait impairment: a bi-centre survey.

Robot-aided training in rehabilitation

Sustainability of motor performance after robotic-assisted treadmill therapy in children: an open, non-randomized baseline-treatment study

Robotic orthosis LOKOMAT: its use in the rehabilitation of locomotion for neuromotor outcomes of patients with brain injury. Presentation of a pilot study.

Cardiovascular Fitness for Robotically Assisted Treadmill Training in Persons With Chronic Incomplete Spinal Cord Injury

LOKOMAT Versus Strength Training in Chronic Incomplete Spinal Cord Injury

Exercise-mediated (LOKOMAT) locomotor recovery and lower-limb neuroplasticity after stroke

Activity_based_restorative_therapies_concepts_and_applications_in_spinal_cord_injury_related_neurorehab

The ATLET Study: Can Subjects With Incomplete Spinal Cord Injury Learn to Walk?

ICORD (International Collaboration On Repair Discoveries) August 2009 LOKOMAT Gait Assisted Walking Project

Effectiveness of Robotic Assisted Gait Training in Children With Cerebral Palsy (PeLoGAIT)

Effect of Robot-assisted Gait Training on Freezing of Gait in Parkinson's Disease

LOKOMAT Training Effects On Multiple Sclerosis Gait Abnormalities

Effect of Passive Gait Training on the Cortical Activity in Patients With Severe Traumatic Brain Injury

Effect of Robot-assisted Training on Foot Drop in Multiple Sclerosis

Functional and Physiological Responses to LOKOMAT Therapy (Pilot Study)

HyperMED Clinical Research/STROKE-2009-563247v2-Hornby.pdf

Pilot study of LOKOMAT versus manual-assisted treadmill training for locomotor recovery post-stroke

Cardiovascular Fitness for Robotically Assisted Treadmill Training in Persons With Chronic Incomplete Spinal Cord Injury

Effect of Robot-assisted Gait Training on Freezing of Gait in Parkinson's Disease

Feasibility and Practice Characteristics of FNS and Gait Robot

Gait Training for Persons With Stroke - Full Text View - ClinicalTrials.gov

Healogica: NCT00883142 - Functional and Physiological Responses to LOKOMAT Therapy

Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the LOKOMAT in Subacute Stroke

LOKOMAT Treadmill Training Effects on MS Gait - Full Text View - ClinicalTrials.gov

Changes in spinal reflex and locomotor activity after a complete spinal cord injury: a common mechanism?  

Kinematic trajectories while walking within the LOKOMAT robotic gait-orthosis.

Cardiovascular Fitness for Robotically Assisted Treadmill Training in Persons With Chronic Incomplete Spinal Cord Injury

Multicenter randomized clinical trial evaluating the effectiveness of the LOKOMAT in subacute stroke.

Gait Training for Persons With Stroke - Tabular View - ClinicalTrials.gov

Functional and Physiological Responses to LOKOMAT Therapy (Pilot Study) - No Study Results Posted - ClinicalTrials.gov

Effect of Robot-Assisted Training on Foot Drop in Multiple Sclerosis - Full Text View - ClinicalTrials.gov

Effect of Robot-Assisted Gait Training on Freezing of Gait in Parkinson's Disease - Full Text View - ClinicalTrials.gov

Neurorehabilitation and Neural Repair   pdf icon

Effectiveness of Robotic Assisted Gait Training in Children With Cerebral Palsy - Tabular View - ClinicalTrials.gov

Full Article | Biomechanics

Enhancing Walking in People With Incomplete Spinal Cord Injury: a Pilot Study - Full Text View - ClinicalTrials.gov

Effect of Robot-Assisted Training on Foot Drop in Multiple Sclerosis - Tabular View - ClinicalTrials.gov

The influence of different LOKOMAT walking conditions on the energy expenditure of hemiparetic patients and healthy subjects.

Gait Training for Persons With Stroke - Related Studies - ClinicalTrials.gov

Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke

Enhancing Walking in People With Incomplete Spinal Cord Injury: a Pilot Study - Tabular View - ClinicalTrials.gov

Prospective, Blinded, Randomized Crossover Study of Gait Rehabilitation in Stroke Patients Using the LOKOMAT

Cardiovascular Fitness for Robotically Assisted Treadmill Training in Persons With Chronic Incomplete Spinal Cord Injury

A method of estimating the degree of active participation during stepping in a driven gait orthosis based on actuator force

Cortical and Spinal Excitability Changes After Robotic Gait Training in Healthy Participants  

Spinal decompression sickness presenting as partial Brown-Sequard syndrome and treated with robotic-assisted body-weight support

Virtual gait training for children with cerebral palsy using the LOKOMAT gait orthosis.

Internally Versus Externally Guided Body Weight-Supported Treadmill Training (BWSTT) for Locomotor Recovery Post-Stroke - Full T

Abnormal joint torque patterns exhibited by chronic stroke subjects while walking with a prescribed physiological gait pattern.

Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the LOKOMAT gait orthosis.

Cortical and spinal excitability changes after robotic gait training in healthy participants.

Measurement of motor recovery after stroke. Outcome assessment and sample size requirements

Low-Velocity Graded Treadmill Stress Testing in Hemiparetic Stroke Patients

Treadmill Aerobic Exercise Training Reduces the Energy Expenditure and Cardiovascular Demands of Hemiparetic Gait in Chronic Str

Load-Regulating Mechanisms in Gait and Posture: Comparative Aspects  

Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the LOKOMAT in Subacute Stroke

Patient-Driven Cooperative Gait Training with the Rehabilitation

“The Use of the LOKOMAT System in Clinical Research”

Multicenter randomized clinical trial evaluating the effectiveness of the LOKOMAT in subacute stroke.

Neurorehabilitation and Neural Repair   pdf icon

Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke: A Randomize

Prospective, Blinded, Randomized Crossover Study of Gait Rehabilitation in Stroke Patients Using the LOKOMAT Gait Orthosis -- Ma

Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke. A Randomize

Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke:

The Evolution of Walking-Related Outcomes Over the First 12 Weeks of Rehabilitation for Incomplete Traumatic Spinal Cord Injury:

Treadmill Exercise Rehabilitation Improves Ambulatory Function and Cardiovascular Fitness in Patients With Chronic Stroke. A Ran

Treadmill Training With Partial Body Weight Support and an Electromechanical Gait Trainer for Restoration of Gait in Subacute St

Speed-Dependent Treadmill Training in Ambulatory Hemiparetic Stroke Patients: A Randomized Controlled Trial