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Objective:To explore the effect of Lokomat training on the walking ability of stroke survivors with lower limb spasm.Methods:Eighty stroke survivors with lower limb spasm were randomly divided into an observation group and a control group, each of 40. Their routine rehabilitation treatment included normal limb positioning, passive joint movement, turnover training and inclined bed standing training. In addition, the control group underwent flat-ground walking training, while the observation group was given Lokomat training 3 times a week for 8 weeks. Both groups were evaluated after 4 and 8 weeks of treatment in terms of their walking ability, degree of lower limb spasm, lower limb motor functioning, balance and ability in the activities of daily life.Results:After 4 and 8 weeks the number of patients walking independently was significantly greater in the observation group. Their average stride frequency, step length on the affected side, support phase time and proportion of weight borne on the affected side were all significantly better than the control group′s averages. At both time points significantly more patients of the observation group had normal lower limb muscle tone. The observation group′s average Fugl-Meyer score, Berg Balance Scale score and modified Barthel Index score had improved significantly compared with those before the treatment, and were significantly better than the control group′s averages at the same time point. After 8 weeks of treatment the average walking speed of the observation group was faster than that of the control group.Conclusions:Lokomat training can significantly improve the walking ability of stroke survivors with lower limb spasm in the short term. Longer-term training can consolidate the effect and further improve the walking speed, motor function in the lower limbs, balance and even facility in daily life activities, as well as relieving spasm.
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Objective To investigate the effect of Lokomat gait training rehabilitation robot on joint motion and lower limb function in hemiplegic patients after stroke.Methods Forty hemiplegic patients after stroke were randomized equally into a robotic group and a control group (20 cases in each group).The robotic group received robotic rehabilitation therapy in addition to routine rehabilitation training,while the control group was only given instructions for routine rehabilitation training.All the patients were assessed at the beginning of the training and at the end of 4,8 and 10 weeks of treatment.The Fugl-Meyer Assessment of lower extremities (FMA),range of motion (ROM) in hip and knee,force and tone of bilateral hip/knee flexors and extensors were used to evaluate stepping function before training,and after 4,8 and 10 weeks of treatment.Results There was no significant difference between the 2 groups with regard to FMA scores,the ROM in hip and knee,as well as force and tone of bilateral hip/ knee flexors and extensors (P ＞ 0.05).After treatment,the robotic group was significantly improved with all the evaluation indexes when compared to its baseline values (P ＜ 0.05).It was also shown that the robotic group improved to a significantly greater extent than the control group (P ＜ 0.05).Pearson's correlation analysis demonstrated a positive relationship between the ROM of knee or hip and lower limb function (P ＜ 0.05).Conclusions The Lokomat gait training rehabilitation robot can improve the lower extremities functions,as indicated by increase of ROM and muscle strength as well as decrease in muscle spasticity in hemiplegic patients after stroke.
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Introduction: The Lokomat® robotic therapy is proposed as a new alternative for the rehabilitation of gait in patients with neurological disorders of central origin. Objective: To describe the effect of the Lokomat® in speed, gait pattern, postural stability, third party assistance, and the need of technical aids for gait in a group of patients with neurological disorders in the Institute Teletón Santiago between April 2008 and June 2009. Patients and Methods: 77 medical records of patients in the Lokomat® program were selected. These included patients with cerebral palsy (CP), stroke (CVA), traumatic brain injury (TBI) and ataxic syndrome. The patients had an average age of 16.2 years (range 4.65 to 25.98 years). Results are evaluated pre and post training measuring gait speed(10 meters test), gait pattern (visual scale of Edinburgh), postural stability and transfers (timed up and go test), third party assistance (functional ambulation categories - FAC) and gait functionality (functional mobility scale- FMS). The Wilcoxon test was applied to measure changes before and after with p < 0.05. Results: Significant changes were observed in all tests in the group of subjects with CP (p < 0.001) after orthopedic surgery and in speed and gait pattern in CP patients after onabotulinum toxin A infiltration. In patients with TBI and stroke changes in gait pattern and functional tests were evident (p < 0.05). In ataxic subjects improvement in postural stability and transfers were recorded (p < 0.01).Conclusions: The Lokomat® robotic orthosis is a useful tool in improving gait related parameters in the neurological diseases analyzed, especially in CP patients after orthopedic surgery.
Introducción: La terapia robotizada con Lokomat® se plantea como una nueva alternativa para la rehabilitación de la marcha en pacientes con patologías neurológicas de origen central. Objetivo: Describir el efecto del Lokomat® en velocidad, patrón de marcha, estabilidad postural, asistencia por terceros, necesidad de ayudas técnicas en la marcha en un grupo de pacientes portadores de patologías neurológicas del Instituto Teletón de Santiago, entre abril-2008 y junio-2009. Pacientes y Métodos: Se seleccionan 77 fichas médicas de pacientes del programa Lokomat®, portadores de parálisis cerebral (PC), accidente vascular encefálico (AVE), traumatismo encéfalo craneano (TEC) y síndrome atáxico, con edad media de 16,2 años (rango 4,65-25,98 años). Se evalúan resultados pre y post entrenamiento en velocidad de marcha (test de 10 metros), patrón de marcha (escala visual de Edimburgo), estabilidad postural y transferencias (test timed up and go), asistencia de terceros (categoría funcional de la marcha) y funcionalidad en la marcha (escala de marcha o movilidad funcional). Se aplica test de Wilcoxon para medir los cambios antes-después con p < 0,05. Resultados: Se observaron cambios significativos en todas las pruebas en el grupo de sujetos con PC postcirugía ortopédica (p < 0,001) y en velocidad y patrón de marcha en el grupo post infiltración con onabotulinumtoxinA. En pacientes con TEC y AVE se evidenciaron cambios en el patrón de marcha y en los test funcionales (p < 0,05). En sujetos atáxicos se registró mejoría en estabilidad postural y transferencias (p < 0,01). Conclusiones: La órtesis robótica Lokomat® es una herramienta útil en la mejoría de parámetros vinculados a la marcha en las patologías neurológicas analizadas, especialmente en el grupo de PC post cirugía ortopédica, donde todos los test registraron mejoras significativas.