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Since September 2006 and over a period of 6 months Miss Tanya Husak Sotomayor has been significantly involved in the clinical trial with the LokoHelp. This trial was led by Mrs. Susanna Freivogel in the Hegau-Jugendwerk in Gailingen am Hochrhein. The meanwhile completed trial examines the effectiveness of the treadmill-locomotor therapy with the gait trainer LokoHelp on patients suffering from central and spinal paresis.
Question: Tanya, you are one of the first physiotherapists who have had the opportunity to work with the LokoHelp. What was your first impression? Tanya: Previously, I have used the manual supported treadmill therapy, which I have come to associate with an uncomfortable position and with physical strain. I did also have the opportunity to see the robotic gait trainer Lokomat in practice. I have to admit, that at first sight, I was a little sceptical about the LokoHelp, but this was just the first impression. I am really amazed that such a simple mechanical device is so effective for the patients.
Question: Actually the LokoHelp has been developed for patients without gait ability. What was your first experience in the clinical application? Tanya: Looking at the seriously handicapped patients and at the LokoHelp, I could not imagine getting the patients onto the treadmill and into the LokoHelp within the available 45 minutes and above all, have enough time to carry out the training. Fortunately, the LokoHelp is user-friendly and I was quickly able to get used to the device and its handling, which left more than enough time for the therapy and for training the walking ability of the patients.
Question: How did the patients respond? Tanya: In the beginning I was concerned that some of the patients would not be able to handle the situation without fear. But I was astonished at how soon the patients began to enjoy the therapy. After becoming familiar with the device, all patients were able to actively contribute after just a few therapy units, some even during the second unit. The patients very quickly grasped the concept of the LokoHelp and what they had to do.
Question: Do you have any clinical results to report? Tanya: Some of our patients are seriously afflicted, so much so, that it was almost impossible for me to achieve good improvement. However, even with those patients we could notice an improvement, which was noticeable to the nursing staff and the relatives as well. Although the ability to walk could not be achieved, the LokoHelp-therapy led to the facilitation of the patients’ care and thus to the enhancement of the patients’ and staff’s quality of life. Less affected patients without the ability to walk, showed an improvement such that they were able to walk independently during the treatment with the LokoHelp.
Question: Could you tell us about a particularly impressive patient? Tanya: I was lucky to work with a patient who was progressing from an absolute dependent physical situation to independent active functions.
Today Mrs. K. is able to walk 300 meters with the help of a rollator walker (or walking frame), but due to her severe posture control deficit she still needs the support of an auxiliary person.
Another patient, Mr. B, suffers from an incomplete paraplegia caused by a spinal cord injury at T2 two years ago. He did not read up on his handicap. And he always said: “I will not leave this house before I am able to walk”. We treated Mr. B. 20 times on the treadmill and after that with the LokoHelp. Even after 14 treatments with the LokoHelp he did not show any remarkable improvement in his ability to walk. This was very disappointing for me, especially because all the others showed so much improvement. It was irritating for me that the reflex, which was initiated during the treadmill therapy, could not be initiated with the LokoHelp. After consulting Mrs. Freivogel, the leading physiotherapist, we realised that during the training, it is imperative that the basics of the locomotor therapy be considered. That means you have to initiate the reflexes for activating the supporting and the free leg by the hip extension and the load. I was completely surprised that after the 16th therapy with the LokoHelp unit Mr. B. began walking with walking sticks. Mr B. has gone from being unable to walk, to now walking with the help of walking sticks. His knees have to be fixed passively into the extension by orthoses. He is so happy about that. Today he says: “Now I am going to stay.” I feel that the optimum reflex is initiated and that the leg makes an extension. I then unintentionally set Mr. B.’s legs falsely so that he had to start with his weaker leg in the supporting leg phase and after supporting the body weight he actually extended his leg actively. This was really a great surprise!
Mr. B. has practiced intensively for 2 months in total. He additionally did some weight training with his arms and he exercised walking with orthoses along the parallel bars. In my opinion the LokoHelp helped to not only invigorate his leg musculature but also to improve his hip stability, so that he is now able to walk with the help of underarm sticks and orthoses outdoors as well.
Question: What is your opinion about the gait pattern of the LokoHelp? Tanya: Well, that’s what I tell all the relatives of all our patients: „It does not look one hundred per cent like the „regular“ gait pattern, but it offers all essential components which are relevant to exercise walking.”
We thank you very much, Tanya, for this interesting and informative conversation. |