J Rehabil Med 2009; 41: 734-739

RANDOMIZED CONTROLLED TRIAL

Improved walking ability and reduced therapeutic stress with an electromechnical gait device.

SUSANNA FREIVOGEL, PT¹, DIETER SCHMALOHR, MD¹ and JAN MEHRHOLZ, PhD^2,3

From the ¹Neurological Rehabilitation Hospital, Hegau Jugendwerk, Gailingen, ²Institute of Rehabilitation Science, Klilnik Bavaria in Kreischa and ³SRH Fachhochschule für Gesundheit, Gera, Germany

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Brain Injury, July 2008; 22(7-8): 625-632

CASE STUDY

Gait training with the newly developed "LokoHelp"-system is feasible for non-ambulatory patients after stroke, spinal cord and brain injury. A feasibility study

SUSANNA FREIVOGEL¹, JAN MEHRHOLZ², TANYA HUSAK-SOTOMAYOR¹, & DIETER SCHMALOHR¹

¹Neurological Rehabilitation Hospital, Hegau Jugendwerk, Gailingen, Germany and ²Department of Neurological Rehabilitation, Klinik Bavaria, Kreischa, Germany

Abstract for Download

Feet moving gait trainer versus leg moving gait trainer
Scientists and users on wide range are discussing whether feet moving gait trainers as the LokoHelp "Pedago" and a leg moving gait trainer lead to different therapy results.
By using the gait trainers for locomotor therapy more and more the conclusion is growing that the feet moving gait trainer has essential advantages. The Lokohelp Group will contribute to the discussion in the course of published studies, commented by Susanna Freivogel, scientific author and physiotherapist. read more

Robotic- versus Therapist-Assisted Locomotor Training in Subjects With Chronic Stroke
A Randomized Controlled Study

T. George Hornby, Donielle D. Campbell, Jennifer H. Kahn, Tobey Demott, Jennifer L. Moore and Heidi R. Roth
Stroke 2008;39;1786-1792

PMID: 18467648 [PubMed - indexed for MEDLINE]                  Link to publication

Background and Purpose:
Background and purpose of the study was the examination of gait-related improvements after therapist- versus robotic assisted locomotor training with the Lokomat.
Reason for the study to be done was the fact that locomotor training (LT) using a treadmill can improve walking ability over conventional
rehabilitation in individuals with hemiparesis, although the personnel requirements often necessary to provide LT may limit its application. The Lokomat that provides consistent symmetrical assistance has been developed to facilitate LT, although its effectiveness in improving locomotor ability has not been well established.

Methods:
Forty-eight ambulatory chronic stroke survivors stratified by severity of locomotor deficits completed a randomized controlled study.
Patients were divided into two groups (less severe and severe gait deficits). Both groups received either 12 LT sessions with manual facilitation from a single therapist or 12 LT sessions with guided symmetrical locomotor assistance using a Lokomat. The assignment to the groups was at random. Each session of both groups was for 30 minutes. Speed was gradually increased in both groups. Patients of both groups were supported by body weight support at 30 – 40 % of their body weight. Support by the Lokomat was given continuously during the session; support by therapist during therapist-assisted training was given just when necessary.

Measures and Results:
Outcome measures included gait speed and symmetry, and clinical measures of activity and participation of patients before and after the 12 sessions.

Greater improvements in speed and single limb stance time on the impaired leg (as measure of the gait symmetry) were observed in subjects who received therapist-assisted LT, with larger speed improvements in those with less severe gait deficits. Perceived rating of the effects of physical limitations on quality of life improved only in subjects with severe gait deficits who received therapist-assisted LT.

Conclusions:
Therapist-assisted LT facilitates greater improvements in walking ability in ambulatory stroke survivors as compared to a similar dosage of LT with the Lokomat.