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Alberto Esquenazi, Stella Lee, Amanda Wikoff, Andrew Packel, Theresa Toczylowski, John Feeley
BACKGROUND: Literature in the application of gait training techniques in persons with traumatic brain injury is limited. Current techniques require of multiple staff and are physically demanding. The use of a robotic locomotor training may provide improved training capacity for this population. OBJECTIVE: To examine the impact of three different modes of locomotor therapy on gait velocity and spatiotemporal symmetry using: an end effector robot (G-EO™); a robotic exoskeleton (Lokomat®) and manual assisted partial-body weight supported treadmill training (PBWSTT) in participants with traumatic brain injury...
January 13, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Christian B Laursen, Jørgen F Nielsen, Ole K Andersen, Erika G Spaich
This study investigated the clinical feasibility of combining the electromechanical gait trainer Lokomat with functional electrical therapy (LokoFET), stimulating the common peroneal nerve during the swing phase of the gait cycle to correct foot drop as an integrated part of gait therapy. Five patients with different acquired brain injuries trained with LokoFET 2-3 times a week for 3-4 weeks. Pre- and post-intervention evaluations were performed to quantify neurophysiological changes related to the patients' foot drop impairment during the swing phase of the gait cycle...
June 13, 2016: European Journal of Translational Myology
Alicia J Hilderley, Darcy Fehlings, Gloria W Lee, F Virginia Wright
BACKGROUND: Enhancement of functional ambulation is a key goal of rehabilitation for children with cerebral palsy (CP) who experience gross motor impairment. Physiotherapy (PT) approaches often involve overground and treadmill-based gait training to promote motor learning, typically as free walking or with body-weight support. Robotic-assisted gait training (RAGT), using a device such as the Lokomat(®)Pro, may permit longer training duration, faster and more variable gait speeds, and support walking pattern guidance more than overground/treadmill training to further capitalize on motor learning principles...
2016: SpringerPlus
Raza Naseem Malik, Rachel Cote, Tania Lam
: Skilled walking, such as obstacle crossing, is an essential component of functional mobility. Sensorimotor integration of visual and proprioceptive inputs is important for successful obstacle crossing. The objective of this study was to understand how proprioceptive deficits affect obstacle-crossing strategies when controlling for variations in motor deficits in ambulatory individuals with spinal cord injury (SCI). Fifteen ambulatory individuals with SCI and 15 able-bodied controls were asked to step over an obstacle scaled to their motor abilities under full and obstructed vision conditions...
January 1, 2017: Journal of Neurophysiology
Alberto Esquenazi, Stella Lee, Amanda Wikoff, Andrew Packel, Theresa Toczylowski, John Feeley
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Tsuyoshi Nakajima, Kiyotaka Kamibayashi, Taku Kitamura, Tomoyoshi Komiyama, E Paul Zehr, Kimitaka Nakazawa
Both active and passive rhythmic limb movements reduce the amplitude of spinal cord Hoffmann (H-) reflexes in muscles of moving and distant limbs. This could have clinical utility in remote modulation of the pathologically hyperactive reflexes found in spasticity after stroke or spinal cord injury. However, such clinical translation is currently hampered by a lack of critical information regarding the minimum or effective duration of passive movement needed for modulating spinal cord excitability. We therefore investigated the H-reflex modulation in the flexor carpi radialis (FCR) muscle during and after various durations (5, 10, 15, and 30 min) of passive stepping in 11 neurologically normal subjects...
2016: Frontiers in Human Neuroscience
Hatice Kumru, Jesus Benito-Penalva, Josep Valls-Sole, Narda Murillo, Josep M Tormos, Cecilia Flores, Joan Vidal
High-frequency rTMS combined with gait training improves lower extremity motor score (LEMS) and gait velocity in SCI subjects who are able to walk over ground. The aim of this study was to optimize the functional outcome in early phases of gait rehabilitation in SCI using rTMS as an additional treatment to physical therapy. The present study included 31 motor incomplete SCI subjects randomized to receive real or sham rTMS, just before Lokomat gait training (15 subjects for real, 16 for sham rTMS). rTMS consisted of one daily session for 20 days over vertex (at 20 Hz)...
December 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Taha Qaiser, Amanda E Chisholm, Tania Lam
Sensorimotor integration is essential for controlling movement and acquiring new motor tasks in humans. The aim of this project was to understand how lower limb proprioceptive sense contributes to the acquisition of a skilled walking task. We assessed lower limb joint position and movement detection sense in healthy human subjects using the Lokomat robotic exoskeleton. Subjects walked on a treadmill to practice a skilled motor task (200 trials) requiring them to match their foot height during the swing phase to the height of a virtual obstacle displayed on a monitor in front of them...
July 5, 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Klaske van Kammen, Anne M Boonstra, Lucas H V van der Woude, Heleen A Reinders-Messelink, Rob den Otter
BACKGROUND: The ability to provide automated movement guidance is unique for robot assisted gait trainers such as the Lokomat. For the design of training protocols for the Lokomat it is crucial to understand how movement guidance affects the patterning of muscle activity that underlies walking, and how these effects interact with settings for bodyweight support and gait speed. METHODS: Ten healthy participants walked in the Lokomat, with varying levels of guidance (0, 50 and 100%), bodyweight support (0 or 50% of participants' body weight) and gait speed (0...
July 2016: Clinical Biomechanics
Dae-Hyouk Bang, Won-Seob Shin
BACKGROUND: Body weight-supported treadmill training assisted by a robotic gait orthosis is a helpful tool for restoring a symmetrical gait pattern in people with gait discrepancies. OBJECTIVE: This study's aim was to compare the effects of robot-assisted gait training (RAGT) versus treadmill gait training (TGT) on spatiotemporal gait parameters, balance, and activities-specific balance confidence with stroke patients. METHODS: Eighteen participants with stroke were randomly assigned to RAGT or TGT...
April 6, 2016: NeuroRehabilitation
Hatice Kumru, Narda Murillo, Jesus Benito-Penalva, Jose M Tormos, Joan Vidal
OBJECTIVE/HYPOTHESIS: Transcranial direct current stimulation (tDCS) is a potential tool to improve motor recovery in patients with neurological disorders. Safety and efficacy of this procedure for lower extremity motor strengthe and gait function in motor incomplete spinal cord injury (SCI) have not yet been addressed. The aim of this study is to optimize the functional outcome in early phases of gait rehabilitation assisted by Lokomat(®) in motor incomplete SCI patients using tDCS as an additional treatment to physical therapy...
May 4, 2016: Neuroscience Letters
Rajiv Ranganathan, Chandramouli Krishnan, Yasin Y Dhaher, William Z Rymer
The motor module hypothesis in motor control proposes that the nervous system can simplify the problem of controlling a large number of muscles in human movement by grouping muscles into a smaller number of modules. Here, we tested one prediction of the modular organization hypothesis by examining whether there is preferential exploration along these motor modules during the learning of a new gait pattern. Healthy college-aged participants learned a new gait pattern which required increased hip and knee flexion during the swing phase while walking in a lower-extremity robot (Lokomat)...
March 21, 2016: Journal of Biomechanics
Mehdi M Mirbagheri
We studied the effects of robotic-assisted locomotor (LOKOMAT) training or an anti-spastic medication (tizanidine) on neuromuscular abnormality associated with spasticity in persons with incomplete Spinal Cord Injury (SCI). Subjects were randomly divided to three groups: Lok, Tiz, and Cont. LOKOMAT training was performed 3 days/week for 4 weeks, with up to 45 minutes of training per session. Tizanidine (2mg) was administered (4\day), for 4 weeks. Subjects in Cont group received no intervention. The participants were evaluated before and after 4 weeks of training, and the effects of training on the intrinsic (muscular) and reflexive components of the neuromuscular properties were quantified over the ankle range-of-motion...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Tania Lam, Katherine Pauhl, Amanda Ferguson, Raza N Malik, Andrei Krassioukov, Janice J Eng
UNLABELLED: People with motor-incomplete spinal cord injury (m-iSCI) can recover basic walking function but still have difficulty performing the skilled walking required for everyday environments. We hypothesized that a robotic-based gait rehabilitation strategy founded on principles of motor learning would be a feasible and potentially effective approach for improving skilled walking in people with m-iSCI. Fifteen individuals with chronic (>1 yr) m-iSCI were randomly allocated to body weight-supported treadmill training (BWSTT) with Lokomat-applied resistance (Loko-R) or conventional Lokomat-assisted BWSTT (Control)...
2015: Journal of Rehabilitation Research and Development
T R M Filippo, M C L De Carvalho, L B Carvalho, D R de Souza, M Imamura, L R Battistella
STUDY DESIGN: One case report of proximal tibia fracture in a patient with incomplete spinal cord injury (SCI) associated with robotic treadmill training. OBJECTIVE: To raise the awareness that bone densitometry may be recommended before starting the robotic treadmill therapy, as well as the active vigilance of symptoms after therapy. SETTING: Institute of Physical and Rehabilitation Medicine, Lucy Montoro Institute for Rehabilitation, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil...
December 2015: Spinal Cord
Amanda E Chisholm, Antoinette Domingo, Jeswin Jeyasurya, Tania Lam
BACKGROUND: Our ability to sense movement is essential for motor control; however, the impact of kinesthesia deficits on functional recovery is not well monitored in the spinal cord injury (SCI) population. One problem is the lack of accurate and reliable tools to measure kinesthesia. OBJECTIVE: The purpose of this study was to establish the validity and reliability of a quantitative robotic assessment tool to measure lower limb kinesthesia in people with SCI. METHODS: Seventeen individuals with an incomplete SCI and 17 age-matched controls completed 2 robotic-based assessments of lower limb kinesthesia sense, separated by at least 1 week...
March 2016: Neurorehabilitation and Neural Repair
Tabea Aurich-Schuler, Birgit Warken, Judith V Graser, Thilo Ulrich, Ingo Borggraefe, Florian Heinen, Andreas Meyer-Heim, Hubertus J A van Hedel, A Sebastian Schroeder
Active participation and the highest level of independence during daily living are primary goals in neurorehabilitation. Therefore, standing and walking are key factors in many rehabilitation programs. Despite inconclusive evidence considering the best application and efficacy of robotic tools in the field of pediatric neurorehabilitation, robotic technologies have been implemented to complement conventional therapies in recent years. A group of experienced therapists and physicians joined in an "expert panel...
August 2015: Neuropediatrics
Felix Schoenrath, Susanne Markendorf, Andreas E Brauchlin, Burkhardt Seifert, Markus J Wilhelm, Martin Czerny, Robert Riener, Volkmar Falk, Christian M Schmied
BACKGROUND: To assess feasibility and safety of a robot-assisted gait therapy with the Lokomat® system in patients early after open heart surgery. METHODS: Within days after open heart surgery 10 patients were subjected to postoperative Lokomat® training (Intervention group, IG) whereas 20 patients served as controls undergoing standard postoperative physiotherapy (Control group, CG). All patients underwent six-minute walk test and evaluation of the muscular strength of the lower limbs by measuring quadriceps peak force...
July 2015: Journal of Cardiac Surgery
Shanon K Phelan, Barbara E Gibson, F Virginia Wright
PURPOSE: Robotic gait training is an emerging intervention that holds great therapeutic promise in the rehabilitation of children with neuromotor disorders such as cerebral palsy (CP). Little is known about children and parents' views on this new technology. The purpose of this qualitative study was to investigate the expectations and experiences of children with CP in relation to robotic gait training using the Lokomat®Pro. METHOD: An interpretivist qualitative design was employed in which perspectives of children and parents were elicited through separate semi-structured interviews to examine expectations of and experiences with the Lokomat...
2015: Disability and Rehabilitation
Hubertus J A van Hedel, Andreas Meyer-Heim, Christina Rüsch-Bohtz
PURPOSE: Robot-assisted gait training (RAGT) can complement conventional therapies in children with cerebral palsy. We investigated changes in walking-related outcomes between children with different Gross Motor Function Classification System (GMFCS) levels and the dose-response relationship. METHODS: Data from 67 children (3.9-19.9 years) with GMFCS levels II-IV were evaluated retrospectively. Every child received RAGT with the Lokomat complementing a multidisciplinary rehabilitation program...
December 2016: Developmental Neurorehabilitation
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