Locomotor training in subjects with sensori-motor deficits: An overview of the robotic gait orthosis Lokomat

Journal of Healthcare Engineering

Volumn 1, Issue 2, 2010, Pages 197-216

  Riener, Robert ^a,b   Lünenburger, Lars ^b,c   Maier, Irin C ^c,d   Colombo, Gery ^b,c   Dietz, Volker ^b  

^a ETH ZURICH   (Switzerland)

^b BALGRIST UNIVERSITY HOSPITAL   (Switzerland)

^c HOCOMA AG   (Switzerland)

^d UNIVERSITY OF ZURICH   (Switzerland)

Author keywords

Assessment; Biofeedback; Gait; Gait therapy; Locomotion; Lokomat; Rehabilitation; Rehabilitation robotics; Robot aided training

Indexed keywords

EID: 78650818159     PISSN: 20402295     EISSN: 20402309     Source Type: Journal    
DOI: 10.1260/2040-2295.1.2.197     Document Type: Article

References (92)

1. Kelly-Hayes M, Robertson JT, Broderick JP, Duncan PW, Hershey LA, Roth EJ, Thies WH, Trombly CA: The american heart association stroke outcome classification: Executive summary. Circulation 1998;97:2474-2478.
2. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Recovery of walking function in stroke patients: The copenhagen stroke study. Archives of physical medicine and rehabilitation 1995;76:27-32.
3. Waters RL, Adkins R, Yakura J, Sie I: Donal munro lecture: Functional and neurologic recovery following acute sci. J Spinal Cord Med 1998;21:195-199.
4. Barbeau H, Wainberg M, Finch L: Description and application of a system for locomotor rehabilitation. Med Biol Eng Comput 1987;25:341-344.
5. Dietz V, Colombo G, Jensen L, Baumgartner L: Locomotor capacity of spinal cord in paraplegic patients. Ann Neurol 1995;37:574-582.
6. Hesse S, Werner C, von Frankenberg S, Bardeleben A: Treadmill training with partial body weight support after stroke. Phys Med Rehabil Clin N Am 2003;14:S111-123.
7. Teasell RW, Bhogal SK, Foley NC, Speechley MR: Gait retraining post stroke. Topics in stroke rehabilitation 2003;10:34-65.
8. Wernig A, Muller S: Laufband locomotion with with body weight support improved walking in persons with severe spinal cord injuries. Paraplegia 1992;vol. 30:pp. 229-238.
9. Wernig A, Nanassy A, Muller S: Laufband (treadmill) therapy in incomplete paraplegia and tetraplegia. J Neurotrauma 1999;16:719-726.
10. Colombo G, Joerg M, Schreier R, Dietz V: Treadmill training of paraplegic patients using a robotic orthosis. J Rehabil Res Dev 2000;37:693-700.
11. Hesse S, Uhlenbrock D: A mechanized gait trainer for restoration of gait. J Rehabil Res Dev 2000;37:701-708.
12. Cramer SC, Riley JD: Neuroplasticity and brain repair after stroke. Curr Opin Neurol 2008;21:76-82.
13. Dietz V, Harkema SJ: Locomotor activity in spinal cord-injured persons. J Appl Physiol 2004;96:1954-1960.
14. Martino G: How the brain repairs itself: New therapeutic strategies in inflammatory and degenerative cns disorders. Lancet Neurol 2004;3:372-378.
15. Calancie B, Needham-Shropshire B, Jacobs P, Willer K, Zych G, Green BA: Involuntary stepping after chronic spinal cord injury. Evidence for a central rhythm generator for locomotion in man. Brain 1994;117 (Pt 5):1143-1159.
16. Bussel B, Roby-Brami A, Azouvi P, Biraben A, Yakovleff A, Held JP: Myoclonus in a patient with spinal cord transection. Possible involvement of the spinal stepping generator. Brain 1988;111 (Pt 5):1235-1245.
17. Dietz V, Colombo G, Jensen L: Locomotor activity in spinal man. Lancet 1994;344:1260-1263.
18. Dietz V: Body weight supported gait training: From laboratory to clinical setting. Brain Res Bull 2008;76:459-463.
19. Dietz V, Grillner S, Trepp A, Hubli M, Bolliger M: Changes in spinal reflex and locomotor activity after a complete spinal cord injury: A common mechanism? Brain 2009.
20. Dobkin BH, Harkema S, Requejo P, Edgerton VR: Modulation of locomotor-like emg activity in subjects with complete and incomplete spinal cord injury. J Neurol Rehabil 1995;9:183-190.
21. Harkema SJ, Hurley SL, Patel UK, Requejo PS, Dobkin BH, Edgerton VR: Human lumbosacral spinal cord interprets loading during stepping. J Neurophysiol 1997;77:797-811.
22. Pearson KG, Collins DF: Reversal of the influence of group ib afferents from plantaris on activity in medial gastrocnemius muscle during locomotor activity. J Neurophysiol 1993;70:1009-1017.
23. Dietz V: Human neuronal control of automatic functional movements: Interaction between central programs and afferent input. Physiol Rev 1992;72:33-69.
24. Dietz V, Muller R, Colombo G: Locomotor activity in spinal man: Significance of afferent input from joint and load receptors. Brain 2002;125:2626-2634.
25. Wirz M, Zemon DH, Rupp R, Scheel A, Colombo G, Dietz V, Hornby TG: Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: Amulticenter trial. Archives of physical medicine and rehabilitation 2005;86:672-680.
26. Curt A, Dietz V: Traumatic cervical spinal cord injury: Relation between somatosensory evoked potentials, neurological deficit, and hand function. Archives of physical medicine and rehabilitation 1996;77:48-53.
27. Curt A, Dietz V: Ambulatory capacity in spinal cord injury: Significance of somatosensory evoked potentials and asia protocol in predicting outcome. Archives of physical medicine and rehabilitation 1997;78:39-43.
28. Curt A, Keck ME, Dietz V: Functional outcome following spinal cord injury: Significance of motorevoked potentials and asia scores. Archives of physical medicine and rehabilitation 1998;79:81-86.
29. Katoh S, el Masry WS: Neurological recovery after conservative treatment of cervical cord injuries. J Bone Joint Surg Br 1994;76:225-228.
30. Barbeau H, Visintin M: Optimal outcomes obtained with body-weight support combined with treadmill training in stroke subjects. Archives of physical medicine and rehabilitation 2003;84:1458-1465.
31. Dietz V: Locomotor training in paraplegic patients. Ann Neurol 1995;38:965.
32. Visintin M, Barbeau H, Korner-Bitensky N, Mayo NE: A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke 1998;29:1122-1128.
33. Dobkin B, Barbeau H, Deforge D, Ditunno J, Elashoff R, Apple D, Basso M, Behrman A, Harkema S, Saulino M, Scott M: The evolution of walking-related outcomes over the first 12 weeks of rehabilitation for incomplete traumatic spinal cord injury: The multicenter randomized spinal cord injury locomotor trial. Neurorehabil Neural Repair 2007;21:25-35.
34. Moseley AM, Stark A, Cameron ID, Pollock A: Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev 2003:CD002840.
35. Dietz V: Good clinical practice in neurorehabilitation. Lancet Neurol 2006;5:377-378.
36. Morrison SA, Backus D: Locomotor training: Is translating evidence into practice financially feasible? J Neurol Phys Ther 2007;31:50-54.
37. Veneman JF, Kruidhof R, Hekman EE, Ekkelenkamp R, Van Asseldonk EH, van der Kooij H: Design and evaluation of the lopes exoskeleton robot for interactive gait rehabilitation. IEEE Trans Neural Syst Rehabil Eng 2007;15:379-386.
38. Banala SK, Kim SH, Agrawal SK, Scholz JP: Robot assisted gait training with active leg exoskeleton (alex). IEEE Trans Neural Syst Rehabil Eng 2009;17:2-8.
39. Aoyagi D, Ichinose WE, Harkema SJ, Reinkensmeyer DJ, Bobrow JE: A robot and control algorithm that can synchronously assist in naturalistic motion during body-weight-supported gait training following neurologic injury. IEEE Trans Neural Syst Rehabil Eng 2007;15:387-400.
40. Ruthenberg BJ, Wasylewski NA, Beard JE: An experimental device for investigating the force and power requirements of a powered gait orthosis. J Rehabil Res Dev 1997;34:203-213.
41. Lünenburger L, Lam T, Riener R, Colombo G: Gait retraining after neurological disorders. in M Akay (ed) Wiley Encyclopedia for Biomedical Engineering: John Wiley & Sons, Hoboken, NJ 2006.
42. Frey M, Colombo G, Vaglio M, Bucher R, Jorg M, Riener R: A novel mechatronic body weight support system. IEEE Trans Neural Syst Rehabil Eng 2006;14:311-321.
43. Colombo G, Bucher R: Device for adjusting the prestress of an elastic means around a predetermined tension or position patent wo2008040554 (a1).
44. Bernstein NA: The co-ordination and regulation of movements. Pergamon Press Ltd, first English edition 1967.
45. Huang VS, Krakauer JW: Robotic neurorehabilitation: A computational motor learning perspective. J Neuroeng Rehabil 2009;6:5.
46. Lewek MD, Cruz TH, Moore JL, Roth HR, Dhaher YY, Hornby TG: Allowing intralimb kinematic variability during locomotor training poststroke improves kinematic consistency: A subgroup analysis from a randomized clinical trial. Phys Ther 2009.
47. Duschau-Wicke A, von Zitzewitz J, Caprez A, Lunenburger L, Riener R: Path control: A method for patient-cooperative robot-aided gait rehabilitation. IEEE Trans Neural Syst Rehabil Eng 2010;18:38-48.
48. Riener R, Lunenburger L, Jezernik S, Anderschitz M, Colombo G, Dietz V: Patient-cooperative strategies for robot-aided treadmill training: First experimental results. IEEE Trans Neural Syst Rehabil Eng 2005;13:380-394.
49. Hogan N: Impedance control: An approach to manipulation. arts I, II, III J Dyn Syst-T ASME 1985;107:1-23.
50. Lance JW: Spasticity: Disordered motor control. Year Book, chapter Pathophysiology of spasticity and clinical experience with Baclofen 1980:184-204.
51. Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW: Classification and definition of disorders causing hypertonia in childhood. Pediatrics 2003;111:e89-97.
52. Ashworth B: Preliminary trial of carisoprodol in multiple sclerosis. Practitioner 1964;192:540-542.
53. Bohannon RW, Smith MB: Interrater reliability of a modified ashworth scale of muscle spasticity. Phys Ther 1987;67:206-207.
54. Lünenburger L, Colombo G, Riener R, Dietz V: Clinical assessments performed during robotic rehabilitation by the gait training robot lokomat. 2005:345-348.
55. Riener R, Lunenburger L, Colombo G: Human-centered robotics applied to gait training and assessment. J Rehabil Res Dev 2006;43:679-694.
56. Bolliger M, Lünenburger L, Bircher S, Colombo G, Dietz V: Reliability of measuring isometric peak torque in the driven gait orthosis "lokomat". in 4th World Congress of Neurorehabilitation, Hong Kong, 2006.
57. Basmajian JV: Muscles alive: Their functions revealed by electromyography. 4th edition Baltimore, Md, Williams and Wilkins 1978:495.
58. Schmidt RA, Wrisberg CA: Motor learning and performance. 2nd Edition, Campaign, Windsor, Leeds, Human Kinetics 2000.
59. Lunenburger L, Colombo G, Riener R: Biofeedback for robotic gait rehabilitation. J Neuroeng Rehabil 2007;4:1.
60. Lunenburger L, Colombo G, Riener R, Dietz V: Biofeedback in gait training with the robotic orthosis lokomat. Conf Proc IEEE Eng Med Biol Soc 2004;7:4888-4891.
61. Banz R, Bolliger M, Colombo G, Dietz V, Lunenburger L: Computerized visual feedback: An adjunct to robotic-assisted gait training. Phys Ther 2008;88:1135-1145.
62. Banz R, Bolliger M, Muller S, Santelli C, Riener R: A method of estimating the degree of active participation during stepping in a driven gait orthosis based on actuator force profile matching. IEEE Trans Neural Syst Rehabil Eng 2009;17:15-22.
63. Lünenburger L, Wellner M, Banz R, Colombo G, Riener R: Combining immersive virtual environments with robot-aided gait training. in 10th International Conference on Rehabilitation Robotics (ICORR), Noordwijk 2007.
64. Beer S, Aschbacher B, Manoglou D, Gamper E, Kool J, Kesselring J: Robot-assisted gait training in multiple sclerosis: A pilot randomized trial. Mult Scler 2008;14:231-236.
65. Borggraefe I, Kiwull L, Schaefer JS, Koerte I, Blaschek A, Meyer-Heim A, Heinen F: Sustainability of motor performance after robotic-assisted treadmill therapy in children: An open, non-randomized baseline-treatment study. Eur J Phys Rehabil Med 2010.
66. Borggraefe I, Meyer-Heim A, Kumar A, Schaefer JS, Berweck S, Heinen F: Improved gait parameters after robotic-assisted locomotor treadmill therapy in a 6-year-old child with cerebral palsy. Mov Disord 2008;23:280-283.
67. Borggraefe I, Schaefer JS, Klaiber M, Dabrowski E, Ammann-Reiffer C, Knecht B, Berweck S, Heinen F, Meyer-Heim A: Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy. Eur J Paediatr Neurol 2010.
68. Hidler J, Nichols D, Pelliccio M, Brady K, Campbell DD, Kahn JH, Hornby TG: Multicenter randomized clinical trial evaluating the effectiveness of the lokomat in subacute stroke. Neurorehabil Neural Repair 2009;23:5-13.
69. Hornby TG, Campbell DD, Kahn JH, Demott T, Moore JL, Roth HR: Enhanced gait-related improvements after therapist-versus robotic-assisted locomotor training in subjects with chronic stroke: A randomized controlled study. Stroke 2008;39:1786-1792.
70. Hornby TG, Zemon DH, Campbell D: Robotic-assisted, body-weight-supported treadmill training in individuals following motor incomplete spinal cord injury. Phys Ther 2005;85:52-66.
71. Husemann B, Muller F, Krewer C, Heller S, Koenig E: Effects of locomotion training with assistance of a robot-driven gait orthosis in hemiparetic patients after stroke: Arandomized controlled pilot study. Stroke 2007;38:349-354.
72. Lo AC, Triche EW: Improving gait in multiple sclerosis using robot-assisted, body weight supported treadmill training. Neurorehabil Neural Repair 2008;22:661-671.
73. Mayr A, Kofler M, Quirbach E, Matzak H, Frohlich K, Saltuari L: Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the lokomat gait orthosis. Neurorehabil Neural Repair 2007;21:307-314.
74. Meyer-Heim A, Ammann-Reiffer C, Schmartz A, Schafer J, Sennhauser FH, Heinen F, Knecht B, Dabrowski E, Borggraefe I: Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy. Arch Dis Child 2009;94:615-620.
75. Meyer-Heim A, Borggraefe I, Ammann-Reiffer C, Berweck S, Sennhauser FH, Colombo G, Knecht B, Heinen F: Feasibility of robotic-assisted locomotor training in children with central gait impairment. Dev Med Child Neurol 2007;49:900-906.
76. Schwartz I, Sajin A, Fisher I, Neeb M, Shochina M, Katz-Leurer M, Meiner Z: The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients: A randomized controlled trial. PM R 2009;1:516-523.
77. Westlake KP, Patten C: Pilot study of lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke. J Neuroeng Rehabil 2009;6:18.
78. Winchester P, McColl R, Querry R, Foreman N, Mosby J, Tansey K, Williamson J: Changes in supraspinal activation patterns following robotic locomotor therapy in motor-incomplete spinal cord injury. Neurorehabil Neural Repair 2005;19:313-324.
79. Nooijen CF, Ter Hoeve N, Field-Fote EC: Gait quality is improved by locomotor training in individuals with sci regardless of training approach. J Neuroeng Rehabil 2009;6:36.
80. Mirbagheri MM, C. Tsao, C., Pelosin E., Rymer W. Z: Therapeutic effects of robotic-assisted locomotor training on neuromuscular properties. Proceedings of the 2005 IEEE, 9th International Conference on Rehabilitation Robotics 2005.
81. Sherman MF, Lam T, Sheel AW: Locomotor-respiratory synchronization after body weight supported treadmill training in incomplete tetraplegia: A case report. Spinal Cord 2009.
82. Hunt KJ, Jack A, Pennycott A, Perret C, Baumberger TH, Kakebeeke TH: Control of work rate-driven exercise facilitates cardiopulmonary training and assessment during robot-assisted gait in incomplete spinal cord injury. Biomed Signal Process Control 2007.
83. Israel JF, Campbell DD, Kahn JH, Hornby TG: Metabolic costs and muscle activity patterns during robotic-and therapist-assisted treadmill walking in individuals with incomplete spinal cord injury. Phys Ther 2006;86:1466-1478.
84. Meyer-Heim A, Ammann-Reiffer C, Schmartz A, Schaefer J, Sennhauser FH, Heinen F, Knecht B, Dabrowski ER, Borggraefe I: Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy. Arch Dis Child 2009.
85. Kwakkel G, Wagenaar RC, Twisk JW, Lankhorst GJ, Koetsier JC: Intensity of leg and arm training after primary middle-cerebral-artery stroke: A randomised trial. Lancet 1999;354:191-196.
86. Nash MS, Jacobs PL, Johnson BM, Field-Fote E: Metabolic and cardiac responses to robotic-assisted locomotion in motor-complete tetraplegia: A case report. J Spinal Cord Med 2004;27:78-82.
87. Blicher JU, Nielsen JF: Cortical and spinal excitability changes after robotic gait training in healthy participants. Neurorehabil Neural Repair 2009;23:143-149.
88. Kamibayashi K, Nakajima T, Takahashi M, Akai M, Nakazawa K: Facilitation of corticospinal excitability in the tibialis anterior muscle during robot-assisted passive stepping in humans. Eur J Neurosci 2009.
89. Querry RG, Pacheco F, Annaswamy T, Goetz L, Winchester PK, Tansey KE: Synchronous stimulation and monitoring of soleus h reflex during robotic body weight-supported ambulation in subjects with spinal cord injury. J Rehabil Res Dev 2008;45:175-186.
90. Dietz V, Muller R: Degradation of neuronal function following a spinal cord injury: Mechanisms and countermeasures. Brain 2004;127:2221-2231.
91. Magagnin V, Caiani EG, Fusini L, Turiel M, Licari V, Bo I, Cerutti S, Porta A: Assessment of the cardiovascular regulation during robotic assisted locomotion in normal subjects: Autoregressive spectral analysis vs empirical mode decomposition. Conf Proc IEEE Eng Med Biol Soc 2008;2008:3844-3847.
92. Magagnin V, Porta A, Fusini L, Licari V, Bo I, Turiel M, Molteni F, Cerutti S, Caiani EG: Evaluation of the autonomic response in healthy subjects during treadmill training with assistance of a robotdriven gait orthosis. Gait Posture 2009;29:504-508.