Robotic walking system that aids regaining walking ability in patients who lost their walking ability completely or partially, is called Lokomat.
What is Robotic Aided Walking Treatment?
Robotic Aided Walking Treatment; is a physical treatment type that targets to regain the patients their walking ability back or correct their walking, who had lost their walking abilities due to neurologic diseases such as stroke, spine injury, brain damage or orthopedic reasons such as hip-knee prosthesis, anterior cruciate ligament injury, with the aid of a robotic device.
How long is Lokomat Treatment being used in the world?
Robotic aided walking treatment is first used in 1995. After obtaining FDA approval to Lokomat use in 2002, robotic aided walking treatment has spread all over the world.
How Lokomat Works?
Lokomat consists of two parts. In the first part the patient is suspended on treadmill in standing upright and tied to robot with the aid of outer straps from legs. The patient’s weight is reduced in certain rates as the result of previous examination with the aids of straps and robot. How to reduce the weight as determined according to the patient's mobility. After determining to which ratio the body weight will be supported by the robot, ratios of the patient’s and device’s contributions to walking is evaluated and works are started.
In the second part, there are computer controlled robotic motors. These robotic pieces are mounted to the legs of the patient with straps by taking the hip and knee joints as reference. When the walking started; while the legs were moving like creating a natural walking movement, receivers on the robotic pieces evaluates the response of body to movement and transmits to computer. With the aid of graphic data created by the computer, at what stage and at what level the patient to have problems in walking are determined. While the leg joints are continuously controlled by computer, robot moves the patient’s legs with natural walking sequence. While robot does not interfere when the patient is in natural walking pattern, robot interferes at necessary level when the walking is impaired. Power measurement receivers on the joints continuously control whether the interaction between patient and Lokomat.
How Lokomat Aids to Patient for Learning Walking?
In patients with lost walking ability, it is highly important to stand up the patient as early as possible for regaining the walking ability and preventing the problems due to immobility. In walking disorders due to neurologic diseases such as stroke and spinal injury, signals coming from the brain cannot reach to muscle In walking disorders due to orthopedic causes, muscles cannot respond to the signals coming from brain.
Repeated walking movement performed with Lokomat aids; regaining the signal flow from brain which is impaired due to disease, simultaneous working of brain and spinal cord, reformation of signal conduction which is interrupted due to disease or injury. Especially in brain and spinal cord patients, lokomat treatment provides reformation of the reflex arc between spinal cord and legs and repetition of movement serials stimulates the nerves and reminds spinal cord how it will initiate and continue walking. With Lokomat treatment sensorial stimulations coming from legs together with visual perception, as the result of the brain’s reorganization and adaptation ability, the duties of the damaged cell groups in the regions that provide walking in brain are learned by other brain cell groups.
What are the Other Benefits of Robotic Aided Walking Treatment?
Lokomat system helps strengthen the muscles and the restoration of blood flow in the legs again in bedridden patients and unable to walk. The bone structure is strengthened of the patient who regained walking ability and osteoporosis and bone fracture risk due to this are prevented. Early standing up the patient prevents the problems such as decubitus ulcers, arterial and venous obstructions and joint limitations due to immobility.
Who can Benefit from Lokomat Treatment?
The main purpose of the treatment is to regain the walking ability to the patients who are unable to walk or to develop walking ability in patients who can walk. For this reason, the patient groups that Lokomat Treatment is recommended commonly are:
- Stroke (cerebral palsy)
- Spinal cord of the neck and waist area
- Brain Injury
- Cerebral Palsy (cerebral palsy in children)
- Parkinson's disease
- Multiple Sclerosis
- After Hip-knee prosthesis surgery
- Anterior and posterior cruciate ligament disease and postoperatively
In order to apply the treatment there must be at least a slight amount of sensory or motor movement in the legs of the patient at least in one main muscle group.
How the Patient is Taken to Treatment?
Like in the other physical treatment applications, the patients are examined in detail by a physical treatment and rehabilitation specialist before the program and if available for the treatment, patient specific treatment program and duration is determined.