Robot-assisted Walking Therapy Using the Lokomat
The Rehabilitation Institute of Chicago (RIC) began clinical trials of robot-assisted walking therapy with the Lokomat® when it was first approved by the Food & Drug Administration in March 2002. In addition to its research studies, RIC now makes robot-assisted walking therapy available in the clinical setting for inpatients and outpatients.
RIC provides Lokomat therapy to help people improve their ability to walk after disability caused by brain and spinal cord injuries, stroke, or neurological and orthopedic conditions.
(Please note: Robot-assisted walking therapy may not be appropriate for everyone, and certain medical conditions may prohibit your participation in this activity.)
Questions and Answers About Lokomat Walking Therapy
What is robot-assisted walking therapy?
This patient is walking on a unique
apparatus, something with an exoskeleton,
that's moving his legs, which he can't
move himself. It is simulating normal
Robot-assisted walking therapy is a form of physical therapy that uses a robotic device to help a person whose ability to walk has been impaired as a result of stroke, spinal cord or brain injury, neurological or orthopedic condition, learn to walk again.
How does the robotic device work?
The person is suspended in a harness over a treadmill and the frame of the robot, attached by straps to the outside of the legs, moves the legs in a natural walking pattern. A computer controls the pace of walking and measures the body’s response to the movement.
How does robot-assisted walking therapy help a person re-learn to walk?
The exact mechanism for walking is still not clear, but it is believed that the repetitive walking pattern helps the brain and spinal cord work together to re-route signals that were interrupted by injury or illness. Currently, this type of therapy is done with the aid of two or more physical therapists that manually move the patient’s legs in a walking pattern. However, the labor-intensive, strenuous nature and variability of the manual method can limit the frequency and duration of the therapy. With robot-assisted walking therapy, the robotic device does most of the heavy work, the pattern and pace are consistent throughout the session, and the exercise can be sustained over longer periods of time.
Are there other benefits to robot-assisted walking therapy?
In addition to training the brain and spinal cord, robot-assisted walking therapy may help strengthen muscles and improve circulation. Also, the weight bearing nature of the exercise may help strengthen bones at risk for osteoporosis (the loss of calcium from bones that makes them fragile and easy to break) due to lack of use.
Who would benefit from robot-assisted walking therapy?
The primary goal of robot-assisted walking therapy is to regain or improve the ability to walk, so it may be most appropriate for people whose ability to walk has been impaired by brain injury, including stroke, incomplete spinal cord injury, or some other neurological or orthopedic condition, such as multiple sclerosis or hip replacement. Among other criteria for participation in robot-assisted walking therapy, a person must have some sensation or movement in at least one major muscle group in the leg. An evaluation by an RIC physician would be required for a course of treatment to be prescribed.
Who should not participate in robot-assisted walking therapy?
As with any form of physical exercise, a person should have a complete physical evaluation to determine if robot-assisted walking therapy is right for them. However, people with certain conditions would generally not be considered good candidates for robot-assisted walking therapy. These conditions include cardiopulmonary disease, high blood pressure or blood pressure that changes dramatically when standing up or walking, seizures, diabetes, unhealed incisions or pressure sores, severe osteoporosis, swelling or contracture of the legs and other conditions that would make independent walking unsafe. An evaluation by a RIC physician would be required for a course of treatment to be prescribed.
How much does robot-assisted walking therapy cost?
The cost of robot-assisted walking therapy will vary according to how often and how long it is required to achieve the maximum benefit for each individual. Many healthcare insurance providers cover robot-assisted walking therapy; you should consult your insurance provider for details.
Where can I participate in robot-assisted walking therapy?
RIC currently offers robot-assisted walking therapy only in the inpatient, outpatient and research centers of our Flagship Hospital, which is located at 345 E. Superior Street in Chicago, Illinois.
How often does a person need to participate in robot-assisted walking therapy?
The effectiveness of robot-assisted walking therapy varies from person to person, so patients should be able to commit to a minimum of 60 minutes of therapy per day, three days per week, for four to eight weeks. Periodic evaluations will be conducted to determine if more sessions would be helpful in achieving the maximum benefit.
How do I schedule an appointment for a physician evaluation for robot-assisted walking therapy?
Based upon the information supplied to RIC, clinical staff will make a preliminary determination of the appropriateness of robot-assisted walking therapy. You will be contacted to determine how best to proceed, which may include scheduling a physician evaluation.
Are the results of robot-assisted walking therapy guaranteed?
No, the results of robot-assisted walking therapy or any other type of therapy are not guaranteed. However, during the course of therapy, periodic evaluations will be conducted to measure improvement and determine if more sessions may help to achieve the maximum benefit.