Can Lokomat therapy with children and adolescents be improved? An adaptive clinical pilot trial comparing Guidance force, Path control, and FreeD

Abstract Background Robot-assisted gait therapy is increasingly being used in pediatric neurorehabilitation to complement conventional physical therapy. The robotic device applied in this study, the Lokomat (Hocoma AG, Switzerland), uses a position control mode (Guidance Force), where exact positions of the knee and hip joints throughout the gait cycle are stipulated. Such a mode has two disadvantages: Movement variability is restricted, and patients tend to walk passively. Kinematic variability and active participation, however, are crucial for motor learning. Recently, two new control modes were introduced. The Path Control mode allows the patient to walk within a virtual tunnel surrounding the ideal movement trajectory. The FreeD was developed to support weight shifting through mediolaterally moveable pelvis and leg cuffs. The aims of this study were twofold: 1) To present an overview of the currently available control modes of the Lokomat. 2) To evaluate if an increase in kinematic variability as provided by the new control modes influenced leg muscle activation patterns and intensity, as well as heart rate while walking in the Lokomat. Methods In 15 adolescents with neurological gait disorders who walked in the Lokomat, 3 conditions were compared: Guidance Force, Path Control, and FreeD. We analyzed surface electromyographic (sEMG) activity from 5 leg muscles of the more affected leg and heart rate. Muscle activation patterns were compared with norm curves. Results Several muscles, as well as heart rate, demonstrated tendencies towards a higher activation during conditions with more kinematic freedom. sEMG activation patterns of the M.rectus femoris and M.vastus medialis showed the highest similarity to over-ground walking under Path Control, whereas walking under FreeD led to unphysiological muscle activation in the tested sample. Conclusions Results indicate that especially Path Control seems promising for adolescent patients undergoing neurorehabilitation, as it increases proximal leg muscle activity while facilitating a physiological muscle activation. Therefore, this may be a solution to increase kinematic variability and patientsâ active participation in robot-assisted gait training.

Tags
Data and Resources
To access the resources you must log in

This item has no data

Identity

Description: The Identity category includes attributes that support the identification of the resource.

Field Value
PID https://www.doi.org/10.6084/m9.figshare.c.3826603.v1
PID https://www.doi.org/10.6084/m9.figshare.c.3826603
URL https://dx.doi.org/10.6084/m9.figshare.c.3826603
URL https://dx.doi.org/10.6084/m9.figshare.c.3826603.v1
Access Modality

Description: The Access Modality category includes attributes that report the modality of exploitation of the resource.

Field Value
Access Right not available
Attribution

Description: Authorships and contributors

Field Value
Author Aurich-Schuler, Tabea
Author Grob, Fabienne
Author Hedel, Hubertus Van
Author LabruyèRe, Rob
Publishing

Description: Attributes about the publishing venue (e.g. journal) and deposit location (e.g. repository)

Field Value
Collected From Datacite
Hosted By figshare
Publication Date 2017-07-14
Publisher Figshare
Additional Info
Field Value
Language Undetermined
Resource Type Dataset
keyword FOS: Biological sciences
system:type dataset
Management Info
Field Value
Source https://science-innovation-policy.openaire.eu/search/dataset?datasetId=dedup_wf_001::cfeaadbf5a9b60a66f2bf51fed18426f
Author jsonws_user
Last Updated 15 December 2020, 18:40 (CET)
Created 15 December 2020, 18:40 (CET)