Gait rehabilitation machines based on programmable footplates

Journal of NeuroEngineering and Rehabilitation, 2007 · DOI: 10.1186/1743-0003-4-2 · Published: February 9, 2007

Assistive Technology Neurorehabilitation Rehabilitation

Simple Explanation

Modern rehabilitation favors repetitive, task-specific training, meaning patients relearn walking by practicing walking movements. Gait rehabilitation machines, particularly those with programmable footplates, address shortcomings of conventional methods. Treadmill training with body weight support allows patients to practice more steps. Gait machines offer repetitive training for floor walking and stair climbing, reducing therapist effort and increasing training intensity. The HapticWalker uses programmable footplates and force sensors, enabling training for various walking situations like stair climbing and perturbations, expanding beyond just floor walking simulation.

Study Duration

Not specified

Participants

155 non-ambulatory stroke patients (DEGAS study)

Evidence Level

RCT (DEGAS study)

Key Findings

1
The DEGAS study showed that machine-supported training (Gait Trainer GT I) resulted in superior gait ability and competence in activities of daily living compared to conventional gait training in stroke patients.
2
Gait Trainer GT I allows patients to practice 800 to 1000 steps per session, a significantly higher number compared to manually assisted treadmill training.
3
The HapticWalker, based on programmable footplates, enables training of arbitrary walking situations, fulfilling task-specific training requirements for motor rehabilitation.

Research Summary

Modern gait rehabilitation emphasizes task-specific and repetitive training, moving away from tone-inhibiting approaches. Gait rehabilitation machines facilitate this by allowing patients to practice numerous steps with reduced therapist effort. The Gait Trainer GT I, utilizing movable footplates, has demonstrated superior outcomes in gait ability and ADL competence for stroke patients in the DEGAS study, attributed to increased training intensity. The HapticWalker extends the footplate concept with programmable features, enabling the simulation of diverse walking scenarios like stair climbing and perturbations, offering a more comprehensive training approach.

Practical Implications

Enhanced Gait Rehabilitation

Gait rehabilitation machines, particularly those with programmable footplates, offer a means to deliver high-intensity, task-specific gait training.

Reduced Therapist Burden

These machines alleviate the physical demands on therapists, allowing them to focus on training supervision and patient-specific adjustments.

Improved Patient Outcomes

Studies such as DEGAS suggest that machine-assisted gait training can lead to improved gait ability and functional independence in stroke patients.

Study Limitations

1
Transfer of learning from one motion pattern to a different one (e.g. transfer from walking on even ground to stair climbing) motion is very limited
2
The tighter the attachment of the leg to a robot arm with a technically limited number of degrees of freedom, the more constrained the resulting leg motion.
3
The workspace and dynamic range of the small Stewart platforms the group designed are very limited and do not allow for natural walking profiles.

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