Motor and psychosocial impact of robot-assisted gait training in a real-world rehabilitation setting: A pilot study

PLOS ONE, 2018 · DOI: https://doi.org/10.1371/journal.pone.0191894 · Published: February 14, 2018

Assistive Technology Neurology Rehabilitation

Simple Explanation

This study investigates the impact of robot-assisted gait training (RAGT) using the Lokomat on patients with walking disabilities in a real-world rehabilitation setting. It looks at both motor improvements and psychosocial well-being. The study uses the Psychosocial Impact of Assistive Device Scale (PIADS) to assess how the Lokomat affects patients' ability, adaptability, and self-esteem. It also measures functional improvements using the Functional Independence Measure (FIM). The findings suggest that Lokomat training has a positive psychosocial impact, with patients showing improvements in gait, motor function, and overall well-being, regardless of their specific condition.

Study Duration

Not specified

Participants

39 patients with walking disabilities (Parkinson’s Disease, Spinal Cord Injury, Ictus Event)

Evidence Level

Pilot study

Key Findings

1
Overall, the PIADS score was positive, indicating a generally favorable psychosocial impact of the Lokomat in the rehabilitation setting.
2
Patients significantly improved in gait measure and motor FIM scale, increased treadmill speed, reduced body weight support and guidance force during Lokomat training.
3
No significant differences in psychosocial impact were observed between different pathological subgroups (Parkinson's Disease, Spinal Cord Injury, Stroke).

Research Summary

This pilot study evaluated the psychosocial impact of robot-assisted gait training (RAGT) using the Lokomat in a real-world, in-patient rehabilitation setting, using the Psychosocial Impact of Assistive Device Scale (PIADS). The study found that Lokomat training had a positive psychosocial impact on patients, improving their ability, adaptability, and self-esteem, irrespective of their specific neurological condition. The findings suggest that the bio-psycho-social framework is important when dealing with patients undergoing intensive neuro-rehabilitation for motor impairments with assistive devices.

Practical Implications

Psychosocial Well-being

Emphasizes the importance of considering psychosocial well-being alongside motor improvements in rehabilitation.

Generalized Approval

The Lokomat has a generalized approval, independent of disease, underlining the importance of psychosocial framework for patients training with assistive robotic-devices.

Tailored Interventions

The PIADS, if associated with specifically designed instruments on RAGT impact, could provide significant information enabling clinicians to move towards a tailored and a more effective real-world rehabilitation intervention.

Study Limitations

1
Relatively small group of patients, limiting the strength of our conclusions.
2
PIADS has not been originally designed for RAGT
3
Lack of standard scales makes difficult to compare the results from different researchers for the subjective assessment of robot devices use

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