Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke

Neurorehabil Neural Repair. 2009 Jan;23(1):5-13. doi: 10.1177/1545968308326632.

Abstract

Objective: To compare the efficacy of robotic-assisted gait training with the Lokomat to conventional gait training in individuals with subacute stroke.

Methods: A total of 63 participants<6 months poststroke with an initial walking speed between 0.1 to 0.6 m/s completed the multicenter, randomized clinical trial. All participants received twenty-four 1-hour sessions of either Lokomat or conventional gait training. Outcome measures were evaluated prior to training, after 12 and 24 sessions, and at a 3-month follow-up exam. Self-selected overground walking speed and distance walked in 6 minutes were the primary outcome measures, whereas secondary outcome measures included balance, mobility and function, cadence and symmetry, level of disability, and quality of life measures.

Results: Participants who received conventional gait training experienced significantly greater gains in walking speed (P=.002) and distance (P=.03) than those trained on the Lokomat. These differences were maintained at the 3-month follow-up evaluation. Secondary measures were not different between the 2 groups, although a 2-fold greater improvement in cadence was observed in the conventional versus Lokomat group.

Conclusions: For subacute stroke participants with moderate to severe gait impairments, the diversity of conventional gait training interventions appears to be more effective than robotic-assisted gait training for facilitating returns in walking ability.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute Disease / therapy
  • Adult
  • Aged
  • Exercise Test / instrumentation
  • Exercise Test / methods*
  • Exercise Therapy / instrumentation*
  • Exercise Therapy / methods
  • Female
  • Gait / physiology
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology
  • Gait Disorders, Neurologic / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology
  • Outcome Assessment, Health Care / methods
  • Physical Therapy Modalities / instrumentation*
  • Postural Balance / physiology
  • Recovery of Function / physiology
  • Robotics / instrumentation*
  • Robotics / methods
  • Stroke / complications
  • Stroke / physiopathology
  • Stroke Rehabilitation*
  • Treatment Outcome
  • Walking / physiology