Differences in muscle activity and temporal step parameters between Lokomat guided walking and treadmill walking in post-stroke hemiparetic patients and healthy walkers.
Klaske van Kammen, Anne M Boonstra, Lucas H V van der Woude and 2 others
PMID 28427422WHAT IT FOUND
In 10 post-stroke patients, Lokomat guided walking at 50% guidance produced lower muscle activity than treadmill walking but made step timing more symmetrical.
This was a lab comparison, not evidence of training benefit.
Key findings
01Compared with treadmill walking, Lokomat guided walking at 50% guidance lowered muscle activity in all measured muscles except biceps femoris in both stroke patients and healthy walkers.
02Stroke patients had less temporal step asymmetry in the Lokomat: the single support phase, longer on the unaffected leg during treadmill walking, was similar between legs during Lokomat guided walking.
03The patient group's muscle patterns became more similar to healthy walkers mainly because activity was generally low in both groups during Lokomat guided walking.
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How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only ten stroke patients were studied, and the findings are from one laboratory session, so they may not reflect what happens over a course of Lokomat training. The participants could already walk with aids or intermittent support (Functional Ambulation Classification 2 to 4), so the results may not apply to patients who cannot step at all or who are much more independent. The Lokomat condition used fixed speed, no bodyweight support, 50% guidance, and elastic foot lifters, which may lower ankle muscle activity and differ from routine training where these settings are changed. The order of conditions was fixed, treadmill first, and participants were not told whether to follow the exoskeleton actively or passively, so muscle activity may not represent a typical training task. The study measured muscle activity and step timing, not walking recovery or training outcomes.
Declared interests
The study was funded by the Groningen University Fund. No other conflicts of interest are reported in the supplied text.
The easy way to misread this
Do not conclude that Lokomat guided walking is better for stroke gait rehabilitation because stepping looked more symmetrical. This study measured muscle activity and step timing in one lab session in ten patients, not walking recovery, and the Lokomat lowered muscle activity, which may reduce active contribution.