Effects of asymmetrical support on lower limb muscle activity during Lokomat guided gait in persons with a chronic stroke: an explorative study.
Sylvana Minkes-Weiland, Heleen A Reinders-Messelink, Anne M Boonstra and 2 others
PMID 36102326WHAT IT FOUND
Changing Lokomat guidance levels, whether symmetrical or asymmetrical, did not alter lower limb muscle activity in ten people with chronic stroke.
The exoskeleton provided enough support that muscle effort remained low and unchanged across all tested conditions.
Key findings
01There was no significant interaction between guidance level and symmetry, indicating that asymmetrical settings did not alter muscle activity compared to symmetrical ones.
02Symmetrical changes in guidance levels generally had no effect on muscle activity, with only one small cluster in the vastus medialis of the affected leg at the higher speed showing a decrease.
03Muscle activity in all Lokomat conditions was remarkably low compared to unrestrained treadmill walking, suggesting the exoskeleton provided sufficient support to minimize active muscular involvement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only ten participants, which limits the generalizability of the findings. It measured only immediate effects, so it does not account for how patients might adapt to different settings over time. Participants were not instructed to try harder or be more active when guidance was reduced, which may have influenced the lack of change in muscle activity. Individual responses varied, with some participants reacting differently to guidance changes, suggesting that a one-size-fits-all approach to setting guidance may not be effective.
Declared interests
The authors declared no conflicts of interest. The study was conducted at Revalidatie Friesland, and the Lokomat was provided by Hocoma AG, but the text does not specify funding sources or author financial ties.
The easy way to misread this
Do not assume that reducing guidance levels will automatically increase a patient's muscle activity or effort. This study found that muscle activity remained low and unchanged across all guidance settings, likely because the exoskeleton provided sufficient support regardless of the level of assistance.