PTOtherJournal of neuroengineering and rehabilitation2023

The FreeD module's lateral translation timing in the gait robot Lokomat: a manual adaptation is necessary.

Tabea Aurich-Schuler, Florian van Dellen, Rob Labruyère

PMID 37596647

WHAT IT FOUND

Default settings on the Lokomat FreeD module shift weight to the stance leg too early in the gait cycle.

Manually delaying the timing by about 5% moves this weight shift closer to the pattern seen in normal overground walking.

Key findings

01The default setting caused the maximum lateral shift of the center of mass to occur at 20.9% of the gait cycle, which is too early compared to the typical 30% seen in healthy walking.

02When therapists manually adjusted the timing, the maximum lateral shift moved to 29.1% of the gait cycle, closely matching the physiological timing of overground walking.

03Therapists' visual assessment of the necessary delay correlated moderately with the actual measured change in timing.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was cross-sectional and only measured immediate kinematic effects. It did not assess whether the more physiological gait pattern leads to better training outcomes or improved walking ability. The analysis focused solely on the center of mass and did not evaluate leg or trunk kinematics. The lateral translation distance was fixed at 2 cm for all participants regardless of their height or leg length. The study used a customized Lokomat setup where leg cuffs could move medially and laterally, which may not reflect standard clinical configurations. Therapists adjusted the timing based on visual observation of the pelvis, while the measurement analyzed the center of mass inside the body, introducing potential discrepancies.

Declared interests

Funding was provided by the Olga Mayenfisch Stiftung, J&K Wonderland Foundation, Stiftung Cerebral, and the Walter Muggli Fonds of the Accentus Foundation. The study was conducted at the Swiss Children’s Rehab of the University Children’s Hospital Zurich.

The easy way to misread this

Do not assume that the more physiological weight-shifting pattern observed in this study improves the effectiveness of gait training. The study only measured immediate kinematics and did not evaluate functional outcomes or long-term training benefits.

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