Abstract
This study deals with the use of a robot-assisted body-weight-supported treadmill training in multiple sclerosis (MS) patients with gait dysfunction. Twenty MS patients (10 men and 10 women) of the mean of 46.3 ± 8.5 years were assigned to a six-week-long training period with the use of robot-assisted treadmill training of increasing intensity of the Lokomat type. The outcome measure consisted of the difference in motion-dependent torque of lower extremity joint muscles after training compared with baseline before training. We found that the training uniformly and significantly augmented the torque of both extensors and flexors of the hip and knee joints. The muscle power in the lower limbs of SM patients was improved, leading to corrective changes of disordered walking movements, which enabled the patients to walk with less effort and less assistance of care givers. The torque augmentation could have its role in affecting the function of the lower extremity muscle groups during walking. The results of this pilot study suggest that the robot-assisted body-weight-supported treadmill training may be a potential adjunct measure in the rehabilitation paradigm of ‘gait reeducation’ in peripheral neuropathies.
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Aurich T, Warken B, Graser JV, Ulrich T, Borggraefe I, Heinen F, Meyer-Heim A, van Hedel HJ, Schroeder AS (2015) Practical recommendations for robot-assisted treadmill therapy (Lokomat) in children with cerebral palsy: indications, goal setting, and clinical implementation within the WHO-ICF framework. Neuropediatrics 46:248–260
Beer S, Aschbacher B, Manoglou D, Gamper E, Kool J, Kesselring J (2008) Robot-assisted gait training in multiple sclerosis: a pilot randomized trial. Mult Scler 14(2):231–236
Calabrò RS, De Luca R, Leo A, Balletta T, Marra A, Bramanti P (2015) Lokomat training in vascular dementia: motor improvement and beyond! Aging Clin Exp Res 27:935–937
Dierick F, Dehas M, Isambert JL, Injeyan S, Bouché AF, Bleyenheuft Y, Portnoy S (2017) Hemorrhagic versus ischemic stroke: who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy? PLoS One 12(6):e0178636
Gandara-Sambade T, Fernandez-Pereira M, Rodriguez-Sotillo A (2017) Robotic systems for gait re-education in cases of spinal cord injury: a systematic review. Rev Neurol 64(5):205–213. (Article in Spanish)
Gor-García-Fogeda MD, Cano de la Cuerda R, Carratalá Tejada M, Alguacil-Diego IM, Molina-Rueda F (2016) Observational gait assessments in people with neurological disorders: a systematic review. Arch Phys Med Rehabil 97(1):131–140
Hart DL, Stobbe TJ, Till CV, Plummer RW (1984) Effect of muscle stabilization on quadriceps femoris torque. Phys Ther 64(9):1375–1380
Hoy MG, Zajac FE, Gordon ME (1990) A musculoskeletal model of the human lower extremity: the effect of muscle, tendon, and moment arm on the moment-angle relationship of musculotendon actuators at the hip, knee, and ankle. J Biomech 23:157–169
Kumru H, Benito-Penalva J, Valls-Sole J, Murillo N, Tormos JM, Flores C, Vidal J (2016a) Placebo-controlled study of rTMS combined with Lokomat® gait training for treatment in subjects with motor incomplete spinal cord injury. Exp Brain Res 234(12):3447–3455
Kumru H, Murillo N, Benito-Penalva J, Tormos JM, Vidal J (2016b) Transcranial direct current stimulation is not effective in the motor strength and gait recovery following motor incomplete spinal cord injury during Lokomat® gait training. Neurosci Lett 620:143–147
Lieber RL, Shoemaker SD (1992) Muscle, joint, and tendon contributions to the torque profile of frog hip joint. Am J Phys 263:R586–R590
McClearn D (1985) Anatomy of raccoon (Procyon lotor) and caoti (Nasua narica and N. nasua) forearm and leg muscles: relations between fiber length, moment-arm length, and joint excursion. J Morphol 183:87–115
Morawietz C, Moffat F (2013) Effects of locomotor training after incomplete spinal cord injury: a systematic review. Arch Phys Med Rehabil 94(11):2297–2308
Nam KY, Kim HJ, Kwon BS, Park JW, Lee HJ, Yoo A (2017) Robot-assisted gait training (Lokomat) improves walking function and activity in people with spinal cord injury: a systematic review. J Neuroeng Rehabil 14:24
Neckel ND, Blonien N, Nichols D, Hidler J (2008) Abnormal joint torque patterns exhibited by chronic stroke subjects while walking with a prescribed physiological gait pattern. J Neuroeng Rehabil 5:19
Polman CH et al (2010) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69(2):292–302
Schwartz I, Sajin A, Moreh E, Fisher I, Neeb M, Forest A, Vaknin-Dembinsky A, Karusis D, Meiner Z (2012) Robot-assisted gait training in multiple sclerosis patients: a randomized trial. Mult Scler 18:881–890
Swinnen E, Beckwée D, Pinte D, Meeusen R, Baeyens JP, Kerckhofs E (2012) Treadmill training in multiple sclerosis: can body weight supportor robot assistance provide added value? A systematic review. Mult Scler Int 2012:240274
van Kammen K, Boonstra AM, van der Woude LH, Reinders-Messelink HA, den Otter R (2016) The combined effects of guidance force, bodyweight support and gait speed on muscle activity during able-bodied walking in the Lokomat. Clin Biomech (Bristol, Avon) 36:65–73
van Kammen K, Boonstra AM, van der Woude LH, Reinders-Messelink HA, den Otter R (2017) Differences in muscle activity and temporal step parameters between Lokomat guided walking and treadmill walking in post-stroke hemiparetic patients and healthy walkers. J Neuroeng Rehabil 14(1):32
Vaney C, Gattlen B, Lugon-Moulin V, Meichtry A, Hausammann R, Foinant D, Anchisi-Bellwald AM, Palaci C, Hilfiker R (2012) Robotic-assisted step training (Lokomat) not superior to equal intensity of over-ground rehabilitation in patients with multiple sclerosis. Neurorehabil Neural Repair 26(3):212–221
Wallard L, Dietrich G, Kerlirzin Y, Bredin J (2017) Robotic-assisted gait training improves walking abilities in diplegic children with cerebral palsy. Eur J Paediatr Neurol 21:557–564
Wier LM, Hatcher MS, Triche EW, Lo AC (2011) Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. J Rehabil Res Dev 48(4):483–492
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Łyp, M., Stanisławska, I., Witek, B., Olszewska-Żaczek, E., Czarny-Działak, M., Kaczor, R. (2018). Robot-Assisted Body-Weight-Supported Treadmill Training in Gait Impairment in Multiple Sclerosis Patients: A Pilot Study. In: Pokorski, M. (eds) Progress in Medical Research. Advances in Experimental Medicine and Biology(), vol 1070. Springer, Cham. https://doi.org/10.1007/5584_2018_158
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DOI: https://doi.org/10.1007/5584_2018_158
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