Kinematic trajectories while walking within the Lokomat robotic gait-orthosis

Background One of the most popular robot assisted rehabilitation devices used is the Lokomat. Unfortunately, not much is known about the behaviors exhibited by subjects in this device. The goal of this study was to evaluate the kinematic patterns of individuals walking inside the Lokomat compared to those demonstrated on a treadmill. Methods Six healthy subjects walked on a treadmill and inside the Lokomat while the motions of the subject and Lokomat were tracked. Joint angles and linear motion were determined for Lokomat and treadmill walking. We also evaluated the variability of the patterns, and the repeatability of measuring techniques. Findings The overall kinematics in the Lokomat are similar to those on a treadmill, however there was significantly more hip and ankle extension, and greater hip and ankle range of motion in the Lokomat (P<0.05). Additionally, the linear movement of joints was reduced in the Lokomat. Subjects tested on repeated sessions presented consistent kinematics, demonstrating the ability to consistently setup and test subjects. Interpretation The reduced degrees of freedom in the Lokomat are believed to be the reason for the specific kinematic differences. We found that despite being firmly attached to the device there was still subject movement relative to the Lokomat. This led to variability in the patterns, where subjects altered their gait pattern from step to step. These results are clinically important as a variable step pattern has been shown to be a more effective gait training strategy than one which forces the same kinematic pattern in successive steps.