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Robotic-assisted Gait Training as Part of the Rehabilitation Program in Persons with Traumatic and Anoxic Brain Injury

      Research Objectives

      Practice based evidence is lacking on the use of robotic-assisted gait training with the brain injured population. In this preliminary study we investigated patients at our facility with traumatic and anoxic brain injury that use the Lokomat as part of their physical therapy program. We analyzed the injury severity level, disability level, walking speeds, frequency of sessions, body weight support and guidance force provided.

      Design

      Retrospective analysis.

      Setting

      Inpatient and outpatient rehabilitation facility.

      Participants

      12 patients with traumatic brain injury, 3 patients with anoxic brain injury, ages 15 years and older.

      Interventions

      Lokomat training in patients with traumatic and anoxic brain injury.

      Main Outcome Measure(s)

      Disability Rating Scale (DRS), Glasgow Coma Scale (GCS), number of sessions, 10 Meter Walk Test, body weight support, guidance force, speed, time and distance.

      Results

      Initial GCS: 3 to 6; DRS: 5 (moderate) to 20 (extremely severe). Number of sessions: 3 to 11, average walking time: 15-18 minutes, walking speeds 1.59 - 1.75 km/hr. Walking distance averages: first session 375.8 meters (m), last session 512 m. Average body weight support: 43%- 57%, guidance force: 74.9 - 90.15. Two people who were unable to walk before training were able to perform 10MWT after training completed, 2 patients had faster 10MWT speeds after training. Most subjects were unable to perform the 10MWT and remained at this level.

      Conclusions

      Training time and distance increased from first to last sessions, overground walking ability improved in some patients. Guidance force and body weight support varied throughout the sessions. Robotic-assisted gait training can be an important addition to the rehabilitation program for persons with brain injury with a wide range of functional and disability levels.

      Key Words

      Robotics, anoxic brain injury, traumatic brain injury

      Disclosures

      None disclosed.