Technology Spotlight: Lokomat

Lokomat RehabilitationA new machine is helping neurological surgery patients make great strides towards recovery – literally.

Named Lokomat, the machine combines high-tech, robotic mechanical legs with low-tech ropes, a body harness and a treadmill to offer intensive locomotion therapy to patients recovering from spinal cord or brain damage. Enclosed in the robotic legs, the patient’s own legs are forced to move in time to a rhythmic, mechanical cadence, while the system also powers sympathetic arm movements and adjusts the height of the torso to resemble a natural-looking gait for each stride.

“The idea behind the Lokomat is to allow retraining – in effect, repatterning – of neurological function after nervous system injury,” says Kim Burcheil, M.D., Professor and Chair of the Department of Neurological Surgery. “If a patient has spinal cord or brain damage, it may allow the nervous system to practice using other circuits to permit and perform movement in a way that passive physical therapy cannot.”

In addition to supporting and enabling the mechanics of walking, the Lokomat provides data to the therapist overseeing the session. Lokomat measures a patient’s activity through “force transducers” fitted directly to the machine’s drives, allowing the level of gait assistance to be adjusted for each leg. Lokomat also has a system that monitors the patient’s gait and provides real-time visual performance and feedback to motivate the patient. It can measure hip and knee stiffness, the isometric force generated by the patient, and range of motion in the hip and knee.

Traditional therapy for such patients has involved two therapists, one on each leg, exerting considerable physical effort on behalf of the patient, but unable to assess the effect of the therapy on the upper body. With the balance and mechanical responsibility now taken on by the machine, a single therapist can observe to determine how best to manipulate the individual controls to suit the patient’s natural gait and other unique locomotive characteristics.

Dr. Burchiel considers such technology as the future of neurological rehabilitation therapy. “Our center has a concentrated effort in rehabilitative, medical and surgical treatments of the worst nervous system disorders and injuries. As such, we need the best and most advanced therapies for rehabilitation, which is exactly what the Lokomat represents,” he says. “Very few centers in the U.S. have such advanced tools.”

The Lokomat  was acquired in June 2007 through the generosity of Alan Amerson, president of Amerson Precision Sheet Metal Inc. in McMinnville, and a patient of Dr. Burchiel’s. It is the only Lokomat machine between Vancouver, British Columbia, and San Francisco.