Is intensive gait training feasible and effective at old age? A retrospective case-control study on the use of Lokomat Free-D in patients with chronic stroke.

BACKGROUND: In the last decade, the number of people over 60 has increased, leading to various healthcare problems. The aim of this retrospective study is to evaluate the effects of robotic rehabilitation in elderly patients as well as their perception of usability and adaptation to intensive robotic neurorehabilitation. METHODS: This is a retrospective case-control study. Eighty elderly stroke patients were included in the analysis using an electronic data retrieval system. The enrolled patients were divided into two groups: the experimental group (EG) underwent rehabilitation training with Lokomat FreeD, equipped with a VR screen, while the control group (CG) performed traditional rehabilitation training. The two groups matched for age, sex, education, brain injury, stroke interval. The rehabilitation protocol included a total of 40 training sessions. RESULTS: Both types of rehabilitation led to an improvement in the perceived level of disability (FIM) and in the performance in gait and balance (TT), highlighting a significant improvement especially in the EG. However, only in the EG, Lokomat training had induced an increase in the distance covered in 10 min (10 m walk test), and a significant improvement in mood (HRS-D). Moreover, Lokomat-FreeD was well tolerated by patients with high levels of usability. CONCLUSIONS: Our results suggest that elderly patients may benefit from high-intensity robotic neurorehabilitation using the Lokomat-Pro FreeD.

A Case Report on Robot-Aided Gait Training in Primary Lateral Sclerosis Rehabilitation: Rationale, Feasibility and Potential Effectiveness of a Novel Rehabilitation Approach.

Primary lateral sclerosis (PLS) is an adult-onset idiopathic disorder of the upper motor neuron system. Robot-aided rehabilitation with the Lokomat-Pro (LT) allows maximizing motor training by finely and individually controlling motor activation. No data are currently available on the use of robot-aided rehabilitation in PLS. The aim of this case study was to evaluate the effectiveness of a customized robotic rehabilitation protocol in PLS. A 54-year-old woman, diagnosed with PLS five years before admission, came to our clinic to undergo rehabilitation training due to gait difficulties with spastic paraparesis. The patient was treated with two different approaches: conventional physiotherapy followed by a combined approach (i.e. PT plus LT). After the conventional PT rehabilitation, no significant functional improvement was noted. However, the combined approach led to a significant improvement in functional motor skills, including walking, balance and lower limb muscle strength, and spasticity. Our experimental training combining robot-aided and conventional rehabilitation could be a promising approach to mitigate the PLS disability burden.