Robot aids the spinal-cord injured

Lokomat helps people with paralysed legs simulate walking movements

In an attempt to get the brain to signal the body to walk again, doctors are using a robot to remind paralysed patients how to put one foot in front of the other.

Patients are strapped into an “exoskeleton” and held in an upright position as Lokomat, the robot, helps them walk. Lokomat simulates a natural gait: Paraplegics who can move their legs to some degree walk along; those without lower-limb sensation have the robot walk for them.

A computer measures their movements and plots these on a graph, giving neurologists information about where the patient is experiencing the most problems.

Although most success stories are anecdotal to date, animal studies suggest the therapy works, and patients love it, says Dr. Keith Tansey, director of the spinal cord injury program at the University of Texas Southwestern Medical Center at Dallas. “Every patient tells me it’s very invigorating.”

He has been using the new robot for only a short time but thinks the device has great potential. “It’ll give us a whole new way to look at what’s happening with the spinal cord and brain after injury.”

The technology makes sense, he says, because it’s believed paralysis may occur when the brain’s signals to the spinal cord are damaged. Having the body walk again may remind the brain, and repair the signalling.

As patients are harnessed into Lokomat, their personal parameters are entered into the computer, such as their measurement from hip to knee, and knee to ankle, so a comfortable gait is provided. The patient then “walks” anywhere from 15 to 30 minutes. Outpatients come into the hospital to use Lokomat three or four times a week.

Paraplegics with some leg sensation have been making the most progress, but that doesn’t mean Lokomat is not able to help complete paraplegics, even those who have lived with paralysis for many years, Tansey says.

The Lokomat may work best in conjunction with other therapies, such as electrical stimulation of the spinal cord or medication.

There are about 10 other Lokomats in the U.S., and one at McMaster University in Hamilton.

© 2004 The Medical Posting

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