Abstract:

BACKGROUND: Therapist-assisted treadmill training is good gait training, but it consumes great physical strength of therapists, and requires many persons. Clinical application was limited. Robot-assisted treadmill training has been paid great attention.
OBJECTIVE: To summarize the role of robot in recovery of walking after spinal cord injury (SCI) and its influence on muscle activation patterns and kinematic patterns.
METHODS: The data used in this review were obtained mainly by the first author from the studies on robot, Lokomat, body-weight support treadmill training and gait rehabilitation of SCI reported in PubMed database (http://www.ncbi.nlm.nih.gov/PubMed) from January 1995 to December 2010, using key words of “spinal cord injury, gait, walking, locomotor, locomotion, rehabilitation, robot, robotic, Lokomat”. The author excluded old, repetitive documents and remained 30 articles for summarizing.
RESULTS AND CONCLUSION: Although there is currently no evidence that robot-assisted gait training improves walking function more than other locomotor training strategies. Several advantages of robotic devices are obvious for applications targeting gait rehabilitation. Robotic devices are passive in nature and focus primarily on repeated movements of the limbs via fixed kinematic trajectories. These types of training abolish the cycle-to-cycle variation in the kinematics and the sensorimotor pathways. They also cannot sensitively monitor important characteristics of the training as therapists do. Therapists need to know the robot devices, understand how to change parameters to continuously challenge the subjects, and are able to assess when the workload is inappropriate for the subject’s abilities so that they can maximize voluntary locomotor performance during assisted stepping to augment the recovery of functional walking.