February 22, 2013
The Michael E. DeBakey VA Medical Center (MEDVAMC) provides robot-assisted walking therapy to help Veterans suffering from stroke, spinal cord injuries, as well as other neurologic conditions.
“When I first entered the hospital, I was unable to walk or do much of anything,” said Gulf War Veteran Daniel Murphy from Bastrop, TX. “I had the opportunity to try out robot-assisted walking therapy in conjunction with other methods of treatment after I suffered my stroke.”
The patient is suspended in a harness over a state-of-the-art treadmill device called a Lokomat®. The frame of the robot, attached by straps to the outside of the legs, moves the patient’s legs in a natural walking pattern. A computer monitors the speed and natural motion of the legs, creating a repetitive walking pattern that seems to help strengthen the muscles, improve circulation, and teach the brain to use and recognize walking motions.
“Besides the obvious primary goal of improving ambulation, the weight-bearing nature of this device can also have an effect on range of motion, bone density, and spasticity,” said John Kertz, M.P.T., N.C.S., a physical therapist in the Spinal Cord Injury Care Line.
The majority of patients treated with the Lokomat® have had their ability to walk impaired due to a stroke, spinal cord injury, or other neurologic condition. The therapy is accomplished during a minimum of 60-minute sessions once a day, three days per week, for four to eight weeks. The computer charts patient progress with measurements for strength, range of motion, and distance.
“This device encourages the patient to walk with a more normal gait. This continuous repetition of movement promotes motor control and neuroplasticity,” said Angelica Rivera, M.P.T., a physical therapist in the Rehabilitation Care Line.
“It allowed me to experience natural movement again; something I haven’t felt in quite a long time. The VA has brought me this far,” said Murphy, who is now able to occasionally walk with the assistance of a cane. “He has come a long way since his stroke,” said Murphy’s wife, Hazel.
An added benefit of this technology is that it helps to reduce physical strain on therapists while increasing consistent therapy for patients. The robotic device does most of the heavy work; therefore, the pattern and pace are consistent throughout the session. Therapists only have to make adjustments and help as needed; thus, pushing patients to their full potential.
“The overall goal is to transition patients from this type of therapy to more functional walking over-ground, whether that is with a walker, a cane, or no assistive device at all,” said Kertz. “This is another great piece of technology VA has to help Veterans regain or improve their ability to walk.”
Robot-assisted walking therapy can be used for both patients just starting rehabilitation or those still improving on an old injury. Some sensation or movement in a majority of the muscle groups in the legs is needed. As with any form of physical exercise, a person should have a complete physical evaluation to determine appropriate therapy for his or her unique situation.