Robot Assisted Gait Technology
What you need to know
Robot assisted gait technology (RAGT) refers to equipment that provides a patient with variable intensity, repetitive ideal gait training. This equipment often uses harnesses or slings to support the body weight of the patient, with lower limbs attached to the gait mechanism in some way. Patients will "walk" using the assistance of the robotic mechanisms on a treadmill. While expensive, they are a useful technology because they reduce physical and temporal strain on therapists and allow patients to experience long instances of perfect cyclical gait with relevant biofeedback and the ability to record muscular force and other temporo-spatial elements of gait
With regard to virtual reality, RAGT may be paired with projectors or computer screens that portray patients in an environment other than a clinic. Theoretically, this may encourage patient motivation due to the contrast between clinic and projected surroundings. It may also be used to prepare patients for gait in a multitude of real-world environments.
Evidence
Intended Patient Population
RAGT systems, in particular the Reha G-EO and Hocoma Lokomat models have been tested in a variety of neurological populations where gait is affected, with stroke being the main focus. Other systems exist, but these two provide excellent examples of design principle and use. An overview of supporting evidence can be seen on their websites:
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However, in order to assess their usefulness in treatments utilising virtual reality, studies using the aforementioned projected environments will be the focus of the following evidence.
Evidence for this intervention with virtual reality exists for the following conditions:
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Stroke
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Multiple Sclerosis
Stroke
Calabro et al., 2017
RCT PEDro 9/10
Technology: Lokomat-Pro + VR game where patient runs while collecting or avoiding objects
Deficits targeted: Motor planning and learning
Multiple Sclerosis
Russo et al., 2018
RCT PEDro 7/10
Technology: Lokomat-Pro + 2D VR game featuring walking
Deficits Targeted: Dynamic balance
Calabro et al., 2017
RCT PEDro 8/10
Technology: Lokomat-Pro + VR walking task
Deficits Targeted: Static/Dynamic balance, muscular tone and functional independence
Interested?
The Hocoma Lokomat-Pro and Reha G-EO can be obtained from a list of distributors listed on their respective websites.
Prices are not visible on the website, however the Lokomat-Pro may retail for as much as $250,000 USD according to some unofficial websites.
