Biofeedback in gait training with the robotic orthosis Lokomat.

Neurological diseases - such as spinal cord injury, stroke and traumatic brain injury - frequently result in gait impairment The recovery of the walking ability requires functional training (i.e. walking), as previous research in man and animal has shown. Because the patient usually has reduced voluntary muscle force early after the incident, his/her movements require external support by physical therapists or special robotic devices. The Lokomat is a robotic gait orthosis with electromechanical drives that supports walking on a treadmill with body weight support. Because the movements are performed according to a predefined trajectory, there is no visible cue to the amount the patient is contributing. However, the forces measured within the drives can deliver an estimation of this contribution. Based on these measurements, biofeedback on the patient's gait performance was added as a new feature. The visual display will allow the patient to get direct feedback on his/her efforts, and will allow the therapist to instruct the patient better. We report here that the biofeedback can correctly reflect the activity of a healthy subject, that patients can benefit from the use, and what the patients' opinion is.