Deans' stroke musings: The effect of the Lokomat® robotic-orthosis system on lower extremity rehabilitation in patients with stroke: a systematic review and meta-analysis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, December 15, 2023

The effect of the Lokomat® robotic-orthosis system on lower extremity rehabilitation in patients with stroke: a systematic review and meta-analysis

My doctor at the time didn't think much of the Lokomat but I considered it great since it was the only thing that could counteract my spasticity. I hated body weight supported treadmill training, it was impossible to walk in those since I needed my bodyweight to at least reduce some of the spasticity. Ask your doctor about this.

The effect of the Lokomat^® robotic-orthosis system on lower extremity rehabilitation in patients with stroke: a systematic review and meta-analysis

Lina Wu^*

Gui Xu

Qiaofeng Wu

Department of Rehabilitation, Foresea Life Insurance Nanning Hospital, Nanning, Guangxi Province, China

Background: The Lokomat^® is a device utilized for gait training in post-stroke patients. Through a systematic review, the objective was to determine whether robot-assisted gait training with the Lokomat^® is more effective in enhancing lower extremity rehabilitation in patients with stroke in comparison to conventional physical therapy (CPT).

Methods: In this study, a systematic search was conducted in various databases, including CINAHL, MEDLINE, PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Physiotherapy Evidence Database (PEDro), as well as bibliographies of previous meta-analyses, to identify all randomized controlled trials that investigated the use of Lokomat^® devices in adult stroke patients. The study aimed to derive pooled estimates of standardized mean differences for six outcomes, namely, Fugl–Meyer Assessment lower-extremity subscale (FMA-LE), Berg Balance Scale (BBS), gait speed, functional ambulation category scale (FAC), timed up and go (TUG), and functional independence measure (FIM), through random effects meta-analyses.

Results: The review analyzed 21 studies with a total of 709 participants and found that the use of Lokomat^® in stroke patients resulted in favorable outcomes for the recovery of balance as measured by the BBS (mean difference = 2.71, 95% CI 1.39 to 4.03; p < 0.0001). However, the FAC showed that Lokomat^® was less effective than the CPT group (mean difference = −0.28, 95% CI −0.45 to 0.11, P = 0.001). There were no significant differences in FMA-LE (mean difference = 1.27, 95% CI −0.88 to 3.42, P = 0.25), gait speed (mean difference = 0.02, 95% CI −0.03 to 0.07, P = 0.44), TUG (mean difference = −0.12, 95% CI −0.71 to 0.46, P = 0.68), or FIM (mean difference = 2.12, 95% CI −2.92 to 7.16, P = 0.41) between the Lokomat^® and CPT groups for stroke patients.

Conclusion: Our results indicate that, with the exception of more notable improvements in balance, robot-assisted gait training utilizing the Lokomat^® was not superior to CPT based on the current literature. Considering its ability to reduce therapists' work intensity and burden, the way in which Lokomat^® is applied should be strengthened, or future randomized controlled trial studies should use more sensitive assessment criteria.