• 대한의용생체공학회:의공학회지
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• 제31권5호
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• pp.344-350
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• 2010

The aim of this study was to investigate the characteristics of the flexion withdrawal reflex modulated during Lokomat treadmill walking in people with spinal cord injury. The influence of the limb position and movement were tested in 5 subjects with chronic spinal cord injury. EMG activities from tibialis anterior and moments of the hip joint elicited by the foot stimulation were examined during Lokomat treadmill walking. To trigger the flexion withdrawal reflex during Lokomat treadmill walking, a train of 10 stimulus pulses was applied at the skin of the medial arch. The TA EMG activity was modulated during gait phase and the largest TA reflex was obtained after heel-off and initial swing phase. During swing phase, TA EMG was 40.9% greater for the extended hip position (phase 6), compared with flexed hip position (phase 8). The measured reflex moment of the hip joint was also modulated during gait phase. In order to characterize the neural contribution of flexion reflex at the hip joint, we compared estimated moments consisted of the static and dynamic components with measured moment of the hip joint. The mean static gains of reflex hip moments for swing and stance phase are -0.1, -0.8, respectively. The mean dynamic gains of reflex hip moments are 0.25 for swing, 0.75 for stance phase. From this study, we postulate that the joint moment and muscle response of flexion withdrawal reflex have the phase-dependent modulation and linear relationship with hip angle and angular velocity for swing phase during Lokomat treadmill walking.

• 한국전문물리치료학회지
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• 제22권2호
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• pp.30-40
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• 2015

Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients' functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186~.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320~.621) showed more effective than Lokomat (.169, 95% CI: .063~.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.