Case Report: Combination of Lokomat® and Armeo®Spring in the Rehabilitation of a Stroke Patient

Nicolás Buffagni, MD Physician

San Andrés Clinic, Mendoza, Argentina

We often combine the ArmeoSpring and Lokomat as part of the rehabilitation program for patients who have both gait and upper extremity impairment. We have experienced very good results and would like to share a patient story as an example of why we find this combined approach beneficial for our patients. Below we describe the initial condition of the patient, how we used the Armeo and Lokomat as part of the rehabilitation program, and the results of the treatment, including before-and-after videos.

Initial Assessment

Male, 22 years old, 20 days after stroke. The patient suffers from left hemiparesis.

Muscle strength 0-5 for every individual muscle according to Medical Research Council Scale.
No reflex response.

Treatment start date: 21 January 2013

Therapy Goals

to train recognition of the left upper extremity, integration into body scheme.
to train proprioception and sensory input.
to decrease associated reactions.
to train gait.
to increase range of motion (ROM) of the left upper extremity.
to train muscle strength.
to train functional movements in the left upper extremity, including hand movement and function.

Intervention

The patient received a treatment program which included conventional therapy, ArmeoSpring therapy and Lokomat therapy.

Armeo®Spring Therapy

1-hour session
3 times per week
for 8 weeks

Lokomat® Therapy

1-hour session
3 times per week
for 8 weeks

Results

We observed improvements in muscle strength and reflexes in all muscle groups evaluated. Moreover, we observed improvement in the performance of activities of daily living measured on the FIM-FAM scale.

	Before	After
Muscle strength upper extremity (global)	25/70	70/70
Muscle strength lower extremity (global)	32/50	50/50
FIM + FAM	173	210

Conclusions

A stroke patient typically is affected both in the functionality of the upper extremities as well as their ability to walk. Based on our experience, combining the application of these two devices with conventional therapy, we would recommend this approach to other clinics with stroke patients.
The multiple improvements that we observed can lead to a higher independence of the patient in daily activities and, thus, a better quality of life.

Our Rehabilitation Team

We are a rehabilitation clinic with a team of specialists in different disciplines including various medical specialties such as neurology, psychology, internal medicine, intensive care, rehabilitation. The team also includes an interdisciplinary team of kinesiologists, nutritionists, occupational therapists, phonoaudiologists, respiratory therapists and nurses.

The departments and units where our patients are treated are: special care, intensive care, family support, amputees, ambulatory, stroke unit and robotics. In the robotics department we have a Lokomat since 2009, an ArmeoSpring since 2012, a Motomed and an Erigo since 2013.

We focus on individualized programs; each patient is treated by an interdisciplinary team to best provide high quality treatment for our patients and their families.