Therapy Session

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ArmeoSpring Pro Instruction Video (Chapter 7 - Extra Time)

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ArmeoSpring Pro Instruction Video (Chapter 6 - Reporting)

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ArmeoSpring Pro Instruction Video (Chapter 5 - Remove the Patient)

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ArmeoSpring Pro Instruction Video (Chapter 4 - Training)

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ArmeoSpring Pro Instruction Video (Chapter 3 - Session Setup)

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ArmeoSpring Pro Instruction Video (Chapter 1 - Hardware)

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C-Gait Assessment

 

The C-Mill C-Gait assessment is a test to visualize the functional walking performance (or adaptation ability while walking). The C-Gait assessment is intended for all patients that are indicated for C-Mill therapy, that can walk and perform gait adaptability tasks for over 18 minutes as this assessment lasts approximately 18 minutes (depending on the patient’s speed).

 

The C-Gait assessment consists of 7 different tasks: visually guided stepping, tandem walking, obstacle avoidance, slalom walking, reaction to unexpected situations, speed adaptations and, if applicable, walking while performing an auditory, cognitive dual task[i].

 

Figure 1: Task evaluation

 

Each task should be executed twice at different degrees of difficulty, once at an easy degree and once at a higher degree (level 2 and level 4).

Each task ends with a pop-up window containing some evaluation questions (figure1).

The questions are:

-Rate the level of challenge

-Has the client supported oneself during the section.

-How often was the handrail used

 

Figure 2: Final evaluation

 

When the protocol is finished, all the tasks are completed, then a pop-up appears with the following questions ( figure 2):

▪ How tiring was the training? Please rate from 6-20, with 6 being ‘not tiring at all’ and 20 being ‘maximum exhaustion’.

▪ How afraid are you to fall when you walk outside? Please rate from 1-10, with 1 being ‘not afraid’ and 10 being ‘extremely afraid.

 

 

Figure 3: C-Gait assessment Outcome measurement

 

After the assessment, the scores of each task will be presented using the spider diagram (figure3).

The C-Gait scores are based on the performance on each task and the difficulty level at which the task is executed (difficulty level * 2 * performance (%) / 100). Five is the highest difficulty level, but only possible to choose for the C-Gait Training[ii]. The score that is displayed in the spider diagram is the highest score achieved on one of the two levels. The maximum score that can be achieved for each task in the C-Gait assessment, therefore, is eight (100% performance on level four).

 

[i] The auditory, cognitive dual task is an auditory Stroop test. The patient hears the words “low” and “high” in a certain pitch. Just like the visual Stroop test, the patient needs to say out loud whether the pitch is high or low. This task can only be performed with additional hardware and software for speech recognition. The software skips the Cognitive tasks in the C-Gait assessment because they are not available.

[ii] The C-Gait assessment has been released; however, the C-Gait training is only available for customers that participated in the C-Gait study.  It won’t be developed further.

VIDEO

Dynamic Range of the Lokomat BWS

The LokomatPro Body Weight Support (BWS) system it is a unique system that adjusts to the physiologic vertical movement of the patient ensuring precise unloading during the all gait cycle To ensure this precise unloading the therapist needs to bring the patient to the dynamic range of the BWS. The patient walks in the dynamic range as soon as the orange indicator on the column of the Lokomat is moving up and down within the range of the vertical gray bar. In this video we will show you how to reach the dynamic range of the Lokomat BWS ensuring the safety of the patient ( safe walk) and then providing an appropriate loading for the patient (physiological walk).

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Q&A

What is the purpose of the Biofeedback Graph and how can I use it?

The Biofeedback Graph is an interactive tool to confirm that your patient remains active during the Lokomat session. In combination with the high number of repetitions achieved during a training session, this effort results in high training intensity.

The purpose of Biofeedback is to enable both the clinician and the patient to visualize objectively the amount of effort the patient is contributing during a gait cycle. Thus, to provide feedback on the performance of the patient.

 

How is it displayed?

Biofeedback Graph can be displayed at any moment of the Lokomat session on the therapist screen if you click on the button Biofeedback Graph on the bottom tab of the Lokomat training screen (Figure 1).

Figure 1: Biofeedback Graph icon on therapist screen.

To display the Biofeedback Graph on the patient screen and therewith enhance the patient’s attention and motivation, choose the Biofeedback Graph on the Library and add it to the therapy plan of your patient (Figure 2).

Figure 2: Biofeedback Graph on patient’s Therapy Plan

In both situations, the Biofeedback Graph is represented as a group of four graphs corresponding to the hip and knee activity for the left and right legs. Every graph has two lines: an orange line that indicates the level of activity during swing phase and a blue line indicating the level of activity during stance phase. On the vertical axis of the graphs (y axis), we can observe the amount of biofeedback units (the Lokocontrol software converts the force measured at the hip and knee joints), while on the horizontal axis (x axis), we can see time in seconds (Figure 3). On a functional level, this allows both the clinician and patient to know whether the patient is active at the appropriate time in the gait cycle.

Figure 3: Biofeedback Graph display with 4 graphs.

Some recommendations for its application:

Based on the experience of Lokomat Users, here are some recommendations on how to benefit from the Biofeedback when treating a patient.

  • Observing the baseline: When starting the training and while the patient is still relatively passive, visualize the Biofeedback Graph to see what a “passive” graph looks like.

It is important to remember that the absolute values of the Biofeedback Graph on the y axis may be different from session to session, that is why we recommend observing the session’s baseline during this passive phase.

  • Assess the patient’s ability to increase effort: Once you have set a baseline, you can assess your patient’s ability to generate more gait-phase-appropriate force i.e., the patient helps with the movement (graph line goes up), or more gait-phase inappropriate activity, i.e., the patient resists the movement (graph line goes down).
  • Use during training: Use the biofeedback screens during training to maximize your patient’s effort. Some examples:
  • Adjust the Biofeedback Graph to show only 1 joint in 1 gait phase and get your patient to focus on that particular movement (Figure 2 and 4).

Figure 4: Biofeedback Graph showing 1 joint on patient’s screen.

  • Monitor your patient’s effort. You can use the Biofeedback Graph to make sure that your patient is training throughout the entire Lokomat session.
  • Monitor the effects of your training adjustments. You can use the Biofeedback Graph to monitor any activation changes in relation to other treatment parameters (speed, loading, guidance force).

 

ArmeoPower Quick Reference Guide: Patient Setup

Download the ArmeoPower Setup QRG here

 

ArmeoPower Quick Reference Guide
Q&A

How to Record Training Data with the LokomatPro, Software Version 6.5

Many therapists want numerical data from training sessions for research or clinical applications. The Lokomat offers a recording function that records biomechanical and technical signals in every session to monitor your patients’ progress.

With software version 6.5 the data are no longer automatically recorded; to record follow the procedure below:

  1. Select the icon System Settings on the bottom of the main menu of the software.
  2. Select SYSTEM SETTINGS in the Lokomat options.
  3. Select CONFIGURATION on the bottom of the page.
  4. Check the box “Record all signals for each session”.
  5. The system will ask you to restart the software (Lokocontrol). Press “OK” to restart.

The data recorded during training are saved by default in D:\Hocoma\Recorder as text files called “Recording_YYMMDD_HHMMSS.txt”. The second half of the file name is a timestamp with two digits for Year, Month, Day, Hour, Minute and Second.

There are many applications that will open the recording .txt file but many therapists use Microsoft Excel for this purpose. Below is a brief instruction on how to open your recorded data in Excel:

  1. Open a Blank workbook in Excel
  2. Select Data > From Text/CSV
  3. Find and select desired Recording .txt file
  4. Click “Import”
  5. Select in a preview the delimiter Semicolon
  6. Press “Load”.

Now the data are ready to be viewed and analyzed.

 

Download the Overview of the Recorded Signals in Lokocontrol V6.5 here
Q&A

What are the Indications and Contraindications for ValedoMotion Therapy?

Q&A

What are the Indications and Contraindications for Andago Therapy?

ArmeoSpring Quick Reference Guide: Patient Setup

Therapy Goals

This document provides a quick overview on all training categroies of the C-Mill and their corresponding treatment goals.

Quick Sheet - Therapy Goals

Therapy Guide

This guideline describes the clinical workflow on the C-mill system and explains the different categories Stand, Step and Walk with their corresponding treatment goals, assessments and training for patients with balance and walking impairments.

C-Mill Therapy Guide
VIDEO

ValedoMotion Instuction Video (Full)

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ValedoMotion Instuction Video (Chapter 1 - Hardware)

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ValedoMotion Instuction Video (Chapter 2 - Software)

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ValedoMotion Instuction Video (Chapter 3 - Training Preparation)

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ValedoMotion Instuction Video (Chapter 4 - Calibration)

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ValedoMotion Instuction Video (Chapter 5 - Range of Motion)

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ValedoMotion Instuction Video (Chapter 6 - Therapy Planning)

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ValedoMotion Instuction Video (Chapter 7 - Training)

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ValedoMotion Instuction Video (Chapter 8 - Reporting)

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VIDEO

ArmeoSenso Instruction Video (Full)

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ArmeoSenso Instruction Video (Chapter 2 - Prepare the Therapy Session)

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ArmeoSenso Instruction Video (Chapter 3 - Training)

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ArmeoSenso Instruction Video (Chapter 4 - Report)

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VIDEO

ArmeoSenso Instruction Video (Chapter 5 - Extra Time)

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Q&A

How to Add and Remove Items from the Armeo Therapy Plan?

On the therapy plan screen, you have a library on the left (holds all of the exercises and assessments) and the therapy plan on the right. From the library on the left you can choose which items you want to include in your therapy plan.

On the top of the library you have the filter options. The first box is a simple click filter where you can switch whether the list is showing exercise or assessments.   The second box is a dropdown menu that sorts the exercises by therapy goal and the third box is a dropdown menu that sorts the exercises by active joints or arm segments. With these filters you can quickly narrow down the list of exercises to only those that serve the patient’s needs.

There are two ways to add items from the library to the therapy plan. You can drag and drop—that is holding the mouse button down after you’ve clicked an item and then moving it over to the therapy plan or you can use the two arrows between the library and the therapy plan. To do so, click the item you wish to add to the therapy plan and then click the right arrow. Removing items from the therapy plan is done in the exact same way. You can drag and drop back into the library or select an item from the therapy plan and then click the left arrow.

To automatically remove all items from the therapy plan you can always click the trash can arrow.

Once you have items in your therapy plan you see the scope of your plan at a glance. Here you can see how long the plan is and how many items you have. The time only counts exercises because assessments are not timed. You can also easily change the order of the items in the therapy plan. Click the item you’d like to change the order of and then click either the up or down arrow to move it up or down in order. You can also drag and drop the items within the therapy plan to change the order.

Check also the instruction video to get more information.

 

VIDEO

Andago Instruction Video (Full)

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Andago Instruction Video (Chapter 1 - Prepare the Patient and the Andago)

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Andago Instruction Video (Chapter 2 - Set up the Patient)

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Andago Instruction Video (Chapter 3 - Training)

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Andago Instruction Video (Chapter 4 - Bring the Patient out of the Andago)

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Andago Instruction Video (Safety Mechanisms)

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Q&A

Which Type of Information Regarding Patient Performance can I Visualize on the Armeo?

Would you like to quantify, monitor and visualize information regarding your patient’s performance and activity during Armeo therapy? With the Armeo 2.x software, there are multiple levels of information you can retrieve, from basic results displayed on the screen, to more complex research features. Please consider that some features are intended exclusively for research purposes.

User Feature Content
All users On-screen scoring Info displayed on the screen during and after exercises includes:

  • Exercise time
  • Score
  • Top score
  • Feedback on activity level (i.e. sparkling etc.)
All users Patient Reports

PDF format

 

 

See User Manual Chapter 4, Section 4: Reporting.

The Patient Report is a therapy record which includes the following:

  • Therapy summary: here you have a summary of all patient sessions in terms of duration and therapy goals.
  • Assessment results:
    • ArmeoSpring –> AROM (range of motion in 1D), AMOVE (range of motion in 3D) and AGOAL (gross coordination)
    • ArmeoPower –> AROM (range of motion in 1D), AMOVE (range of motion in 3D) AGOAL (gross coordination), and AFORCE (torque)
  • Exercise results: for each selected patient session you will see the scoring of the exercise and the time the patient played.
  • Session results: here you will see for each selected patient session the Arm weight support (forearm and upper arm) and the reach results.
All users Patient Reports in a Spreadsheet (XLS or CSV ) format* Enables to export patient reports in the XLS/CSV format, which can be imported to Microsoft Excel or similar software such as Matlab for further data analysis and visualization. The reports will contain all information from the PDF patient reports, and can be exported by clicking on a specific icon (see User Manual Chapter 4, section 4, and page 66).

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Clinical Researcher
(all devices)
Research Output**

 

 

The research output enables you to capture patient movements in terms of hand trajectories and joint angles as well as events that are triggered in exercises or assessments. Thus, these log files enable you to recover the full interaction of a patient and an exercise or assessment. Contact clinical.research@hocoma.com for more detailed information.

 

Advanced Options for Scientific Researchers

Please contact us at clinical.research@hocoma.com for additional advanced interface options that are available for research teams with their own software development capabilities.

*Available for Armeocontrol 2.2 onwards. Please contact your Hocoma Sales representative to schedule an upgrade.

**Please note these features are research features, which are not part of standard Armeo delivery and are provided without any guarantee and further support.

VIDEO

ArmeoPower Setup Video

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ArmeoSpring Instruction Video (Chapter 1 - Hardware)

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ArmeoSpring Instruction Video (Chapter 3 - Session Setup)

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ArmeoSpring Instruction Video (Chapter 4 - Training)

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ArmeoSpring Instruction Video (Chapter 5 - Report)

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ArmeoSpring Instruction Video (Chapter 6 - Extra Time)

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ArmeoSpring Instruction Video (Chapter 7 - Side Change)

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ManovoSpring Setup Video

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Q&A

How do I Attach and Remove the FES Cables to and from the ErigoPro?

When attaching and removing the FES cables to and from the ErigoPro and the electrodes, some details must be considered in order to guarantee the lifespan of your Erigo and your FES cables.

Attaching the FES Cables to the Erigo

  • When plugging the FES cables into the FES module of your Erigo, always consider the colour code. E.g. the blue plug corresponds to the blue jack of the Erigo.
  • To plug into the jack, the cable needs to face vertically upright.

  • Always hold the plug at the lower, horizontal end, not at the cable.

Removing the FES Cables from the Erigo

  • When removing the cable from the jack on the Erigo, pull on the horizontal part of the plug. There is a spring mechanism which releases when the horizontal part of the plug is being pulled outwards straight.
  • Don’t pull on the vertical part of the plug nor on the cable itself!

Removing the Electrodes from the FES Cables

  • When removing the electrode from the FES cable, pull on the plugging ends of the cables. Don’t pull on the cables!

Avoid Tension on the Cables or Plugs at Any Time

  • In order to avoid damaging the FES cables or plugs, make sure that there is no tension on the cables at any time during the Erigo session, especially in the flexion phase of the patient’s stepping pattern
Q&A

Is it Possible to Train Children on the Erigo?

Erigo training is not limited due to age but to the size of the patient. As long as it is possible to appropriately adjust the device to the patient it is possible to use the Erigo with patients of all ages.

The patient size for Erigo training is defined by:

  • A maximum weight of 135 kg (297 lb)
  • Leg length (measured from the foot sole to the greater trochanter) less than 69 cm (27 in.) or greater than 104 cm (41 in.)
VIDEO

V6.5 Software Instruction (Full Video)

Please note that this instruction video was produced with/for a LokomatPro. Some of the features and settings shown in the video differ from the available ones in the LokomatNanos. Nevertheless, this video instructs the usage of Lokocontrol V6.5 also for LokomatNanos.

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V6.5 Software Instruction (Chapter 1 - Introduction)

Please note that this instruction video was produced with/for a LokomatPro. Some of the features and settings shown in the video differ from the available ones in the LokomatNanos. Nevertheless, this video instructs the usage of Lokocontrol V6.5 also for LokomatNanos.

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V6.5 Software Instruction (Chapter 2 - Create / Select Patient)

Please note that this instruction video was produced with/for a LokomatPro. Some of the features and settings shown in the video differ from the available ones in the LokomatNanos. Nevertheless, this video instructs the usage of Lokocontrol V6.5 also for LokomatNanos.

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V6.5 Software Instruction (Chapter 3 - Prepare the Lokomat)

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V6.5 Software Instruction (Chapter 4 - Training)

Please note that this instruction video was produced with/for a LokomatPro. Some of the features and settings shown in the video differ from the available ones in the LokomatNanos. Nevertheless, this video instructs the usage of Lokocontrol V6.5 also for LokomatNanos.

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V6.5 Software Instruction Video (Chapter 5 - Challenge the Patient)

Please note that this instruction video was produced with/for a LokomatPro. Some of the features and settings shown in the video differ from the available ones in the LokomatNanos. Nevertheless, this video instructs the usage of Lokocontrol V6.5 also for LokomatNanos.

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V6.5 Software Instruction Video (Chapter 6 - Exercise Settings)

Please note that this instruction video was produced with/for a LokomatPro. Some of the features and settings shown in the video differ from the available ones in the LokomatNanos. Nevertheless, this video instructs the usage of Lokocontrol V6.5 also for LokomatNanos.

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V6.5 Software Instruction Video (Chapter 7 - Report)

Please note that this instruction video was produced with/for a LokomatPro. Some of the features and settings shown in the video differ from the available ones in the LokomatNanos. Nevertheless, this video instructs the usage of Lokocontrol V6.5 also for LokomatNanos.

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VIDEO

FreeD Pediatric Frontal Plane Settings

This video shows in detail how to set the frontal plane with the pediatric FreeD module.

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FreeD (Adult) Frontal Plane Settings

This video shows in detail how to set the frontal plane with the adult FreeD module.

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Q&A

C-Mill Assessment Questions

 

Q: Is the width between the projected steps, that are projected onto the belt for standing balance applications and assessments, specific for each patient?

A: Yes. The width between the projected feet is based on the length of the patient.

Q: Why is there no score for the cognitive dual task of the C-Gait assessment?

A: The cognitive dual task requires additional hardware (a special headset). The patient needs to indicate if the words ‘high’ and ‘low’ are spoken with a high or low pitch.

Q: Is a harness required during the execution of a balance assessment?

A: Yes, a patient should always wear a safety harness, that is attached to a safety portal via a safety line.

Q: What can be deducted from the shape of the butterfly?

A: The butterfly can visualize relative differences between left and right steps, or difficulties in weight assumption from one leg to the other. Furthermore, it can visualize step width and gait asymmetries. Absolute values for step length cannot be visualized with the butterfly, because the butterfly reflects the CoP (Center of Pressure) trajectory on the belt surface and this is also depended on the treadmill speed.

Q&A

C-Mill CueFors Questions

 

Q: Track images: some images can only have a positive or negative score. What is the underlying logic per image?

A: Cues can only have a positive score. Animals can both have a negative as well as positive score and obstacles can only have a negative score.

Q: How are the default width and height of the stepping stones/ obstacles determined? And where can I find the exact dimensions?

A: The width and height are based on the foot dimensions that need to be stored for each patient/subject in the database. The exact dimensions of the stepping stones or obstacles can be seen in the CUEING.csv file, which is created when the measurement is exported.

Q&A

C-Mill General Questions

 

Q: What types of training/services/support does Motek provide?

A: Motek provides different services, for example additional or advanced training, research services or on-site support during the clinical usage of a system with patients (companionship). We can also consult you during the implementation phase of your system or share experiences regarding reimbursement.

For a complete overview of our services, please send an email to clinical.applications@motekforcelink.com.

Q: Where can I find other centers to exchange experiences?

A: Please contact us via clinical.applications@motekforcelink.com and we will try to put you into contact with other centers. If applicable, please describe the specific characteristics/requirements of the centers you are looking for.

Q&A

What do I Need to Consider During Patient Setup with LokomatPro with FreeD?

FreeD is an optional module of the Lokomat that provides a more natural and physiologic gait pattern while supporting lateral transition of the body weight. In order to setup a patient on a safe and efficient way with the new FreeD module we recommend you to read this entry. Below, you will find a detailed description of a patient setup with and without FreeD.

LokomatPro

  1. Measure upper and lower legs, adjust the orthoses and enter the values in the software.
  2. Select the cuffs and attach them to the orthoses.
  3. Select the harness and leg loops. Fix the harness on the patient.
  4. Attach the patient to the support frame and lift the patient. Close the swivel door and lower the orthoses.
  5. Adjust the height of the Lokomat by placing the hip cushions directly above the greater trochanter. Set the pelvic depth and width using the dedicated hand wheels. Fix the pelvis by fastening the strap around the pelvis and by adjusting the orthosis to the rings on the harness.
  6. Close the upper cuff and check the knee axis, adjust lower leg length if necessary. Close the middle and lower cuffs.
  7. Adjust the upper cuff bracket so that the orthosis is aligned with the patient’s femur. Adjust the lower bracket so that an imaginary lines through the lower leg falls behind the lateral malleolus. Adjust the middle bracket and check the knee extension.
  8. Adjust the upper, middle and lower cuffs so as to follow the anatomical axes of the patient’s legs and so as to set the track width.
  9. Fasten the foot lifters.

 

LokomatPro with FreeD

  1.  Measure upper and lower legs, adjust the orthoses and enter the values in the software.
  2. Select the cuffs and attach them to the orthoses. The upper cuffs are delivered in sizes 9 and 7 and should fit most patients. If this is not the case, the middle cuffs can be used.
  3. Select the harness and leg loops. Fix the harness on the patient.
  4. Attach the patient to the support frame and lift the patient. Close the swivel door and lower the orthoses. Open the pelvic orthosis to its maximum width.

    Opening pelvic orthosis to maximum width

  5. Adjust the height of the Lokomat by aligning the greater trochanter with the white plastic indicators.

    Alignment of the white indicator with the greater trochanter

    Adjust the pelvic depth by turning on the hand wheel and the pelvic width by pushing inwards on the pelvic cushions (to open, push button and pull). Attach the patient harness to the orthosis by buckling the pelvic straps on the harness.

  6. Close the upper cuff and check the knee axis, adjust lower leg length if necessary. Close the middle and lower cuffs.
  7. Adjust the upper cuff bracket so that the “Lokomat femur” is aligned with the patient’s femur. Adjust the lower bracket so that an imaginary lines through the lower leg falls behind the lateral malleolus. Adjust the middle bracket and check the knee extension.
  8. Fasten the foot lifters.
  9. Adjust the lower cuff so as to set the track width (frontal plane alignment). Set the amount of lateral and medial translation of the upper and middle cuffs and close the blocking mechanism screws.
  10. Check that each leg does not collide with the foot lifter bar of the opposite leg at any time during the gait phase.

 

Handout: Setup Differences Between FreeD and non-FreeD
Q&A

What can I do if the Patient is Uncomfortable in the Harness?

A proper setup will increase comfortable for the patient in the Lokomat. Here we provide some practical tips.

Minimize “Hang” Time

When you set your patient up, be as efficient as possible to minimize the time he is fully suspended. Be systematic in your setup; this will help you be quick and thorough.

Positioning the Harness

  • Groin padding: The Lokomat offers two groin pads. Make sure they are placed in such a way as to cover the sensitive groin area. Take into consideration that the most of the pressure is anterior rather than posterior, so ensure that the padding is placed forward enough to provide good protection.

Groin Paddings

  • Selecting the leg straps: Two different options are provided, a triangular pelvic harness or two separate straps. Some patients will prefer one option over the other. When using the triangular harness, we recommend placing one groin pad horizontally. Make sure the leg straps are long enough to cover the patient’s sensitive area and that they are tightened symmetrically on both sides.

Pelvic Harness

Leg Straps

  • Attaching the leg straps: The leg straps can be attached to the harness in two different ways. If your patient feels uncomfortable with the medial position, try the lateral position. This position may affect superior translation of the harness on your patient, but it may be more comfortable.
  • Placing the harness: Check that the harness is straight and symmetric. If the weight is not evenly distributed, the harness might put more pressure on one specific area, which will cause discomfort. Make sure the harness is not too high, especially on women, to avoid pressure on the breasts.
Q&A

How do I Change to Pediatric Orthosis on the LokomatPro?

Do you use the LokomatPro with both adult and pediatric patients?

Would you like a clear, step-by-step procedure to quickly and effectively change from adult to pediatric orthosis?

Watch the video or download the handout below!

 

Handout: How do I Change to Pediatric Orthosis on the LokomatPro?
Q&A

How Can I Improve Lokomat Setup in Patients with a Narrow Pelvis?

Patients with a narrow pelvis, in particular children, may experience difficulties when training with the Lokomat because the cuffs might collide during walking. To avoid this and ensure a safe and correct walking pattern throughout the entire training session, follow these recommendations:

  • Frontal plane settings (indicated by letters):
    Check whether the cuffs are placed correctly during setup. Leave enough space between the cuffs, especially around the thighs and knee joints, to avoid collision once the pelvis is fixed (picture 1).
    Make sure that the legs are correctly aligned. If the cuffs still collide with each other, move them laterally (towards the letter “A”).

Picture 1

 

  • Cuff size: Make sure that the selected cuff size is not too large.

 

  • Specific hip pads: Thicker hip pads are provided together with the pediatric orthosis. They increase the space between both orthoses during setup, thereby avoiding the collision of the cuffs during walking (picture 2).

Picture 2