Robotic walking machines help patients ‘retrain’ their bodies
Lokomat walking machine designed to help patients with spinal injuries
Michael Coss survived a catastrophic accident on the Coquihalla Highway that put him in hospital and in the care of doctors who said he would never walk again.
But 11 years later, the former allaround athlete, Molson’s sales rep and pilot, is more than just walking, he walks in 10K fun runs and this past year climbed the steps of more than 20 storeys in a building for a fundraiser.
After emerging from a coma after more than six months after his 2006 accident, Coss eventually graduated from the hospital bed to wheelchair to walking with a cane.
“Now I’m learning to walk without a cane,” said Coss, who wrote a book about his experience called The Courage to Come Back: Triumph over TBI — A Story of Hope.
He and his physio, Pauline Martin, owner of Neuromotion Physiotherapy, credit a robotic walking machine he had the fortune of using at Martin’s Vancouver clinic.
That robot, called the Lokomat, was purchased by the family of one of Martin’s Vancouver clients, as was the machine at her Victoria clinic.
She said her clients in the Fraser Valley also could benefit from the machines, which medical studies have found can produce better results for patients with incomplete spinal cord injuries.
Martin, with the help of Coss, has launched Project Lokomat, a fundraiser with the goal of raising $500,000 for a state-of-the-art robot-assisted physiological gait rehabilitation therapy for her Surrey clinic.
It’s designed to help people with traumatic and acquired neurological disorders, spinal injuries or individuals recovering from stroke.
“The public doesn’t know this exists until they need it,” said Martin.
Coss believes the robot helped him graduate from wheelchair to walking.
He was actively involved in hockey, golf, baseball and soccer and was on his way to a golf tournament in Kelowna with his wife and six-month-old twins on a morning in May when he lost control of his vehicle on the highway. He suffered severe injuries, including a head injury.
He was grateful for the robotassisted gait training he accessed through Martin’s clinic.
Coss would be strapped into the apparatus that would help him to repeat motions that would train his body back into walking. Rather than relying on physiotherapists to guide his steps or supporting his weight on his arms while practising walking in between parallel bars, Coss would be moving swiftly, evenly and purposefully with the help of the robot.
ELECTRONICALLY CORRECTED
Each movement would be electronically corrected according to the data fed into his profile, gently adjusting his leg into the proper position.
“I helped me to retrain my body to be able to walk without a cane,” he said.
Coss attended the sessions for two years and he eagerly anticipated the weekly visits to the clinic.
“It was such a powerful thing, a feeling of being powerful and of confidence and freedom,” he said. “It was magical. It was better than winning the 6/49.”
And he couldn’t get enough of them. “I would say that those onehour sessions were the highlight of my week among all my rehab activities,” he said. “That one session a week was the one I looked forward to the most.”
Martin said not only does the machine provide the biofeedback that helps the patients’ rehabilitation, it allows them to train for a longer time without fatiguing.
“It requires much less effort for the individual to be upright so they can do it longer,” she said.
And it requires fewer staff to assist the patients.
A research study comparing robot-assisted gait training to “overground walking training” and “body weight supported” treadmill training for incomplete spinal cord injury patients published this year in the Journal of NeuroEngineering and Rehabilitation found the robots reduced the number of staff needed and improved outcomes.
It found that two or three therapists were needed during manually facilitated treadmill rehab.
The study also found that groups training with the robot showed “significantly greater improvements in gait distance, strength and functional level of mobility and independence,” compared to regular rehab.
The review concluded that robot-assisted gait training in incomplete spinal cord injury patients “showed promise in restoring functional walking ” which “might enable them to maintain a healthy lifestyle and increase their level of physical activity.”
Martin said the fundraiser was launched because the cost of the Lokomat is too expensive to be borne by the patients who benefit by it.
“It would cost a patient $500 an hour or something for us to be able to pay for it” and for the $10,000 in annual upkeep the machine requires, she said.
Her clinic said the Lokomat has appeared in 325 peer-reviewed publications and is the “most scientifically and therapeutically reviewed robotic device in the world.”
It allows for “greater efficiency of treadmill training ” and reduces “physical demand on therapists,” according to the clinic. The Lokomat also aids rehabilitation because it “uniquely stimulates brain regions that may have been affected by brain injury,” according to the company.
Martin, who said the machines at her other two clinics in Victoria and Vancouver are used continually throughout the day, would like to see the technology available throughout the province.
She said there are only a handful of the machines across Canada but there’s one at each of the 40 veterans hospitals in the U.S.
I would say that those one-hour sessions were the highlight of my week among all my rehab activities. That one session a week was the one I looked forward to the most.