Duration of Treatment Effect for Lokomat Robotic-Assisted Gait Training
The treatment effect of Lokomat robotic-assisted gait training typically lasts 12-18 months after completion of therapy, with benefits gradually waning thereafter if not maintained with ongoing rehabilitation. 1
Factors Affecting Duration of Treatment Effect
Training Parameters
- Intensity: Higher intensity training (77%-95% of maximal heart rate) produces more durable improvements in walking performance 1
- Frequency: At least three sessions per week for optimal results 1
- Session Duration: Minimum 30 minutes per session 1, 2
- Program Length: A minimum program duration of 12 weeks is recommended for more lasting effects 1
Patient-Specific Factors
- Phase of Recovery: Patients in subacute phase may show better long-term retention of gains compared to those in chronic phases 1
- Severity of Impairment: More severely impaired patients may require longer training periods to achieve lasting results 1
- Continued Practice: Without continued practice or maintenance therapy, gains typically begin to diminish after 12-18 months 1
Maintenance Strategies to Prolong Effects
- Combination Therapy: Combining Lokomat training with conventional physical therapy enhances durability of effects 1, 3
- Continued Rehabilitation: Continuing rehabilitation for as long as the patient continues to achieve treatment goals is recommended 1
- Complementary Interventions: Incorporating strengthening exercises, balance training, and functional electrical stimulation may help maintain gains 1
Evidence on Treatment Duration
Research indicates that benefits from robotic-assisted gait training follow similar patterns to other rehabilitation interventions:
- Benefits typically persist for about 12-18 months but gradually decline thereafter 1
- The American Heart Association/American Stroke Association notes that improvements in gait velocity at 6 weeks were not consistently sustained at 3 and 6 months without continued intervention 1
- Studies show that within-group comparisons demonstrate significant improvements during the training period, but these may not be maintained long-term without continued practice 4
Clinical Implications
- Regular reassessment is necessary to monitor for decline in function
- Consider periodic "booster" sessions if decline in function is observed
- Transition to home exercise programs or community-based exercise to maintain gains
- Patient education about the importance of continued physical activity is crucial for maintaining improvements
Lokomat training should be viewed as part of a comprehensive rehabilitation program rather than a standalone intervention, as the evidence suggests that combined approaches yield more sustainable results than robotic training alone 1, 3.