Technology to enhance locomotor function

Abstract

Technology plays an important role in the rehabilitation of patients with impairments of the lower extremity due to disease or trauma of the central nervous system (CNS). In gait rehabilitation, compensatory or restorative strategies are applied depending on the time after trauma and the severity of impairment. Advances in the understanding of CNS plasticity led to the establishment of task-oriented restorative therapies, first of all body weight supported treadmill training, either manually or robotically assisted. Although robotic therapies have not been shown to be superior, they relieve therapists from the exhaustive work of assisting the stepping movements. At this point, locomotion robots provide advanced therapeutic options like intensive gait training also at home and improvement of training quality through the integration of real-time movement feedback. For enhancement of mobility in individuals with severe sensorimotor impairments and the associated limited potential for recovery, compensatory strategies including wheelchairs and more recently active exoskeletons need to be considered. It will be exciting to see whether technological progress in mechatronics, energy storage, and intuitive control will result in exoskeletons capable of replacing traditional walking aids in everyday life conditions.