Introduction: Multiple sclerosis is a chronic autoimmune neurodegenerative disease of the
central nervous system, most commonly affecting young adults. It is characterized by
inflammatory demyelination with axonal damage, which can lead to highly complex and
unpredictable neurological deficits. Gait disturbances represent one of the most limiting
aspects of the disease, making directing rehabilitation towards improving mobility in this
population crucial. For patients with severe limitations, robot-assisted training, often defined
as task-oriented, holds particular promise. Such gait training is facilitated by the Lokomat,
defined as an exoskeleton approach where pelvis and knee kinematics are controlled, and
the patient's weight is supported. It is designed for intensive gait rehabilitation therapy in
adults and pediatric patients with severe to moderate gait impairments and functional
mobility. Purpose: The purpose of this diploma work was to determine the effectiveness of
robot-assisted gait training using the Lokomat compared to conventional approaches in
patients with multiple sclerosis based on a review of scientific and professional literature.
Methods: A descriptive method of literature review was used in this diploma. Scientific
articles were searched in the PubMed database in November 2023. Included were articles of
controlled clinical trials and randomized controlled clinical trials examining the impact of
Lokomat use in patients with multiple sclerosis. Results: Eight studies involving a total of
321 subjects were included in this review. Seven studies compared the intervention group
with a control group that underwent conventional gait therapy or received physiotherapy
combined with gait training. In three studies, Lokomat showed statistically significant
improvements in gait speed and endurance compared to the control group, one study reported
such improvements in balance. Lokomat also demonstrated statistically significant
improvements in knee extensor strength, cadence and step length compared to conventional
approaches. Discussion and Conclusion: Based on results, it can be concluded that robot-assisted gait training with Lokomat can improve speed, endurance, and other gait parameters
in patients with multiple sclerosis. Positive effects were also demonstrated with conventional
approaches; however, incorporating Lokomat gait training into rehabilitation programs can
be an effective choice for MS patients. Further research is needed to determine the optimal
combination of Lokomat training parameters.
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