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Gait Trainer - Body Weight Support System

Body weight support systems are being used for rehabilitation of locomotion in practices catering to a variety of patient populations including those with neural impairments, orthopedic injuries and degenerative diseases. These systems can be used to provide stability during locomotion and to help progress weight bearing according to a patient's needs.

Awakenings Health Institute is One (1) of only fourteen (14) Private outfits in the entire country to poses a Gait Trainer of this complexity and magnitude.

Clinical evidence suggests that rewiring of spinal circuitry can occur following injury and further, studies show that rehabilitative interventions can improve function. Awakenings is outfitted with a Body Weight Support System (BWS) Gait Trainer. BWS Systems have been used to improve walking function in people with neurological disorders and spinal chord injury. The BWS system provides environment for improvements in lower extremity strength, mobility and feeling.

• Facilitates step training, using a harness and treadmill
• Provides stability during locomotion
• Allows for progressive weight bearing

Background on BWS

Spinal cord injuries, stroke, and other catastrophic neurological injuries have substantial medical and economic impacts. Efforts to improve patients' medical status and quality of life are important not only for humane reasons but also because of growing pressure to reduce U.S. healthcare costs.

Technique

Research has demonstrated that the spinal cord may be able to learn to take steps without input from the brain through a new therapy called locomotor training. However, it is difficult to quantify and control the costly training, which is physically demanding for therapists.

Robomedica plans a three-year project to build and test a robotic step-training device for re-training individuals with neurologic impairments to walk. The device will simulate the efforts of three to four physical therapists during locomotor training, operating with greater consistency and reliability than is possible for a human therapist, while reducing labor costs. The device also will monitor and record patient progress and thus demonstrate measurable results.

The system will consist of lightweight leg robots that can control and respond to leg movements, a body weight support system that can control and respond to limb loading and keep the torso in a correct position for stepping, and a controller that provides power assistance for stepping and enhances sensory input to the spinal cord only when needed -- unlike existing systems, which force the limbs in a fixed stepping pattern. Innovative proprietary approaches will be used to address the key challenges, which include the design of a device that can generate substantial forces for enhancing sensory input, and development of an adaptive robot control algorithm.

The device will be tested in two small pilot studies: The first will focus on electromyographic patterns (electrical activity associated with skeletal muscles) in patients during training with the robotic device versus training with therapists, and the second study will determine whether training on the robotic device can induce changes in patient ability to step independently on a treadmill. Researchers at the University of California, Los Angeles, will conduct the tests and contribute to experimental design and data analysis, and researchers at the University of California, Irvine, will collaborate on hardware development and integration. The ATP funds will accelerate the project significantly -- Robomedica is a startup and does not have sufficient private investment to conduct such high-risk research. If successfully developed, the new technology will improve gait rehabilitation dramatically, help thousands of Americans with spinal cord injury gain fitness and become more self-sufficient, and substantially reduce the tens of billions of dollars spent annually on treatment and indirect costs of neurologic injuries.