The effects of lokomat virtual reality applications on balance and spatiotemporal parameters of gait in stroke patients

Stroke is an important health problem worldwide. Emotional, cognitive, sensory and motor problems occur with stroke. Motor problems are especially balance and walking problems and they are related to each other. So balance and gait rehabilitation are primary goals in stroke. Lokomat is a device commonly used in stroke rehabilitation. Lokomat have many adjustable features and one of them is VR combined with APF. Our study was aimed to examine the specific effects of these feature on balance and spatiotemporal gait parameters. The study was conducted with 56 individuals with chronic stroke in four groups. Three Lokomat groups received 18 sessions of Lokomat with virtual reality applications (Group I endurance applications, Group II attention and motivation applications, Group III activity timing applications), and conventional physiotherapy five days a week for six weeks. Control group only received conventional physiotherapy. Walking speed and distance, spatiotemporal parameters and balance assessments were recorded. While walking speed and distance increased significantly in all groups, Group-I was found to be superior in these parameters (p<0.001). No significant difference were found between groups in spatiotemporal parameters (p>0.005). Balance scores increased in all groups and in Berg Balance Scale, Center of Pressure Area (Closed Eyes) and Limits of Stability Group III was found superior (p<0.001). The effects of Lokomat VR&APF on balance and spatiotemporal parameters in robotic walking rehabilitation are different. Patients should be evaluated to determine their needs and patient-specific exercise should be selected.