Lokomat® vs RoboGait® Under Different Guidance Force Settings in Motor-Incomplete SCI

This pilot study investigated the effects of two robotic-assisted gait training systems, Lokomat® V6 (Hocoma AG, Switzerland) and RoboGait® (BAMA Teknoloji, Türkiye), applied under different guidance force (GF) settings, on walking ability, functional mobility, and health-related quality of life in individuals with motor-incomplete spinal cord injury (iSCI).

Eligible participants were aged 18 years or older, with injury at T3 level or below, AIS C or D classification, and injury duration of 2 years or less. Exclusion criteria included severe spasticity (Modified Ashworth Scale ≥ 3), joint disorders, implanted electronic devices, orthostatic hypotension, cardiac problems, or conditions preventing secure positioning in the robotic systems.

Participants were assigned to three groups according to their average GF during training: Lok90- (GF < 90% with Lokomat®), Lok90+ (GF ≥ 90% with Lokomat®), and RG (GF ≥ 90% with RoboGait®). All participants completed 10 treadmill-based gait training sessions over 4 weeks, with three sessions per week. Walking speed and angular parameters were individually adjusted to enhance comfort, reduce fatigue, and encourage active participation. Alongside robotic gait training, all participants received conventional physiotherapy that included stretching, strengthening, balance, walking, and mobility exercises.

The primary outcome was walking status, measured using the Walking Index for Spinal Cord Injury II (WISCI II). Secondary outcomes included, functional mobility (Timed Up and Go Test, TUG), lower extremity muscle strength (LEMS), balance (Berg Balance Scale, BBS), functional independence (Spinal Cord Independence Measure III, SCIM III), and health-related quality of life (WHOQOL-BREF-TR). The study aimed to determine whether the type of robotic system and GF settings influence functional outcomes in iSCI rehabilitation.

Inclusion criteria

• Adults aged 18 years or older.
• Diagnosis of spinal cord injury (SCI) at T3 level or below.
• Injury duration of no more than 2 years.
• Functional classification of C or D based on the American Spinal Injury Association (ASIA) Impairment Scale.
• ICD-10 diagnosis codes between S24.73-S24.77 or S34.70

Exclusion criteria

• Participation in another study.
• Joint disorders affecting mobility.
• Implanted electronic devices.
• Orthostatic hypotension.
• Severe spasticity in the lower extremities (Modified Ashworth Scale score ≥ 3).
• Cardiac problems or conditions impairing stabilization in the robotic systems.
• Presence of a colostomy.