Sensory-Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Tannenstrasse 1, 8092, Zurich, Switzerland.
Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.
J Neuroeng Rehabil. 2022 Apr 22;19(1):40. doi: 10.1186/s12984-022-01017-3.
Lokomat therapy for gait rehabilitation has become increasingly popular. Most evidence suggests that Lokomat therapy is equally effective as but not superior to standard therapy approaches. One reason might be that the Lokomat parameters to personalize therapy, such as gait speed, body weight support and Guidance Force, are not optimally used. However, there is little evidence available about the influence of Lokomat parameters on the effectiveness of the therapy. Nevertheless, an appropriate reporting of the applied therapy parameters is key to the successful clinical transfer of study results. The aim of this scoping review was therefore to evaluate how the currently available clinical studies report Lokomat parameter settings and map the current literature on Lokomat therapy parameters.
A systematic literature search was performed in three databases: Pubmed, Scopus and Embase. All primary research articles performing therapy with the Lokomat in neurologic populations in English or German were included. The quality of reporting of all clinical studies was assessed with a framework developed for this particular purpose. We identified 208 studies investigating Lokomat therapy in patients with neurologic diseases. The reporting quality was generally poor. Less than a third of the studies indicate which parameter settings have been applied. The usability of the reporting for a clinical transfer of promising results is therefore limited.
Although the currently available evidence on Lokomat parameters suggests that therapy parameters might have an influence on the effectiveness, there is currently not enough evidence available to provide detailed recommendations. Nevertheless, clinicians should pay close attention to the reported therapy parameters when translating research findings to their own clinical practice. To this end, we propose that the quality of reporting should be improved and we provide a reporting framework for authors as a quality control before submitting a Lokomat-related article.
Lokomat 疗法在步态康复中的应用越来越受欢迎。大多数证据表明 Lokomat 疗法与标准疗法同样有效，但并不优于标准疗法。一个原因可能是 Lokomat 用于个性化治疗的参数，如步行速度、身体重量支持和引导力，没有得到最佳利用。然而，关于 Lokomat 参数对治疗效果的影响，证据很少。然而，对应用治疗参数的适当报告是成功将研究结果临床转化的关键。因此，本范围综述的目的是评估目前可用的临床研究如何报告 Lokomat 参数设置，并绘制 Lokomat 治疗参数的当前文献图谱。
在 Pubmed、Scopus 和 Embase 这三个数据库中进行了系统文献检索。纳入了所有使用 Lokomat 对神经人群进行治疗的英语或德语原始研究文章。使用为此特定目的开发的框架评估了所有临床研究的报告质量。我们确定了 208 项研究，这些研究调查了 Lokomat 疗法在神经疾病患者中的应用。报告的质量普遍较差。只有不到三分之一的研究表明应用了哪些参数设置。因此，报告的可用性限制了有前途的研究结果在临床中的应用。
尽管目前关于 Lokomat 参数的证据表明治疗参数可能对疗效有影响，但目前还没有足够的证据提供详细的建议。然而，临床医生在将研究结果转化为自己的临床实践时，应密切关注报告的治疗参数。为此，我们建议提高报告质量，并为作者提供一个报告框架，作为提交与 Lokomat 相关文章的质量控制。
