Simulator for the rehabilitation of Lokomat: best clinics abroad

Lokomat is a robotic system used to practise walking within a neurological rehabilitation programme. An overhead harness supports part of the person's body weight while powered leg orthoses guide stepping on a treadmill. A therapist adjusts the assistance and workload to encourage active participation at a manageable level. Training may be considered after stroke, spinal cord injury or brain injury, and for selected children with cerebral palsy. Having one of these diagnoses does not automatically make someone a suitable candidate.

Assessment considers joint movement, bone and skin health, tolerance of standing, safe fitting of the equipment and communication of discomfort. Sessions complement practice of balance and movement outside the device; independent walking cannot be guaranteed. Patients may consider a centre abroad to access suitable Lokomat equipment and a team combining robotic training with other therapies. Comparing programmes should include functional goals, staff training, accessible accommodation and arrangements for continuing rehabilitation at home.

Defining the goals of gait training

Lokomat provides repeated stepping practice with adjustable support. The rehabilitation team identifies relevant goals, such as accepting weight through the legs, contributing to a step or tolerating activity. After stroke, robotic gait training combined with physiotherapy can help some people regain independent walking. Evidence across this category of devices does not establish the same benefit for every diagnosis or prove that one brand suits everyone. It forms part of comprehensive rehabilitation.

Assessment before starting

The team reviews neurological history, previous surgery, fractures, joint replacements, pain and restrictions on weight bearing. Examination includes hip, knee and ankle movement, muscle tone, joint stability and tolerance of an upright position. Significant bone fragility, unhealed fractures, fixed contractures or an unsafe fit can prevent use. Body measurements must suit the particular system and available adult or paediatric orthoses.

Before travelling, clarify assistance needs, wheelchair access, transport and the centre's instructions about clothing, footwear and existing braces. For children, explain the session in an understandable way and agree how they can report fear, pain or discomfort.

What happens during a session

A trained therapist fits the harness and leg orthoses, checks alignment and sets the treadmill speed. Body weight support and robotic guidance are adjusted to the person's abilities. The patient contributes to movement where possible; interactive screen activities may support attention and motivation. Session length and frequency depend on tolerance and treatment goals rather than a universal course. The therapist reviews settings as the person responds.

Safety and progress outside the device

Fatigue, skin irritation, pain and joint overload are possible. Dizziness, unusual numbness or discomfort should be reported immediately so that training can stop and the cause be assessed. Suspension does not remove every risk. Progress should also be measured through walking, everyday activities and assistance needs outside the machine. Home exercises and walking aids require guidance from the treating team.

Costs and practical planning

An estimate should cover initial assessment, therapist time, planned sessions and other therapies. Accommodation, accessible transport and caregiver support may add costs. Ask what happens if assessment shows that the equipment is unsuitable or the programme needs modification.

Frequently asked questions

Does Lokomat guarantee independent walking?

No. Outcomes depend on the neurological injury, existing abilities and the wider programme.

Can it be used after joint replacement?

Only after the team checks movement restrictions and safe fitting.

Does the robot replace a therapist?

No. A trained professional supervises treatment and helps apply skills to daily life.