The order of gait training, including Lokomat® and Physiotherapy, do not influence gait symmetry in subacute ambulatory persons with stroke in Electromechanical-assisted training for walking after stroke

Little evidence has been provided regarding the effect of the Lokomat® on the coordination of gait pattern. It was hypothesized that the Lokomat® would increase gait symmetry more than physiotherapy in sub-acute stroke patients.
Thirteen patients were randomised to intervention group Lokomat® and physiotherapy or physiotherapy and Lokomat® in a cross-over study. Both interventions consisted of three weeks gait training, and gait symmetry, expressed as absolute step length ratio (SLR) and single support stance time in impaired extremity (SSS), and self-selected gait speed (SWS) were collected in a 3D gait analysis system.
There was no differences in gait parameters between gait intervention groups, but a trend suggested that the physiotherapy- Lokomat® group improved more than Lokomat®- physiotherapy during the first three weeks measuring SSS (p=.028) and SWS (p=.06). SWS showed significant improvements in Lokomat® (0.08 m/s, p=.018) and physiotherapy (0.26 m/s, p=.028) after three and six weeks of training (Lokomat®: 0.12, p=.028; physiotherapy: 0.1, p=.028). Additionally, intervention groups showed clinical relevant changes in SSS (5.4%-10.5%) and in walking speed (0.18 m/s to 0.36 m/s).
No differences were found between physiotherapy and Lokomat® gait training, but results indicated clinical relevant changes in gait symmetry and gait speed for both interventions.