Robotic Gait Training in Specific Neurological Conditions: Rationale and Application

This chapter focuses on robotic gait training. As a basis, it summarizes the neurophysio-logical rationale for such training. These neurophysiological findings are mostly based on animal studies. The observations from these studies led to the development of theories such as the spinal central pattern generator (CPG). In a deductive manner, studies have then also been performed on human participants showing similar phenomena. Based on the neurophysiological mechanisms, robot-assisted locomotor training is justified even in patients with severe functional limitations.Those patients would not be able to maintain an upright posture while performing stepping movements in a conventional training condition.The clinical application of robotic gait training is, therefore, another focus of this chapter. Different robotic devices and their relevant characteristics are introduced. Not all devices are designed to purely assist locomotor training by maximally exploiting the neuroplastic potential of the central nervous system. Some devices can also be considered assistive technologies which support patients in their daily life mobility. General aspects which are relevant for robotic gait training during rehabilitation are summarized. Then the chapter takes the translation of the fundamental principles one step further and addresses the application of robotic gait training in specific neurological conditions, that is, in stroke, traumatic brain injury (TBI), spinal cord injury (SCI), multiple sclerosis (MS), and Parkinson’s disease. These parts are written by experts in their respective fields. Every section follows the same structure and informs the reader about the condition in general, specific gait limitations, and the rehabilitation thereof. If available, the latter is supported by recent high-level evidence. In the other cases, relevant primary studies are summarized. Because specific clinical guidelines for the application of robotic gait training are largely missing, the e