Pediatric Andago and Lokomat physical therapy for walking

What is pediatric Andago and Lokomat physical therapy for walking?

Lokomat and Andago are robotic devices that support a child’s body weight and help their legs move through the motions of walking. The devices include a harness that safely holds a child with attached braces that guide their legs as they practice walking. Our therapists adjust the devices to each child’s size, and they fit children from about age 5 through young adults.

Our physical therapy team uses Lokomat and Andago devices as part of the Gait and Mobility Program at Children's Health. The program provides comprehensive therapy for children who have difficulty walking because of traumatic injuries, developmental disabilities and certain chronic conditions.

What are the benefits of pediatric Andago and Lokomat physical therapy for walking?

The Lokomat and Andago devices can help children who need support to improve their walking ability, speed and endurance. Depending on your child’s level of walking, they might use one or both systems.

• Lokomat system - The Lokomat system is designed to work with a treadmill, providing body-weight support as your child practices walking on the treadmill. We use Lokomat for children who are not walking or are having difficulty walking, to get them started with supported treadmill walking.

• Andago System - Children can progress to the Andago system as their strength, mobility and walking ability improve. Andago supports children as they walk “over ground,” also called free walking, which means not on a treadmill.

The Lokomat and Andago systems can help your child improve their walking function, speed, mobility and endurance, with benefits including:

• Increased strength in the legs and trunk

• Improved muscle tone and control

• Improved blood circulation

• Improved posture

• Reduced reliance on assistive devices, such as walkers

• Increased bone mineral density through weight-bearing exercise

• Retraining of the brain and spinal cord for walking, through the repetitive patterns that the devices provide

What to expect with pediatric Andago and Lokomat physical therapy for walking

The Lokomat and Andago devices can help children who have injuries, developmental disabilities or chronic conditions such as:

• Cerebral palsy (CP)

• Traumatic brain injury (TBI)

• Spinal cord injury

• Multiple sclerosis

• Guillain-Barré syndrome

• Stroke

• Muscle weakness

• Acute flaccid myelitis

Robotic-assisted locomotor training with these devices may not be appropriate for everyone. The physical therapists (PT) at Children’s Health perform a thorough evaluation to determine whether the therapy may be right for your child.

What to expect before pediatric Andago and Lokomat physical therapy for walking

When our physical therapy team receives the referral from your child’s doctor, we schedule a 1.5-hour session for an evaluation. If the Lokomat or Andago is an appropriate option for your child, we work closely with you to understand your treatment goals for your child. We then develop a care plan with the number and length of sessions to help your child achieve those goals.

It may take one to two sessions to set up and adjust the device for your child and help them get comfortable with the device. We take the time to show your child the device and how it works, because it is a large piece of equipment that might be scary. We show you and your child videos of children walking in the Lokomat or Andago so you can see what it’s like. We help them get used to it by showing them some of the games and activities that the device provides.

What to expect during pediatric Andago and Lokomat physical therapy for walking

The Lokomat device has robotic leg braces that move your child’s legs in a walking pattern. The therapists can adjust the motions, including speed and patterns. The braces can have different settings for each leg, in case one leg needs more assistance. The devices also include virtual reality activities and interactive games to help motivate and entertain your child.

Both devices provide dynamic body weight support, which means that the harness consistently supports your child’s weight when they move. As your child walks, the devices support the same amount of weight with all your child’s movements: up, down and side-to-side.

During each session, the therapist stays by your child’s side to guide their activities and gently encourage them with instructions and cues. As your child progresses, we engage them with games and activities that provide more motivation and stimulation. Over time, we can decrease the guidance that the braces provide so that your child is doing more of the work. Our goal is that your child’s legs take on more of the body weight, which can improve their walking motion, strength, speed and endurance.

What to wear and bring to pediatric Andago and Lokomat physical therapy for walking

• Workout clothes, especially long pants, because the robotic leg braces have cuffs that could rub against your child’s skin if they wear shorts

• Athletic shoes

• Leg or feet braces, if your child uses them

What to expect after pediatric Andago and Lokomat physical therapy for walking

We regularly reassess your child to check their progress and adjust their care plan as needed. After Lokomat and Andago therapy, your child may or may not continue with other physical therapy, depending on their therapy goals.

What questions should I ask my provider about pediatric Andago and Lokomat physical therapy for walking?

If your child’s doctor recommends physical therapy with robotic-assisted gait/locomotor training, you may want to know more before deciding on treatment.

Some questions to ask include:

• Is the physical therapist specifically trained in the use of Andago and/or Lokomat?

• Will I need to do anything to prepare my child before Pediatric Andago and Lokomat Therapy?

• Will my child need any special equipment after Pediatric Andago and Lokomat Therapy?