Article

The purpose of this case report is to describe attempts to prevent skin-related
adverse events from occurring and protect the skin once breakdown occurred in a
person with chronic stroke during locomotor training. There is scant literature
in how to address skin during locomotor training with the Lokomat((R)),
particularly when a patient presents with sensory deficits and frail skin. The
patient was a 75-year-old male survivor of stroke who participated in the
Lokomat((R)) group of a randomized clinical pilot study comparing locomotor
training with the Lokomat((R)) and conventional means. He had diminished
sensation to light touch and proprioception on his left leg with skin on both
lower legs presenting as thin, flaky, and virtually hairless. Although much
effort was put towards prevention of skin breakdown, he developed numerous
skin-related adverse events during his training. However, his skin healed
completely with reduced training intensity and initiation of "pre-wrapping" his
lower legs with Akton((R)) viscoelastic polymer sheets and elastic bandages.
Significant improvements were noted in his Functional Improvement Measure()
locomotion score and Stroke Impact Scale domains of strength, participation/role
function, and total recovery, though not in his 10-m walk test velocity or 6-min
walk test. The Akton((R)) sheets and team approach between study team, patient,
and his wife allowed simultaneous safe continuation of locomotor training with
the Lokomat((R)) and healing of his skin breakdown.

Langue : ANGLAIS