Effect of Lyra Gait Training on the Mobility of Geriatric Rehabilitation Inpatients
Effect of Lyra Gait Training on the Mobility of Geriatric Rehabilitation Inpatients
This study evaluates the effect of the addition of gait training to physical therapy on the
 gait of geriatric rehabilitation inpatients. Half of the patients will receive gait training
 with a gait training machine and conventional physical therapy in combination, the other half
 of the patients will receive conventional physical therapy alone.
The geriatric rehabilitation inpatients recruited for this study primarily have difficulties
 with muscle weakness and walking generally due to a prolonged period of bed rest (as opposed
 to patients who primarily have cognitive disorders or neurological diseases), generalized
 muscle weakness and deconditioning. The rehabilitation goal for these patients is to be
 discharged home (not institutionalized) with improved mobility. Geriatric patients require
 intensive training in order to reach their pre-hospital levels of mobility and physical
 functional performance. Usual care involves physical therapy sessions, generally six times
 per week. Regaining mobility is crucial for quality of life and functional independence.

 The aim of this intervention trial is to compare the effectiveness of Lyra gait training plus
 conventional physical therapy (intervention group) on gait compared to conventional physical
 therapy alone (control group) in geriatric rehabilitation patients. We hypothesize that,
 post-intervention, the intervention group will have better mobility and physical functional
 performance than the control group. Trial results will provide physical therapists and
 rehabilitation physicians with valuable information to better treat their inpatients and more
 efficiently use the limited time available for inpatient physical therapy sessions.
 Specifically, physical therapists should be better able to determine if the benefit of the
 Lyra gait trainer for geriatric rehabilitation inpatients with primarily muscle
 deconditioning is strong enough to warrant their extra time investment of providing the Lyra
 gait training. Results should also help determine in the future if the target population
 should continue with outpatient therapy after their discharge home. If this trial supports
 our hypothesis, then the trial results will provide data needed for the sample size
 calculation for a subsequent, larger trial.

 The THERA-Trainer Lyra (from Ability AG, distributed by medica Medizintechnik GmbH) is an
 automated gait trainer with adjustable body weight support (no exoskeleton) and adjustable
 pedals (not a treadmill) that move in a physiological gait pattern derived from natural human
 walking movements. The upright position and the repetitive movement patterns activate muscle
 memory and allow safe gait training at the individual's performance limit throughout
 rehabilitation. The Lyra gait training is used to regain walking ability, improve gait speed,
 improve endurance and improve the gait pattern in geriatric rehabilitation patients.

 Ten patients should be enrolled in this study:

 Intervention group (n=5): Lyra gait training thrice weekly and conventional physical therapy
 (6 times per week) during inpatient period. After discharge home, continuation of thrice
 weekly Lyra gait training and discontinuation of physiotherapy.

 Control group (n=5): Conventional physical therapy (6 times per week) during inpatient
 period. After discharge home, discontinuation of physical therapy.

 At enrollment (Visit 1), all participants will be rehabilitation inpatients. The duration of
 the inpatient period will be determined clinically based on medical need and will thus vary
 from patient to patient. The average length of stay for the targeted population is
 approximately two weeks. Visit 2 will be performed shortly before the patient is discharged
 home. For each participant, the outpatient period (between Visit 2 and Visit 3) will be the
 same duration as the inpatient period (between Visit 1 and Visit 2).
Inclusion Criteria:

 -  65 years of age or older

 -  Rehabilitation inpatients at Felix Platter Hospital with primarily muscle weakness and
 difficulty walking

 -  Community-dwellers before hospital admission with planned discharge home

 -  Body weight 150 kg or less

 -  Body height between 100 cm and 195 cm

 -  Mini-Mental State Examination score 21 points or more

 -  Signed informed consent for study participation

 Exclusion Criteria:

 -  Clinically significant neurologic or musculoskeletal diseases which severly affect
 walking, e.g. advanced Parkinson's disease or hemiplegia

 -  Severe cardiac insufficiency

 -  Advanced chronic pulmonary disease (COPD Gold IV)

 -  Amputations of extremities (except missing fingers)

 -  Blindness

 -  Inability to understand and speak German well enough to understand the patient
 information, training and assessment instructions