title: Robot-assisted training for heart failure patients - a small pilot study.
abstract: OBJECTIVE
  The objective of this study was assess robot-assisted gait therapy with the Lokomat® system in heart failure patients.
  
  
  METHODS
  Patients (n = 5) with stable heart failure and a left ventricular ejection fraction of less than 45% completed a four-week aerobic training period with three trainings per week and an integrated dynamic resistance training of the lower limbs. Patients underwent testing of cardiac and inflammatory biomarkers. A cardiopulmonary exercise test, a quality of life score and an evaluation of the muscular strength by measuring the peak quadriceps force was performed.
  
  
  RESULTS
  No adverse events occurred. The combined training resulted in an improvement in peak work rate (range: 6% to 36%) and peak quadriceps force (range: 3% to 80%) in all participants. Peak oxygen consumption (range: –3% to + 61%) increased in three, and oxygen pulse (range: –7% to + 44%) in four of five patients. The quality of life assessment indicated better well-being in all participants. NT-ProBNP (+233 to –733 ng/ml) and the inflammatory biomarkers (hsCRP and IL6) decreased in four of five patients (IL 6: +0.5 to –2 mg/l, hsCRP: +0.2 to –6.5 mg/l).
  
  
  CONCLUSIONS
  Robot-assisted gait therapy with the Lokomat® System is feasible in heart failure patients and was safe in this trial. The combined aerobic and resistance training intervention with augmented feedback resulted in benefits in exercise capacity, muscle strength and quality of life, as well as an improvement of cardiac (NT-ProBNP) and inflammatory (IL6, hsCRP) biomarkers. Results can only be considered as preliminary and need further validation in larger studies. (ClinicalTrials.gov number, NCT 02146196)
authors.forename: Felix
authors.initials: F
authors.lastname: Schoenrath
authors.forename: Susanne
authors.initials: S
authors.lastname: Markendorf
authors.forename: Andreas Emil
authors.initials: AE
authors.lastname: Brauchlin
authors.forename: Michelle
authors.initials: M
authors.lastname: Frank
authors.forename: Markus Johannes
authors.initials: MJ
authors.lastname: Wilhelm
authors.forename: Lanja
authors.initials: L
authors.lastname: Saleh
authors.forename: Robert
authors.initials: R
authors.lastname: Riener
authors.forename: Christian Marc
authors.initials: CM
authors.lastname: Schmied
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010101:Oxygen Consumption / Q000502:physiology; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods*; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Robot-assisted gait therapy; augmented feedback; heart failure; pilot trial; rehabilitation