Patients with partially severed spinal chords often end up as paraplegics, despite thousands of dollars of rehabilitation. New research and the Lokomat, a tool invented by engineers at Swiss-based Hocoma (hocoma.ch) could change many of those outcomes. It suspends a patient above a treadmill and physically moves the patient's feet, legs, and hips, recreating a correct or normal gait. During initial sessions, the device can carry the patient's entire weight. As patients get stronger and more comfortable, the machine can be programmed to let them assume some of the load, gradually increasing it until they are walking solo. The device can be adjusted to fit a variety of patients, and a new version accommodates children.

The process works based on the neuroelasticity of the human brain and spinal cord. So despite losing connections between parts of the nervous system that once controlled walking and leg movement, repeating the motions used in walking builds new connections. It might take hundreds of thousands, perhaps millions of repetitions, but eventually, many patients respond to the therapy and learn to walk again. Lokomat works with minimal supervision from rehabilitation specialists. In fact, one specialist could probably monitor four or five patients on Lokomat machines at once.

The machine has load and motion sensors in all its joints, so Lokomat can be used to objectively evaluate new patients, telling rehab personnel what a patient's range of motion and strength levels are. Over the course of therapy, it can tell doctors and staff if the patient is making progress, a critical factor for securing Medicare payment. Currently, these assessments are subjective and inconsistent.