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During the sixth session with the lokomat, the patient expressed a desire to increase her walking duration to 40 minutes.At approximately 35 minutes into the session, she began to exhibit fatigable clonus in the right calf muscle complex.Despite this, she remained able to achieve adequate foot clearance with the assistance of foot lifters.The patient reported that her foot felt "weird"; at that point, clonus was explained to her, and reassurance was provided that this can occur in the context of fatigue.As the patient was close to achieving her session goal and she was encouraged to continue walking safely with support, the decision was made to continue for a further 2-3 minutes before resting.At approximately 38 minutes, the lokomat stumble detection / cut-off feature activated, leaving the patient's right foot trapped behind her, positioned in plantar flexion and inversion within the foot lifter.
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Patient was diagnosed with marked osteoporosis after the event, which is a contraindication for lokomat training.Lokomat stumbling detection worked as intended, but osteoporotic fibula did not withstand the occurring forces.The responsible healthcare professional involuntarily treated a contraindicated patient, which led to the incident.
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