Hocoma AG is a Swiss medical technology company headquartered in Volketswil, Switzerland, specializing in the development and manufacture of robotic rehabilitation devices for patients with neurological disorders. Founded in 1996 as a spin-off from the Swiss Federal Institute of Technology (ETH Zurich), Hocoma has grown to become one of the world's leading providers of robot-assisted rehabilitation therapy solutions, with products deployed in over 1,000 clinical and research facilities across 40+ countries[1].
The company's product portfolio addresses the full spectrum of neurorehabilitation, from early mobilization through to advanced gait training and upper limb recovery. Hocoma's devices are used to treat patients recovering from stroke, Parkinson's disease, multiple sclerosis, spinal cord injury, traumatic brain injury, and other neurological conditions that impair motor function. Hocoma operates as a subsidiary of DIH Holding AG, a global provider of rehabilitation solutions that includes subsidiaries in the United States (DIH), China, and Europe.
Hocoma was founded in 1996 by Professor Leonardi and Professor Colombo at ETH Zurich, with the goal of translating robotics research into clinical rehabilitation applications. The company's early focus was on gait rehabilitation, driven by the recognition that repetitive, high-intensity task-specific training was essential for neuroplastic recovery — yet traditional therapy approaches were constrained by therapist fatigue and limited session duration. The founding team developed the first prototype of what would become the Lokomat system in collaboration with clinicians and researchers at the Swiss Paraplegic Centre[1:1].
During the 2000s, Hocoma expanded its product portfolio significantly:
The company established its US subsidiary in 2005 and expanded into Asian markets through distribution partnerships. During this period, Hocoma accumulated extensive clinical evidence supporting the efficacy of robot-assisted therapy, positioning the company as a market leader.
Following 2010, Hocoma continued expanding globally:
Today, Hocoma maintains its primary R&D and manufacturing operations in Switzerland, with global sales and support operations through DIH's international network.
The Lokomat is Hocoma's flagship product — a robotic gait training system that enables patients with neurological disorders to practice walking with accurate, repeatable, high-intensity training[2].
System Components:
| Component | Description |
|---|---|
| LokomatPro | Full-featured gait orthosis with dynamic body weight support |
| LokomatNano | Compact version for space-constrained facilities |
| Dynamic Body Weight Support (DynaPS) | Active weight relief system allowing natural gait patterns |
| Hocomatraining | Software platform for protocol management and progress tracking |
| Sensorimotor Gait Analysis | Built-in measurement of gait parameters |
Technical Specifications:
Clinical Utility: The Lokomat allows patients to practice walking with a physiological gait pattern from the earliest stages of rehabilitation, even before they can bear full weight. The system provides precise, repeatable training that is difficult or impossible to achieve with manual assisted walking[3]. The dynamic body weight support system allows natural vertical movement during gait, avoiding the "treadmill gait" pattern that static support systems can produce[4].
Evidence for Parkinson's Disease: Multiple studies have evaluated Lokomat training in PD patients, demonstrating improvements in gait velocity, stride length, cadence, and functional mobility[5][@gall2014]. The intensive, task-specific nature of Lokomat training aligns with principles of neuroplasticity that suggest high-repetition, meaningful movement drives neural reorganization in the damaged motor system.
The ErigoPro is an advanced tilt table with integrated robotic leg movement for early mobilization and circulation recovery[6]:
Clinical Applications:
The ArmeoPower provides robot-assisted arm therapy for patients with moderate to severe upper limb impairment[@armeo]:
Therapeutic Approach: The ArmeoPower uses an "assist-as-needed" control strategy — the robot provides exactly as much assistance as the patient requires to complete the movement, gradually reducing support as the patient's abilities improve. This approach promotes active patient participation while ensuring successful movement completion.
Evidence: Research demonstrates that Armeo therapy combined with conventional rehabilitation produces greater improvements in arm function than conventional therapy alone, with effect sizes most pronounced in the subacute phase after stroke[7][8][9].
The ArmeoSpring provides arm weight support for patients with mild to moderate impairment:
The ArmeoBoom provides over-ground arm training support:
The VALEO functional electrical stimulation (FES) system integrates electrical stimulation with movement training[10]:
Foot Drop Application: VALEO addresses foot drop — a common gait impairment in Parkinson's disease and stroke — by electrically stimulating the tibialis anterior muscle during swing phase, producing a more natural dorsiflexion pattern.
Research on robot-assisted gait training with Hocoma systems in PD patients has grown substantially over the past decade:
Meer et al. (2017)[5:1]:
Galli et al. (2014)[@gall2014]:
Calabrò et al. (2014)[11]:
Mehrholz et al. (2017) — Cochrane Review[12]:
Hidler et al. (2009)[3:1]:
Hornby et al. (2008)[4:1]:
Schroter et al. (2009)[8:1]:
The broader evidence base for robot-assisted rehabilitation supports Hocoma's technology:
Parkinson's disease is characterized by gait impairment including reduced velocity, shortened stride length, shuffling, and in some patients, freezing of gait. The Lokomat addresses these symptoms through:
Pattern Normalization: The robotic gait orthosis guides patients through a physiological gait pattern with full stride length and proper swing/stance phase characteristics. Over repeated sessions, this intensive practice may help retrain the motor system to generate more normal movement patterns.
Intensity: The Lokomat enables training sessions of 30-60 minutes with consistent, accurate assistance — far exceeding what therapists can provide manually. Research suggests that gait recovery depends on achieving high step counts and intensive practice.
Visuomotor Feedback: Patients can observe their gait pattern on screen, providing real-time feedback that may support motor learning through visual error correction.
Freezing of gait — a sudden, episodic inability to initiate or continue walking — is a particularly disabling PD symptom. Robot-assisted gait training may help address freezing through:
Postural instability and falls are major causes of disability and injury in PD. While the Lokomat focuses on gait training, Hocoma's systems can be integrated with balance training to address this domain:
Exercise has been shown to benefit non-motor symptoms of PD including depression, fatigue, and cognitive impairment. The intensive nature of robot-assisted training may amplify these benefits:
The Hocomatraining software platform provides:
Hocoma devices use several advanced control strategies:
"Assist-as-Needed" Control: The robot provides only the assistance required for successful task completion, gradually reducing support as the patient improves. This approach maximizes patient engagement and motor learning.
Guidance Force Control: Adjustable resistance that guides the patient through the intended movement while allowing some deviation for error correction learning.
Performance-Based Progression: Software algorithms adjust difficulty based on real-time assessment of patient performance, ensuring optimal challenge level.
Hocoma devices incorporate multiple safety features:
Hocoma competes in the rehabilitation robotics market with several established companies:
| Company | Key Products | Market Position |
|---|---|---|
| Hocoma | Lokomat, Armeo, Erigo | Market leader in gait robotics |
| Tyromotion | TYMO, AMADEO, PABLO | Strong in gaming-integrated therapy |
| Reo (Japan) | ReoGo, ReoArm | Asian market leader |
| Ekso Bionics | EksoGT, EksoNR | Exoskeleton focus, US market |
| Bionik | InMotion robots | Research-focused |
| Cyberdyne | HAL exoskeleton | Advanced robotics, Japan focus |
Hocoma Differentiation:
| Region | Status | Products |
|---|---|---|
| FDA (USA) | 510(k) cleared | Lokomat, ArmeoPower, ArmeoSpring, Erigo |
| CE Mark (EU) | Class IIa medical device | Full product line |
| PMDA (Japan) | Approved | Gait and arm therapy systems |
| TGA (Australia) | Approved | Full product line |
| NMPA (China) | Approved via DIH | Gait and arm therapy systems |
Hocoma operates globally through the DIH network:
Hocoma and DIH continue developing next-generation rehabilitation technologies:
Hidler J, et al. Novel approaches to gait rehabilitation using robotic devices. J NeuroEngineering Rehabil. 2009. ↩︎ ↩︎
Hornby T, et al. Enhanced gait training using robotic guidance. J NeuroEngineering Rehabil. 2008. ↩︎ ↩︎
Meer J, et al. Lokomat gait training in Parkinson's disease. J NeuroEngineering Rehabil. 2017. ↩︎ ↩︎
Winstein C, et al. Effects of intensive robot-assisted training on motor recovery after stroke. Neurorehabil Neural Repair. 2014. ↩︎
Schroter O, et al. Effects of robot-assisted arm therapy in chronic stroke. J Rehabil Med. 2009. ↩︎ ↩︎
Mayer S, et al. Armeo therapy for upper limb rehabilitation in neurological disorders. NeuroRehabilitation. 2019. ↩︎
Calabro R, et al. Robot-assisted gait training in Parkinson's disease. Expert Rev Med Devices. 2014. ↩︎
Mehrholz J, et al. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2017. ↩︎