Robot-assisted gait training in multiple sclerosis patients: a randomized trial

• Published in: Multiple sclerosis Vol. 18; no. 6; pp. 881 - 890
• Main Authors: Schwartz, Isabella, Sajin, Anna, Moreh, Elior, Fisher, Iris, Neeb, Martin, Forest, Adina, Vaknin-Dembinsky, Adi, Karusis, Dimitrios, Meiner, Zeev
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.06.2012; Sage Publications; Sage Publications Ltd
• Subjects: Adult; Aged; Biological and medical sciences; Biomechanical Phenomena; Chi-Square Distribution; Clinical trials; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disability Evaluation; Equipment Design; Female; Gait; Humans; Israel; Locomotor activity; Lower Extremity - physiopathology; Male; Medical sciences; Middle Aged; Motor Activity; Multiple sclerosis; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple Sclerosis, Chronic Progressive - diagnosis; Multiple Sclerosis, Chronic Progressive - physiopathology; Multiple Sclerosis, Chronic Progressive - rehabilitation; Multiple Sclerosis, Relapsing-Remitting - diagnosis; Multiple Sclerosis, Relapsing-Remitting - physiopathology; Multiple Sclerosis, Relapsing-Remitting - rehabilitation; Neurology; Orthotic Devices; Postural Balance; Predictive Value of Tests; Preservation; Prospective Studies; Quality of Life; Recovery of Function; Robotics; robots; Therapy, Computer-Assisted - instrumentation; Time Factors; Treatment Outcome; Walking; Weight-Bearing; Israel; robot-assisted gait training; rehabilitation; multiple sclerosis; EDSS; Human; Nervous system diseases; Multiple sclerosis; Central nervous system disease; Degenerative disease; Rehabilitation; Robot; Inflammatory disease
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458511431075

Background: Preservation of locomotor activity in multiple sclerosis (MS) patients is of utmost importance. Robotic-assisted body weight-supported treadmill training is a promising method to improve gait functions in neurologically impaired patients, although its effectiveness in MS patients is still unknown. Objective: To compare the effectiveness of robot-assisted gait training (RAGT) with that of conventional walking treatment (CWT) on gait and generalized functions in a group of stable MS patients. Methods: A prospective randomized controlled trial of 12 sessions of RAGT or CWT in MS patients of EDSS score 5–7. Primary outcome measures were gait parameters and the secondary outcomes were functional and quality of life parameters. All tests were performed at baseline, 3 and 6 months post-treatment by a blinded rater. Results: Fifteen and 17 patients were randomly allocated to RAGT and CWT, respectively. Both groups were comparable at baseline in all parameters. As compared with baseline, although some gait parameters improved significantly following the treatment at each time point there was no difference between the groups. Both FIM and EDSS scores improved significantly post-treatment with no difference between the groups. At 6 months, most gait and functional parameters had returned to baseline. Conclusions: Robot-assisted gait training is feasible and safe and may be an effective additional therapeutic option in MS patients with severe walking disabilities.