File
Altenburger P1, Pilutti L2, Molt R3, Cardinal R1,4, Rajendra SD5, Frame J4, Wichlinski R1, Kraus S1, Wilson M1, Needham M1, Noyes S1, Riedford M1, Peters A1
1Indiana University, Physical Therapy, Indianapolis, United States, 2University of Ottawa, Interdisciplinary School of Health Sciences, Ottawa, Canada, 3University of Alabama at Birmingham, Physical Therapy, Birmingham, United States, 4Indiana University Health, Rehabilitation Services, Indianapolis, United States, 5Indiana University Health, Physical Therapy, Indianapolis, United States
Background: Progressive multiple sclerosis (MS) is characterized clinically by gradual disease progression and accumulation of neurological disability, independent of relapses. Rehabilitation has been recommended as a means to reduce disability and restore function. High quality evidence supporting progressive MS rehabilitation is limited. An end-effector robot-assisted gait trainer (RAGT) addresses many of the limitations of therapist-assisted gait training while providing an environment for regaining mobility and independence.
Purpose: The purpose of this study was to establish the safety and feasibility of RAGT and determine its impact on movement capacity, fatigue, and quality of life in patients with progressive MS.
Methods: Single-blinded, randomized clinical trial using RAGT. Subjects trained 2 times per week for 10 weeks for a total of 20 training sessions. Physical Therapists individualized training intensity and RAGT characteristics to maximize benefits for each subject. Motor capacity outcomes (Walking speed and endurance [2 MWT]) and quality of life measures (Modified Fatigue Impact Scale [MFIS] and the Multiple Sclerosis Impact Scale 29 [MSIS-29]) were assessed at baseline and after the final training session (20th session). Subjects were monitored at each visit for adverse
Results: Five subjects with progressive MS have completed the RAGT protocol. Four women and one man ranging in age from 33 to 63. The group has a range of EDSS scores from 4.5 to 6.5. There was no reported adverse event for any subject. Three of the five subjects experienced a 10% or greater increase in walking speed with an average improvement of 0.062 m/s. The group averaged 13% improvement in fast walking speed. Subjects experienced an average improvement of 10% on the MFIS and 15% on the MSIS-29. MFIS subscales revealed the greatest amount of improvement in the physical domain (44%). The MSIS-29 subscales indicated that individuals had a significant decrease in physical disability (18%).
Conclusion(s): These five subjects with progressive MS tolerated the treatment dosage of 2 times per week for 20 weeks and did not experience any adverse event throughout the robotic training. Focused gait training using RAGT resulted in improvement in walking speed. Subjects reported that training reduced their disability and fatigue enhancing their overall quality of life.
Implications: These findings, while not conclusive, indicate that individuals with progressive MS responded favorably to RAGT training. This was evident with individuals who had mild and moderate/severe walking impairment. Subject interviews following completion of the study indicated that the robotic training improved their quality of life. These early outcomes warrant further investigation of the G-EO end-effector as a viable option for managing individuals with progressive MS.
Keywords: Robotic rehabilitation, Progressive MS, Quality of life
Funding acknowledgements: US National Multiple Sclerosis Society Grant # PP-1603-08269
Purpose: The purpose of this study was to establish the safety and feasibility of RAGT and determine its impact on movement capacity, fatigue, and quality of life in patients with progressive MS.
Methods: Single-blinded, randomized clinical trial using RAGT. Subjects trained 2 times per week for 10 weeks for a total of 20 training sessions. Physical Therapists individualized training intensity and RAGT characteristics to maximize benefits for each subject. Motor capacity outcomes (Walking speed and endurance [2 MWT]) and quality of life measures (Modified Fatigue Impact Scale [MFIS] and the Multiple Sclerosis Impact Scale 29 [MSIS-29]) were assessed at baseline and after the final training session (20th session). Subjects were monitored at each visit for adverse
Results: Five subjects with progressive MS have completed the RAGT protocol. Four women and one man ranging in age from 33 to 63. The group has a range of EDSS scores from 4.5 to 6.5. There was no reported adverse event for any subject. Three of the five subjects experienced a 10% or greater increase in walking speed with an average improvement of 0.062 m/s. The group averaged 13% improvement in fast walking speed. Subjects experienced an average improvement of 10% on the MFIS and 15% on the MSIS-29. MFIS subscales revealed the greatest amount of improvement in the physical domain (44%). The MSIS-29 subscales indicated that individuals had a significant decrease in physical disability (18%).
Conclusion(s): These five subjects with progressive MS tolerated the treatment dosage of 2 times per week for 20 weeks and did not experience any adverse event throughout the robotic training. Focused gait training using RAGT resulted in improvement in walking speed. Subjects reported that training reduced their disability and fatigue enhancing their overall quality of life.
Implications: These findings, while not conclusive, indicate that individuals with progressive MS responded favorably to RAGT training. This was evident with individuals who had mild and moderate/severe walking impairment. Subject interviews following completion of the study indicated that the robotic training improved their quality of life. These early outcomes warrant further investigation of the G-EO end-effector as a viable option for managing individuals with progressive MS.
Keywords: Robotic rehabilitation, Progressive MS, Quality of life
Funding acknowledgements: US National Multiple Sclerosis Society Grant # PP-1603-08269
Topic: Robotics & technology; Neurology: multiple sclerosis
Ethics approval required: Yes
Institution: Indiana University
Ethics committee: Office of Research Compliance - Indiana University
Ethics number: 1701909134R001
All authors, affiliations and abstracts have been published as submitted.
