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Application of Bedside Lower Extremity Rehabilitation Robots in Stroke Rehabilitation: A Randomized Controlled Trial
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Robot-assisted gait training in multiple sclerosis: a pilot randomized trial.

S Beer1, B Aschbacher, D Manoglou

  • 1Department of Neurology and Neurorehabilitation, Rehabilitation Centre, CH-7317 Valens, Switzerland. s.beer@klinik-valens.ch

Multiple Sclerosis (Houndmills, Basingstoke, England)
|October 19, 2007
PubMed
Summary

Robot-assisted gait training (RAGT) shows promise for improving walking ability and knee strength in multiple sclerosis (MS) patients with severe mobility issues. While preliminary, RAGT appears feasible and potentially more effective than conventional training, warranting further investigation.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Robotics in Healthcare

Background:

  • Multiple sclerosis (MS) frequently causes severe walking disabilities.
  • Robot-assisted gait training (RAGT) is an emerging technology for rehabilitation.
  • Feasibility and efficacy of RAGT in MS patients with advanced disability remain under-explored.

Purpose of the Study:

  • To assess the feasibility of robot-assisted gait training (RAGT) in MS patients with severe walking impairments (EDSS 6.0-7.5).
  • To conduct an explanatory analysis of RAGT's efficacy compared to conventional walking training (CWT).

Main Methods:

  • A prospective, randomized, controlled pilot trial involving 35 stable MS patients undergoing inpatient rehabilitation.
  • Intervention: 15 sessions of RAGT or CWT over three weeks, alongside a multimodal rehabilitation program.
  • Outcome measures: Walking velocity, 6-minute walking distance, stride length, knee-extensor strength, Extended Barthel Index (EBI), and patient-reported RAGT acceptance (VAS).

Main Results:

  • RAGT was found to be feasible with high patient acceptance and convenience.
  • Effect sizes favored RAGT for walking velocity (0.700), walking distance (0.401), and knee-extensor strength (1.105 right, 0.650 left), though not statistically significant.
  • Within-group analysis showed improvements in walking velocity, distance, and strength for RAGT, versus only velocity for CWT. Gains reverted to baseline at 6-month follow-up.

Conclusions:

  • Robot-assisted gait training (RAGT) is a feasible therapeutic option for MS patients with severe walking disabilities.
  • Preliminary results suggest RAGT may offer greater benefits for walking velocity and knee-extensor strength compared to CWT.
  • Larger studies are required to confirm efficacy, as this pilot trial was underpowered (requiring 106 patients per group for significance).