Robot-assisted gait training is not superior to intensive overground walking in multiple sclerosis with severe...

Rehabilitation may attenuate the impact on mobility of patients with progressive multiple sclerosis (MS) and severe gait disabilities.

In this randomized controlled trial, we compared robot-assisted gait training (RAGT) with conventional therapy (CT) in terms of gait speed, mobility, balance, fatigue and quality of life (QoL).

Seventy-two patients with MS (expanded disability status scale score 6.0-7.0) were randomized to receive 12 training sessions over a 4-week period of RAGT (n = 36) or overground walking therapy (n = 36). The primary outcome was gait speed, assessed by the timed 25-foot walk test. Secondary outcome measures were walking endurance, balance, depression, fatigue and QoL. Tests were performed at baseline, intermediate, at the end of treatment and at a 3-month follow-up.

Sixty-six patients completed the treatments. At the end of treatment with respect to baseline, both groups significantly improved gait speed (p < 0.001) and most secondary outcomes without between-group differences. Outcome values returned to baseline at follow-up.

RAGT was not superior to CT in improving gait speed in patients with progressive MS and severe gait disabilities where a positive, even transitory, effect of rehabilitation was observed.