Robot-assisted gait training shows promise in patients with MS

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Gait disturbances and walking difficulties are common features of
multiple sclerosis (MS). Physical therapy can be effective in
increasing mobility; however, conventional walking training (CWT) is
physically demanding for the therapist and the manual stimulation of
gait pattern provided by this therapy is quite basic. Robot-assisted
gait training (RAGT) might facilitate more-effective support of
walking movements. Researchers from the Rehabilitation Centre, Valens,
Switzerland have examined the efficacy of RAGT in MS patients with
severe walking disabilities.

In this pilot study, 35 patients were randomized to receive 15
sessions of either RAGT (n = 19) or CWT (n = 16) over a 3-week period,
during an inpatient rehabilitation stay. In total, 14 patients from
the RAGT group and 15 patients from the CWT group completed the full
course of walking training.

Significant improvements over baseline in 20 m walking velocity were
seen in both the RAGT group and the CWT group (P = 0.003 and P =
0.026, respectively). By contrast, only the patients in the RAGT group
showed significant improvements in walking distance, and in extensor
strength in the right and left knees (P = 0.006, P = 0.006 and P =
0.004, respectively). Between-group differences as measured by effect
size were large for the end points of walking velocity and knee-
extensor strength (effect size >0.6 for each) and moderate for 6 min
walking distance (effect size 0.4-0.6), all favoring RAGT. Walking
safety as rated by the patients (Visual Analogue Scale) was lower
after RAGT than after CWT, but this difference was not significant.
Overall patient satisfaction with RAGT was high. The researchers
conclude that larger studies of RAGT in MS are warranted.