Exoskeleton Therapy Improves Disability in Multiple Sclerosis

Robotic-exoskeleton assisted exercise rehabilitation (REAER) therapy is shown to improve mobility, cognition, and brain connectivity in people with substantial MS-related neurological disabilities.

Robotic-exoskeleton assisted exercise rehabilitation (REAER) therapy is an effective intervention, that is shown to improve mobility, cognition and brain connectivity in people with substantial MS-related neurological disability as per the first pilot randomized controlled trial study "A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis," by Kessler Foundation/Jody Banks, published in the journal Multiple Sclerosis and Related Disorders.

Multiple sclerosis (MS) is a demyelinating autoimmune neurological condition that commonly affects the myelin sheath (outer fatty cover of nerves), brain, optic nerves, and spinal cord.

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‘Robotic-exoskeleton assisted exercise rehabilitation (REAER) therapy is shown to improve mobility, cognition, and brain connectivity in people with substantial MS-related neurological disabilities. This promises for improving the lives of MS patients with co-occurring mobility and cognitive disability.’

It results in a range of incapacitating symptoms that differ from one person to another such as unsteadiness, blurred vision, tingling sensations, memory problems, and fatigue. The lack of treatment options is a major problem for people with MS, especially those with substantial MS-related neurological disabilities.

Exercise rehabilitation, such as walking, is shown to be an effective approach to symptom management, with evidence suggesting that even a single exercise rehabilitation intervention can improve both mobility and cognition in MS.

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However, in people with MS who have a substantial disability, there is a lack of efficacy of exercise rehabilitation on mobility and cognitive outcomes with no demonstrated convincing results from adaptive exercise rehabilitation.

The present study enrolled 10 participants with significant MS-related neurological disability, to explore the use of robotic exoskeletons in managing symptoms. Robotic exoskeleton is a relatively new approach that enables participants to walk over-ground in a progressive regimen that involves close engagement with a therapist.

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REAER allows participants to walk at volumes needed to realize functional adaptations via vigorous neurophysiological demands, which lead to improved cognition and mobility. Functional MRI was utilized to assess the exercise effects on brain activity patterns.

It was found that REAER revealed positive outcomes by largely improving participants' functional mobility, walking endurance, cognitive processing speed, and brain connectivity after four weeks when compared to conventional gait training.

"Four weeks is relatively short for an exercise training study. Seeing improvements within this timeframe shows the potential for exercise to change how we treat MS. Exercise is really powerful behavior that involves many brain regions and networks that can improve over time and result in improved function," says Dr. Sandroff, a senior research scientist at Kessler Foundation and director of the Exercise Neurorehabilitation Research Laboratory.

"This is particularly exciting because therapy using robotic exoskeletons shows such promise for improving the lives of people with co-occurring mobility and cognitive disability, a cohort that likely has the greatest potential to benefit from this new technology. We're eager to design a larger trial to further study these effects. Based on our initial results, we're optimistic that this approach may be superior to the current standard of care," says Dr. Androwis, lead author and research scientist in the Center for Mobility and Rehabilitation Engineering Research at Kessler Foundation.

Source-Medindia