Robot-Assisted Body-Weight-Supported Treadmill Training in Gait Impairment in Multiple Sclerosis Patients: A Pilot Study

Łyp, Marek; Stanisławska, I.; Witek, B.; Olszewska-Żaczek, Ewelina; Czarny-Działak, Małgorzata; Kaczor, Ryszard

doi:10.1007/5584_2018_158

Cited by 9 publications

(11 citation statements)

References 20 publications

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“…The change in intensity load on the femoral quadriceps was also measured with similar data published by Beer et al [ 36 ], thus confirming a moderate to large improvement in gait speed and endurance as well as an increase in knee extensor strength in the group of patients with severe disability (EDSS of 6–7.5). The assumption was that the Lokomat ® could create a higher intensity eccentric quadriceps exercise differently from what occurs during ground training where muscle activation is mainly concentric and of lower intensity [ 21 , 42 ]. Interestingly, the parameters assessing disability and perception of quality of life both improved after treatments in all study groups with a higher positive trend in all outcomes measured in the RAGT than in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…There are already studies in the literature that have investigated the effects of RAGT on MS patients and have shown encouraging results regarding improvements in functional status, gait performance and quality of life [ 17 , 20 , 21 , 22 , 27 , 36 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Most of them used different RAGT protocols in terms of treatment sessions, frequency, and criteria for progression as well as a different study design and methods making data poorly comparable [ 27 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…RAGT has been applied to several neurological pathologies such as stroke, traumatic brain injury (TBI), spinal cord injury (SCI), MS, Parkinson’s disease and cerebral palsy, suggesting improvements in functional performance and gait parameters [ 20 ]. Namely, a 2018 pilot study showed that RAGT seems to have a beneficial effect on lower limb strength and autonomy in walking in MS patients [ 21 ]. A recent review and meta-analysis suggest that RAGT is not only safe and tolerated, but even superior to conventional gait training in improving perceived fatigue and spasticity [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

et al. 2021

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Background and Objectives: Gait disorders represent one of the most disabling aspects in multiple sclerosis (MS) that strongly influence patient quality of life. The improvement of walking ability is a primary goal for rehabilitation treatment. The aim of this study is to evaluate the effectiveness of robot-assisted gait training (RAGT) in association with physiotherapy treatment in patients affected by MS in comparison with ground conventional gait training. Study design: Randomized controlled crossover trial. Materials and Methods: Twenty-seven participants affected by MS with EDSS scores between 3.5 and 7 were enrolled, of whom seventeen completed the study. They received five training sessions per week over five weeks of conventional gait training with (experimental group) or without (control group) the inclusion of RAGT. The patients were prospectively evaluated before and after the first treatment session and, after the crossover phase, before and after the second treatment session. The evaluation was based on the 25-foot walk test (25FW, main outcome), 6 min walk test (6MWT), Tinetti Test, Modified Ashworth Scale, and modified Motricity Index for lower limbs. We also measured disability parameters using Functional Independence Measure and Quality of Life Index, and instrumental kinematic and gait parameters: knee extensor strength, double-time support, step length ratio; 17 patients reached the final evaluation. Results: Both groups significantly improved on gait parameters, motor abilities, and autonomy recovery in daily living activities with generally better results of RAGT over control treatment. In particular, the RAGT group improved more than control group in the 25FW (p = 0.004) and the 6MWT (p = 0.022). Conclusions: RAGT is a valid treatment option that in association with physiotherapy could induce positive effects in MS-correlated gait disorders. Our results showed greater effectiveness in recovering gait speed and resistance than conventional gait training.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

et al. 2021

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“…Seventeen RCTs [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] (537 participants) were included. All articles were published in English.…”

Section: Resultsmentioning

confidence: 99%

Use of Robotic Devices for Gait Training in Patients Diagnosed with Multiple Sclerosis: Current State of the Art

Cruz

2022

Sensors

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Multiple sclerosis (MS) is a neurodegenerative disease that produces alterations in balance and gait in most patients. Robot-assisted gait training devices have been proposed as a complementary approach to conventional rehabilitation treatment as a means of improving these alterations. The aim of this study was to investigate the available scientific evidence on the benefits of the use of robotics in the physiotherapy treatment in people with MS. A systematic review of randomized controlled trials was performed. Studies from the last five years on walking in adults with MS were included. The PEDro scale was used to assess the methodological quality of the included studies, and the Jadad scale was used to assess the level of evidence and the degree of recommendation. Seventeen studies met the eligibility criteria. For the improvement of gait speed, robotic devices do not appear to be superior, compared to the rest of the interventions evaluated. The methodological quality of the studies was moderate–low. For this reason, robot-assisted gait training is considered just as effective as conventional rehabilitation training for improving gait in people with MS.

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“…The novelty of the presented control system is related to the possibility of using the function describing a patient's gait pattern. This approach is particularly interesting due to the results of previous studies, which despite their high effectiveness also suggest that an incorrect gait pattern can be consolidated while training on a treadmill under unloaded conditions when the active body weight support system works only in the constant force mode [30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

Modeling and Control of an Underactuated System for Dynamic Body Weight Support

2021

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This article concerns the stability analysis of a control system for a dynamic body weight support system in a rehabilitation device for the re-education of human gait. The paper presents a physical model of the device, which characterizes the most important physical phenomena associated with the movement of the system, i.e., inertia, damping, and elasticity. The device has one active and one passive element. They are connected by a connector with elastic and damping properties. This solution provides the kinematic chain required due to interactions with humans, while at the same time ensures that the device is an underactuated system. The article also presents the methodology used to verify the stability of the control system while acting as an active body weight support system. The paper formulates the mathematical model of the system that was used in the synthesis of control using the Lyapunov theory of stability. The results of simulation and experimental tests are also presented.

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Robot-Assisted Body-Weight-Supported Treadmill Training in Gait Impairment in Multiple Sclerosis Patients: A Pilot Study

Cited by 9 publications

References 20 publications

Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

Use of Robotic Devices for Gait Training in Patients Diagnosed with Multiple Sclerosis: Current State of the Art

Modeling and Control of an Underactuated System for Dynamic Body Weight Support

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