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

Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
Department of Traumatology, Orthopaedics and Disaster Surgery, First Moscow State Medical University (Sechenov University), 6-1 Bolshaya Pirogovskaya St., 119991 Moscow, Russia
Mechanical and Industrial Engineering Department, University of Brescia, 25121 Brescia, Italy
Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy
Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, 50103 Kaunas, Lithuania
Laboratory of Preclinical Drug Investigation, Institute of Cardiology, Lithuanian University of Health Sciences, 50166 Kaunas, Lithuania
Rehabilitation and Pain Rehabilitation Unit, Department of High Technology, Habilita Care and Research Hospitals, 24040 Zingonia di Ciserano, Italy
Opusmedica PC&R, Persons Care & Research Network Piacenza, 29121 Piacenza, Italy
Author to whom correspondence should be addressed.
Academic Editors: Juan Pablo Romero and Marcos Rios Lago
Received: 21 May 2021 / Revised: 7 July 2021 / Accepted: 7 July 2021 / Published: 14 July 2021
(This article belongs to the Special Issue Neurorehabilitation of Neurodegenerative Diseases and Brain Damage)
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. View Full-Text
Keywords: multiple sclerosis; robotic training; gait recovery; rehabilitation; exercise multiple sclerosis; robotic training; gait recovery; rehabilitation; exercise
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MDPI and ACS Style

Sconza, C.; Negrini, F.; Di Matteo, B.; Borboni, A.; Boccia, G.; Petrikonis, I.; Stankevičius, E.; Casale, R. Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial. Medicina 2021, 57, 713.

AMA Style

Sconza C, Negrini F, Di Matteo B, Borboni A, Boccia G, Petrikonis I, Stankevičius E, Casale R. Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial. Medicina. 2021; 57(7):713.

Chicago/Turabian Style

Sconza, Cristiano, Francesco Negrini, Berardo Di Matteo, Alberto Borboni, Gennaro Boccia, Ignas Petrikonis, Edgaras Stankevičius, and Roberto Casale. 2021. "Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial" Medicina 57, no. 7: 713.

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