A team of experts in multiple sclerosis (MS) from the Kessler Foundation led the first controlled randomized pilot trial of robot-assisted exercise rehabilitation (REAER) effects on mobility, cognition, and brain connectivity in people with substantial MS-related disability. Their results showed that REAER is probably an effective intervention and is a promising therapy to improve the lives of people with MS.
The article “A controlled randomized pilot trial of rehabilitation exercises assisted with robotic exoskeleton in multiple sclerosis,” was published on April 4, 2021 by Multiple Sclerosis and Related Disorders.
The authors are Ghaith J. Androwis, Ph.D., Brian M. Sandroff, Ph.D., Peter Niewrzol, MA, Glenn R. Wylie, DPhil, Guang Yue, Ph.D., and John DeLuca, Ph.D. D., of the Kessler Foundation, and Farris Fakhoury, DPT, of the Kessler Rehabilitation Institute.
People with MS often have impairments in both mobility and cognition, and there are few therapies to control the range of debilitating symptoms. This lack of treatment options is a major problem for people with MS, especially those with substantial MS-related neurological disability.
Previous research shows that exercise rehabilitation, such as walking, is an effective approach to symptom management, with some research suggesting that even a single exercise rehabilitation intervention can improve mobility and fitness. cognition.
However, there is a lack of effectiveness of exercise rehabilitation on mobility and cognitive outcomes in people with MS who have a substantial disability. Adaptive exercise rehabilitation approaches such as supported body weight training of treadmills and robot-assisted gait training have not shown convincing results. In addition, adaptive interventions lack key interactions between patients and therapists that can improve efficacy.
In that pilot study of 10 participants with significant MS-related neurological disability, the researchers explored the use of robotic exoskeletons to control symptoms. Rehabilitation exercise using robotic exoskeletons is a relatively new approach that allows participants to walk on the ground in a progressive regimen that involves a close commitment to a therapist. The Foundation has dedicated an Ekso NR to MS studies to facilitate research in this area.
Compared to conventional gait training, REAER allows participants to walk with the volumes needed to perform functional adaptations — through vigorous neurophysiological demands — that lead to improved cognition and mobility. The effects on brain activity patterns were studied using the functional MRI functions of the Rocco Ortenzio Neuroimaging Center of the Kessler Foundation.
The researchers compared participants ’improvement after four weeks of REAER versus four weeks of conventional gait training, looking at functional mobility, walking endurance, cognitive processing speed, and brain connectivity.
The results were positive: in relation to conventional gait training, four weeks of REAER were associated with large improvements in functional mobility (ηp2 = .38), cognitive processing speed (ηp2 = .53), and the results of brain connectivity, the most significant among the thalamus. and ventromedial prefrontal cortex (ηp2 = .72). “Four weeks is relatively short for an exercise training study,” noted Dr. Sandroff, a senior researcher at the Kessler Foundation and director of the Exercise Neurorehabilitation Research Laboratory. “Viewing improvements in this time period shows the potential of exercise to change the way we treat MS. Exercise is a really powerful behavior that involves many brain regions and networks that can improve over time and improve function. “
“This is particularly exciting because therapy using robotic exoskeletons demonstrates this promise to improve the lives of people with joint mobility and cognitive impairment, a cohort that probably has the greatest potential to benefit from this new technology,” he said. Dr. Androwis, leading author and research scientist at the Mobility and Research Center for Rehabilitation Engineering of the Kessler Foundation. “We look forward to designing a broader trial to study these effects. Based on our initial results, we are optimistic that this approach may be superior to the current level of attention.”
Ghaith J. Androwis et al, controlled randomized pilot trial of rehabilitation of robotic exoskeleton-assisted exercises in multiple sclerosis, Multiple Sclerosis and Related Disorders (2021). DOI: 10.1016 / j.msard.2021.102936
Provided by the Kessler Foundation
Citation: Exoskeleton Therapy Improves Mobility, Cognition, and Brain Connectivity in People with MS (2021, May 28) Retrieved May 29, 2021 at https://medicalxpress.com/news/2021-05-exoskeleton- therapy-mobility-cognition-brain.html
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