Evaluation of patients enrolled in a proof-of-concept study demonstrates that an exoskeleton can safely and effectively enhance rehabilitation of patients with multiple sclerosis (MS), according to a proof-of-concept study sponsored by the Cleveland Clinic.
Prior research suggests that physical therapy training with an exoskeleton could improve outcomes for people after a stroke or among those living with spinal cord injuries.
“People with MS had heard about the technology and wanted to know if they could benefit from it — that is how I got interested in this in the first place,” principal investigator Francois Bethoux, MD, says, in a media release from Medscape Medical News.
Bethoux evaluated five people with multiple sclerosis, each of whom participated in 24 physical therapy sessions (three 1-hour sessions over 8 weeks) while wearing the Ekso Bionics Gait Training (Ekso GT) exoskeleton.
The participants had relapsing or progressive MS and severe mobility limitations, defined as score between 5.5 and 7.5 on the Expanded Disability Status Scale, per the release.
“In terms of getting some informal feedback, it was all very positive,” said Bethoux, director of rehabilitation services at the Mellen Center for Multiple Sclerosis, Neurologic Institute at the Cleveland Clinic.
He reports being particularly encouraged by the primary outcome, defined as the percentage of participants who did not complete the study.
“No one dropped out. They each attended all training sessions, which is highly unusual,” he shares. “Some of these patients are quite disabled, and it’s an effort for them to come to us for these physical therapy sessions.”
The fact that participants attended all sessions, including a follow-up evaluation at 14 weeks, “really shows a high level of motivation and a high level of satisfaction with the use of the device,” he adds, in the release.
A second primary outcome is to assess adverse events during or between training sessions. “It’s not fully analyzed data,” Bethoux states, “but we didn’t see any safety concerns that arose during this proof-of-concept study.”
“It looks like, in terms of safety and feasibility, it all looks good,” he adds.
One goal is to augment participation in the physical therapy sessions, which include stretching, over-ground gait training, and gait training.
“The ultimate goal is to improve their day-to-day walking without the device, using a walker, cane, or no assistive device,” Bethoux continues, in the release. However, he cautions, independent walking may not be a realistic outcome.
“My gut feeling from having done a number of rehab studies in MS is we rarely hope to get people off whatever walking aide they were using before. It’s about more day-to-day mobility, so they can participate in more activities, or participate better or longer,” he notes.
[Source: Medscape Medical News]
