The Effects of One Month of Lower Limb Powered Exoskeleton Gait Training Compared to the Conventional Gait Training on Treadmills in People with Multiple Sclerosis: A Pilot Study

Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system, characterised by a wide symptom spectrum. Ambulation dysfunctions are the most experienced impairments among people with MS (pwMS). Lower limb powered exoskeletons claim to reduce training-related fatigue levels yet providing patients with task-specific stimuli. The aim of the study is to compare the effects of exoskeleton training (Et) compared to conventional training performed on treadmills (Tt) on walking abilities. Methods: 5 MS patients with an EDSS ≤ 2.5, performed 4 weeks (2 sessions/week) of gait training for each training modality. Participants performed functional assessment sessions before and after each training intervention that included: Timed-Up-and-Go (TUG) test, 6-min Walking test (6MWT), and Maximal Voluntary Isometric Contraction (MVIC) assessment. Non-parametric Friedman Test was used to test differences between training protocols. Results: Despite the lack of statistical significance, Et showed greater improvements in some parameters belonging to TUG, 6MWT, and MVIC performances. Moreover, some of the participants achieved clinically significant improvements supporting Et approach. Conclusion: Physical activity helps pwMS in symptom management and slows down the progression of the disease. Gait rehabilitation performed on treadmills, overground or with the aid of exoskeletons aims at improving gait and balance performances in pwMS. The positive tendencies in favour of Et found in the current pilot study support future research in the direction of the innovative robot-assisted gait rehabilitation.