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Neurorehabil Neural Repair. 2008 Nov-Dec;22(6):661-71. doi: 10.1177/1545968308318473.

Improving gait in multiple sclerosis using robot-assisted, body weight supported treadmill training.

Author information

1
Department of Clinical Neurosciences at Brown University, Providence VA Medical Center, Providence, Rhode Island 02909-4799, USA. albert_lo@brown.edu

Abstract

BACKGROUND:

The majority of patients with multiple sclerosis (MS) develop progressive gait impairment, which can start early in the disease and worsen over a lifetime. A promising outpatient intervention to help improve gait function with potential for addressing this treatment gap is task-repetitive gait training.

METHODS:

Body weight supported treadmill training (BWSTT) with or without robotic assistance (Lokomat) was tested using a randomized crossover design in 13 patients with relapsing-remitting, secondary progressive or primary progressive MS. Patients received 6 training sessions over 3 weeks of each intervention. Outcomes included changes in the timed 25-foot walk (T25FW), the 6-minute walk treadmill test (6MW) distance, the Kurtzke Expanded Disability Status Scale (EDSS), as well as double-limb support time and step length ratio.

RESULTS:

There were no major differences in outcomes between treatment groups. The study population significantly improved on gait outcomes and the EDSS following BWSTT, including a 31% improvement in the T25FW, a 38.5% improvement in the 6MW, and a 1-point gain for the EDSS. Differences in pre/post changes were noted depending on gender, disease subtype, affected limb, and baseline EDSS.

CONCLUSIONS:

Although no differences in gait outcomes or the EDSS were found between treatment groups, this small pilot study of task-repetitive gait training resulted in significant within-subject improvements. BWSTT appears to be an activity-dependent intervention with potential to reduce gait impairment in MS.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00156676.

PMID:
18971381
DOI:
10.1177/1545968308318473
[Indexed for MEDLINE]
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