News Pilot Study Participant Helping Test Exoskeleton Device for MS Therapy Encouraged by Results Pilot Study Participant Helping Test Exoskeleton Device for MS Therapy Encouraged by Results by Mary Chapman | January 22, 2020 Share this article: Share article via email Copy article link Since being diagnosed with multiple sclerosis (MS) 20 years ago, Kathy Miskaās ability to walk has steadily worsened, especially in recent years. As a participant of a pilot study at the Cleveland Clinic Mellen Center for Multiple Sclerosis, however, she is cheered by the effect of a robotic device that attaches to her body during physical therapy. Miska, 56, of Strongsville, Ohio, is one of five people with MS participating in a research study (NCT04000373) that is evaluating the safety and feasibility of the EksoGT exoskeleton in MS gait rehabilitation. Findings from the study, which is near completion, are expected to be published this year. Funded by a private donor and a Cleveland Clinic Caregiver Catalyst Grant, the study is among the first to determine whether the wearable Ekso Bionics device works in patients withĀ MS who have severe mobility limitations. The technology is currently approved in the U.S. for use in rehabilitation programs for stroke and spinal cord injury. āThe idea is to use the exoskeleton as part of PT [physical therapy] to hopefully achieve better results, particularly when the patients canāt do much walking by themselves and canāt (fully) exercise their legs,ā Francois Bethoux, MD, chair of Cleveland Clinicās department of physical medicine and rehabilitation, and principal study investigator, said in Cleveland Clinic news story. āJust like with muscles, with the nervous center you āuse it or lose it.ā The goal is that the patient will find it easier to walk even when theyāre not using the device,ā Bethoux said. During physical therapy, a trained therapist straps the adjustable device onto the patient, whose legs, feet, and torso are supported by a metal brace. Guided by the therapist, the exoskeleton manipulates the legs and waist as the patient stands, walks on a level surface, and sits. Knee and hip joints are driven by battery-powered motors as the patient uses an assistive device such as a cane for balance and body positioning. āI feel like I have really made progress,ā Miska said. She recently finished the studyās 24 three-times-weekly, hour-long training sessions, which were spread over eight weeks. Sessions consist of stretching, overground gait training, and gait training with the exoskeleton. āMy posture looks better and my walking has improved,” Miska said. “Hopefully, this will get me stronger. Itās encouraging.ā Therapists say Miskaās walking speed has increased, and her endurance and gait have improved. āIt seems to be really making a difference in Kathyās gait training,ā said Matthew Sutliff, one of Miskaās physical therapists. āShe has a lot of weakness in her right leg, but her left leg is a bit stronger. So we programmed the device to give her a fair amount of support for her right leg to teach the proper step pattern. As we continued, we slowly reduced assistance for the right leg, requiring her muscles to perform more of the work.ā According to Sutliff, the exoskeleton stimulates the ānerve memory,ā so that muscles ultimately take over. āThe brain is constantly adapting to what we do,ā he said. āBy continually repeating something in a certain format, the hope is to ‘rewire neural pathways in the brain’ to walk better, more naturally and safely.ā The pilot study is assessing the exoskeleton’s safety, specifically examining adverse events during or between treatment sessions. In particular, the researchers are assessing falls and musculoskeletal pain. The device’s efficacy is evaluated based on the patient’s spasticity, hip flexor strength, gait parameters, and walk tests. All of these assessments are performed without the patient wearing the device. āOur aim with this pilot study is to assess the feasibility and safety of EksoGT exoskeleton use in individuals with MS and to collect preliminary efficacy data on gait and walking outcomes,ā Bethoux said in another Cleveland story. āEncouraging findings would support the design of a larger clinical trial of this device for gait training in people with MS.ā Print This Page About the Author Mary Chapman Mary graduated from Wayne State University with a degree in journalism. She began her career at United Press International, then spent a decade reporting for the Bureau of National Affairs, Inc. (now Bloomberg Industry Group). Mary has written extensively for The New York Times, and her work has appeared in publications such as Time, Newsweek, Fortune, and the Chicago Tribune. Sheās won a Society of Professional Journalists award for outstanding reporting. Tags Cleveland Clinic, gait, physical therapy, rehabilitation
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