Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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Effect of Two Different Rehabilitation Training with a Robotic Gait System in Body Weight Support and a Proprioceptive Sensory-motor Exercises on Unstable Platforms in Rehabilitation of Gait and Balance Impairment and Fatigue in Multiple Sclerosis

Saggini R, Ancona E, Supplizi M, Barassi, Carmignano SM and Bellomo RG

Walking and balance disturbances and fatigue are key symptoms in patients with MS, and major causes of discomfort, even in patients with mild disability since the early stages of the disease.

The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and proprioceptive sensory-motor exercises on unstable platforms in improving walking and balance performance. We enrolled 41 patients with relapsing-remitting MS at early stage and low or mild disability: patients in group A underwent a robotic gait rehabilitation treatment which involved the use of SPAD (Sistema Posturale Antigravitario Dinamico), patients in group B underwent a cycle of sensory-motor training in our laboratory of performance enhancement; patients in both groups were subjected to neuromuscular manual therapy. All treatment was provided with 3 sessions per week for 6 weeks (for a total of 18 sessions). Patients were evaluated by administration of the Functional Independence Measure (FIMTM), the Expanded Disability Status Scale (EDSS), the Berg Balance Scale (BBS), the Fatigue Severity Scale (FSS), and the Modified Fatigue Impact Scale (MFIS), and by performing stabilometric and gait analysis.

Results show statistically significant improvement of the FIMTM and the BBS average score in all patients, reduction of the EDSS average score in all patients (but in a statistically significant manner only in group A), reduction in average scores obtained in both evaluation questionnaires of fatigue (non-significant improvement of the FSS average score in the overall sample and in both groups, statistically significant reduction of the MFIS average scores), improvement in stabilometric parameters in all patients (but in a statistically significant manner only in group B) and statistically significant improvement in temporal parameters of gait in all patients.

So body weight supported gait training and sensory-motor exercises on unstable platforms are feasible and could be safely used as additional therapeutic.