Feasibility and Outcomes of Gait Training With a Powered Exoskeleton in Individuals With Multiple Sclerosis

Abstract

Objective: The aim of the study was to report on real-world use of a powered exoskeleton for outpatient gait training in multiple sclerosis.

Design: We conducted a retrospective chart review on 21 patients with multiple sclerosis who completed physical therapy gait training sessions using a powered exoskeleton. Training descriptors, powered exoskeleton parameters, adverse events, and performance on mobility tests without powered exoskeleton were compared between first and last session.

Results: The median number of gait training sessions was 11. There was a statistically significant increase in walk time ( P = 0.008), number of steps ( P = 0.011), and programmed step length ( P < 0.001) while using powered exoskeleton. Three patients exhibited a greater than 20% increase in walking speed on the Timed 25 Foot Walk. The time to complete the Timed Up and Go increased ( P = 0.029), although patients who did not use a wheelchair outdoors showed a smaller mean increase in Timed Up and Go time (0.59 secs vs. 8.69 secs, P = 0.050). Five patients had one mild adverse event without impact on training participation.

Conclusions: Our findings suggest that gait training with a powered exoskeleton is safe and feasible in individuals with multiple sclerosis. Changes in mobility outcomes without powered exoskeleton were highly variable between patients. Further research is needed to establish the value of powered exoskeleton gait training and predictors of response to gait training.

Keywords: Exoskeleton; Gait; Multiple Sclerosis; Physical Therapy.