Many people who have multiple sclerosis (MS) face increasing difficulty with walking, which can interfere with the ability to adequately perform exercise. Exercise is important for the prevention of problems like weight gain, heart disease, osteoporosis and diabetes. Additionally, exercise can help with symptoms commonly associated with MS such as fatigue and depression.
For individuals with leg weakness, powered exoskeletons can provide the stability and power needed for successful walking. In early studies of individuals with spinal cord injury (SCI), we found that even those who have no leg strength could learn to stand and walk using an exoskeleton, with supervision, for up to 90 minutes. Here we propose to evaluate the use of one powered exoskeleton, the ReWalk™, to assist with walking and to provide a means of exercise in individuals with MS.
The primary goal of this study is to determine how feasible an exoskeleton walking program is in people with MS who have moderate to high disability, corresponding to an Expanded Disability Status Scale score of 5.0 to 7.5. Participants learn to use the ReWalk in sessions scheduled three times per week for 8 weeks. We measure how well participants can to walk with the ReWalk and how long it takes them to learn. We also assess the symptoms commonly experienced in MS such as fatigue, depression, muscle spasms, pain, balance problems, and sleep disturbances for changes that occur during the study.
To our knowledge, this is the first powered exoskeleton study in MS. The timing of this study is particularly fortuitous as powered exoskeletons are now available in rehabilitation centers and may be available for home use in the near future. A demonstration of successful exoskeleton walking in MS may thus translate into a new rehabilitation treatment, and within a few years into a means of independent home exercise and/or independent ambulation for individuals with MS.