Feasibility and safety of a powered exoskeleton for assisted walking for persons with multiple sclerosis: a single-group preliminary study

Publication date: Available online 16 March 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Allan J. Kozlowski, Michelle Fabian, Dipan Lad, Andrew Delgado
ObjectiveTo examine the feasibility, safety, and secondary benefit potential of exoskeleton-assisted walking with one device for persons with multiple sclerosis (MS)DesignSingle-group longitudinal preliminary study with 8-week baseline, 8-week intervention, and 4-week follow-up.SettingOutpatient MS clinic at tertiary care hospital.ParticipantsThe 13 participants were mostly female who ranged in age from 38-62 years and on Expanded Disability Status Scale scores from 5.5-7.0.InterventionsExoskeleton-assisted walk trainingMain Outcome MeasuresPrimary outcomes were accessibility (enrollment/screen-pass), tolerability (completion/drop-out), learnability (time to event for standing, walking, and sitting with little or no assistance), acceptability (satisfaction on the device subscale of the Quebec User Evaluation of Satisfaction with assistive Technology version 2, or QUEST 2.0), and safety (event rates standardized to person-time exposure in the powered exoskeleton). Secondary outcomes were walking without the device (Timed 25 Foot Walk Test and 6 Minute Walk Test distance), spasticity (Modified Ashworth Scale), and health-related quality of life (PROMIS Pain Interference and Neuro-QoL fatigue, sleep disturbance, depression, and positive affect and well-being).ResultsThe device was accessible to 11 and tolerated by 5 participants. Learnability was moderate, with 5-15 sessions required to walk with minimal assistance. Safety was good; the highest adverse event rate was for skin issues at 151/1000 hours exposure. Acceptability ranged from 'not very satisfied' to 'very satisfied.' Participants who walked routinely improved qualitatively on sitting, standing, or walking posture. Two participants improved and 2 worsened on one or more quality of life domain. The pattern of spasticity scores may indicate potential benefit.ConclusionsThe device appeared feasible and safe for about a third of our sample, for whom routine exoskeleton-assisted walking may offer secondary benefits.



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