Efficiency of ExoAtlet exoskeleton in the rehabilitation of patients with multiple sclerosis

Question. Multiple sclerosis (MS) is an immuno-mediated demyelinating inflammatory disease that is increasingly observed in young and middle age. The possibility of stabilization under the influence of drugs that change the course of MS, encourages the search for new and most effective methods of rehabilitation. Now, a promising area of physical rehabilitation is robotic mechanotherapy, which provides high efficiency of training.

Materials and methods. The study included 38 MS patients with lower limb paresis. To assess the severity of neurological and functional deficits, we used an Expanded Disability Status Scale (EDSS). To evaluate walking, we used the MBN-Biomechanics clinical motion analysis complex and Tekscan force-measuring insoles before and after the course of therapy. Training sessions were held on the Exoatlet exoskeleton daily for 9-10 days.

Results. All patients showed good tolerance of the proposed loads. When assessing the level of disability on the EDSS scale, a statistically significant (p<0.001) improvement in this indicator was found both immediately after the rehabilitation course and after 3 months, what demonstrated a long-term maintenance of the achieved results. There was significant improvement of the structure of the walk after a course of training: increased movement speed and amplitude of the angular displacements in the joints of the lower extremities, the disappearance of the of cyclic EMG profile phenomena, changing the vertical component from rounded to distinct double-peaked, the increase in peaks of electrical activity of all muscles and their concentration in the adequate phase of the locomotor cycle, increase the average electrical activity of muscles while increasing movement speed, the appearance of two branches of the parabola with a clear minimum in the curve of electrical activity for 10 m of walk.

Conclusions. After a course of training in the exoskeleton, patients showed positive changes in the biomechanical structure of walking. The presented results confirm the effectiveness of robotic assistance for walking and maintaining a vertical posture using the ExoAtlet exoskeleton to restore the ability to move in patients with multiple sclerosis.