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Lauren M. Wier, MPH; Mary S. Hatcher, MD; Elizabeth W. Triche, PhD; Albert C. Lo, MD, PhD

Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. Lauren M. Wier, MPH; Mary S. Hatcher, MD; Elizabeth W. Triche, PhD; Albert C. Lo, MD, PhD. Study Aim

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Lauren M. Wier, MPH; Mary S. Hatcher, MD; Elizabeth W. Triche, PhD; Albert C. Lo, MD, PhD

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  1. Effect of robot-assisted versus conventional body-weight-supportedtreadmill training on quality of life for people with multiple sclerosis Lauren M. Wier, MPH; Mary S. Hatcher, MD; Elizabeth W. Triche, PhD; Albert C. Lo, MD, PhD

  2. Study Aim • Determine whether body-weight-supported treadmill training (BWSTT) improves quality of life (QOL) for people with multiple sclerosis (MS). Relevance • MS impairs QOL because of its early onset, range of impairments, unpredictable course, progressive nature, and lack of cure/effective treatment. • Past studies have shown that exercise improves QOL for patients with MS.

  3. Methods • Participants with MS and gait problems (n = 13) randomly received 2 blocks of 6 twice-a-week training sessions: • Robot-assisted BWSTT then BWSTT alone. • or • BWSTT alone then robot-assisted BWSTT. • QOL was assessed by 3 self-report questionnaires: • MS Quality of Life Inventory (SF-36 + 9 symptom-based scales). • Fatigue Severity Scale (FSS). • Single-item measure of general Life Satisfaction (LS).

  4. Methods • Participants with MS and gait problems (n = 13) randomly received 2 blocks of 6 twice-a-week training sessions: • Robot-assisted BWSTT then BWSTT alone. or • BWSTT alone then robot-assisted BWSTT. • QOL was assessed by 3 self-report questionnaires: • MS Quality of Life Inventory (SF-36 + 9 symptom-based scales). • Fatigue Severity Scale (FSS). • Single-item measure of general Life Satisfaction (LS).

  5. Results • Randomized Treatment Comparison • Midpoint (before crossover): • No significant difference in QOL measures between unassisted and robot-assisted BWSTT. • Study Start vs End: • Significantly improved PCS (SF-36) for participants receiving robot-assisted BWSTT 1st (15.6% increase) vs 2nd (2.0% increase) (p = 0.008). • Longitudinal Treatment Effects • Midpoint: • Significantly improved FSS (p = 0.01), fatigue impact (p = 0.03), pain effects (p = 0.04). • Study Start vs End: • Significant within-participant lon-gitudinal improvements: PCS (p = 0.03), fatigue impact (p = 0.03), pain effects (p = 0.02), perceived deficits (p = 0.03), LS (p = 0.03). • Significant 1-point improvement in EDSS (p = 0.003).

  6. Conclusions • Both robot-assisted and unassisted BWSTT improved QOL, but did not significantly differ. • Limited evidence of treatment order effect favored sequencing robot-assisted BWSTT before unassisted BWSTT • Improvements possibly due to endorphin release, improved physical health, excitement about potential treatment benefits, opportunity for proactive MS management, and social interactions inherent to participation.

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