The Impact of Robotic Exoskeleton Gait Training on Gait Adaptability in Persons with Multiple Sclerosis

There have been numerous research studies investigating the feasibility and effectiveness of exoskeleton-assisted gait training as a treatment for lower extremity motor rehabilitation in persons with multiple sclerosis. However, while most of the research on exoskeleton-assisted gait training investigate its impact on general gait and balance during ambulation, investigating the effectiveness of the exoskeleton gait training regarding walking adaptability remains underexplored. The present study aims to investigate the effectiveness of exoskeleton-assisted gait training compared to traditional gait training with regards to walking adaptability in persons with MS. The study is a secondary analysis using data from a Kessler Foundation study investigating the feasibility and effectiveness of gait training for persons with MS assisted by an Ekso robotic exoskeleton compared to traditional gait training over the course of 8 weeks. The study specifically analyzes the data gathered from three gait adaptability tests performed on a C-Mill augmented reality treadmill: random stepping stones, obstacle avoidance, and track. The results indicate that while there were no significant differences between exoskeleton-assisted gait training and traditional gait training, effect sizes indicate that the exoskeleton-assisted gait training provide as much clinically relevant improvement to gait adaptability as traditional gait training from pre-treatment to post-treatment. Future studies that investigate the impact of exoskeleton-assisted gait training on gait adaptability should incorporate larger samples of persons with MS, using the C-Mill gait adaptability tests to assess gait adaptability improvement from pre-treatment to post-treatment.