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Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: a randomized controlled trial

Identifieur interne : 000E88 ( Main/Merge ); précédent : 000E87; suivant : 000E89

Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: a randomized controlled trial

Auteurs : Marialuisa Gandolfi [Italie] ; Christian Geroin [Italie] ; Alessandro Picelli [Italie] ; Daniele Munari [Italie] ; Andreas Waldner [Italie] ; Stefano Tamburin [Italie] ; Fabio Marchioretto [Italie] ; Nicola Smania [Italie]

Source :

RBID : PMC:4033226

Abstract

Background: Extensive research on both healthy subjects and patients with central nervous damage has elucidated a crucial role of postural adjustment reactions and central sensory integration processes in generating and “shaping” locomotor function, respectively. Whether robotic-assisted gait devices might improve these functions in Multiple sclerosis (MS) patients is not fully investigated in literature.

Purpose: The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and sensory integration balance training (SIBT) in improving walking and balance performance in patients with MS.

Methods: Twenty-two patients with MS (EDSS: 1.5–6.5) were randomly assigned to two groups. The RAGT group (n = 12) underwent end-effector system training. The SIBT group (n = 10) underwent specific balance exercises. Each patient received twelve 50-min treatment sessions (2 days/week). A blinded rater evaluated patients before and after treatment as well as 1 month post treatment. Primary outcomes were walking speed and Berg Balance Scale. Secondary outcomes were the Activities-specific Balance Confidence Scale, Sensory Organization Balance Test, Stabilometric Assessment, Fatigue Severity Scale, cadence, step length, single and double support time, Multiple Sclerosis Quality of Life-54.

Results: Between groups comparisons showed no significant differences on primary and secondary outcome measures over time. Within group comparisons showed significant improvements in both groups on the Berg Balance Scale (P = 0.001). Changes approaching significance were found on gait speed (P = 0.07) only in the RAGT group. Significant changes in balance task-related domains during standing and walking conditions were found in the SIBT group.

Conclusion: Balance disorders in patients with MS may be ameliorated by RAGT and by SIBT.


Url:
DOI: 10.3389/fnhum.2014.00318
PubMed: 24904361
PubMed Central: 4033226

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PMC:4033226

Le document en format XML

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<name sortKey="Picelli, Alessandro" sort="Picelli, Alessandro" uniqKey="Picelli A" first="Alessandro" last="Picelli">Alessandro Picelli</name>
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<name sortKey="Munari, Daniele" sort="Munari, Daniele" uniqKey="Munari D" first="Daniele" last="Munari">Daniele Munari</name>
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<institution>Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona</institution>
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<name sortKey="Waldner, Andreas" sort="Waldner, Andreas" uniqKey="Waldner A" first="Andreas" last="Waldner">Andreas Waldner</name>
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<name sortKey="Tamburin, Stefano" sort="Tamburin, Stefano" uniqKey="Tamburin S" first="Stefano" last="Tamburin">Stefano Tamburin</name>
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<name sortKey="Marchioretto, Fabio" sort="Marchioretto, Fabio" uniqKey="Marchioretto F" first="Fabio" last="Marchioretto">Fabio Marchioretto</name>
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<institution>Neurological Unit, Sacro Cuore–Don Calabria Hospital</institution>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
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<name sortKey="Smania, Nicola" sort="Smania, Nicola" uniqKey="Smania N" first="Nicola" last="Smania">Nicola Smania</name>
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<nlm:aff id="aff1">
<institution>Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona</institution>
<country>Verona, Italy</country>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
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<affiliation wicri:level="1">
<nlm:aff id="aff5">
<institution>Neurological Rehabilitation Unit, Azienda Ospedaliera Universitaria Integrata</institution>
<country>Verona, Italy</country>
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<country xml:lang="fr">Italie</country>
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<title xml:lang="en" level="a" type="main">Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: a randomized controlled trial</title>
<author>
<name sortKey="Gandolfi, Marialuisa" sort="Gandolfi, Marialuisa" uniqKey="Gandolfi M" first="Marialuisa" last="Gandolfi">Marialuisa Gandolfi</name>
<affiliation wicri:level="1">
<nlm:aff id="aff1">
<institution>Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Geroin, Christian" sort="Geroin, Christian" uniqKey="Geroin C" first="Christian" last="Geroin">Christian Geroin</name>
<affiliation wicri:level="1">
<nlm:aff id="aff1">
<institution>Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Picelli, Alessandro" sort="Picelli, Alessandro" uniqKey="Picelli A" first="Alessandro" last="Picelli">Alessandro Picelli</name>
<affiliation wicri:level="1">
<nlm:aff id="aff1">
<institution>Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Munari, Daniele" sort="Munari, Daniele" uniqKey="Munari D" first="Daniele" last="Munari">Daniele Munari</name>
<affiliation wicri:level="1">
<nlm:aff id="aff1">
<institution>Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Waldner, Andreas" sort="Waldner, Andreas" uniqKey="Waldner A" first="Andreas" last="Waldner">Andreas Waldner</name>
<affiliation wicri:level="1">
<nlm:aff id="aff2">
<institution>Department of Neurological Rehabilitation, Private Hospital Villa Melitta</institution>
<country>Bolzano, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Tamburin, Stefano" sort="Tamburin, Stefano" uniqKey="Tamburin S" first="Stefano" last="Tamburin">Stefano Tamburin</name>
<affiliation wicri:level="1">
<nlm:aff id="aff3">
<institution>Neurology Section, Department of Neurological and Movement Sciences, University of Verona</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Marchioretto, Fabio" sort="Marchioretto, Fabio" uniqKey="Marchioretto F" first="Fabio" last="Marchioretto">Fabio Marchioretto</name>
<affiliation wicri:level="1">
<nlm:aff id="aff4">
<institution>Neurological Unit, Sacro Cuore–Don Calabria Hospital</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Smania, Nicola" sort="Smania, Nicola" uniqKey="Smania N" first="Nicola" last="Smania">Nicola Smania</name>
<affiliation wicri:level="1">
<nlm:aff id="aff1">
<institution>Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="aff5">
<institution>Neurological Rehabilitation Unit, Azienda Ospedaliera Universitaria Integrata</institution>
<country>Verona, Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea></wicri:regionArea>
<wicri:regionArea># see nlm:aff region in country</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Frontiers in Human Neuroscience</title>
<idno type="eISSN">1662-5161</idno>
<imprint>
<date when="2014">2014</date>
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<front>
<div type="abstract" xml:lang="en">
<p>
<bold>Background:</bold>
Extensive research on both healthy subjects and patients with central nervous damage has elucidated a crucial role of postural adjustment reactions and central sensory integration processes in generating and “shaping” locomotor function, respectively. Whether robotic-assisted gait devices might improve these functions in Multiple sclerosis (MS) patients is not fully investigated in literature.</p>
<p>
<bold>Purpose:</bold>
The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and sensory integration balance training (SIBT) in improving walking and balance performance in patients with MS.</p>
<p>
<bold>Methods:</bold>
Twenty-two patients with MS (EDSS: 1.5–6.5) were randomly assigned to two groups. The RAGT group (
<italic>n</italic>
= 12) underwent end-effector system training. The SIBT group (
<italic>n</italic>
= 10) underwent specific balance exercises. Each patient received twelve 50-min treatment sessions (2 days/week). A blinded rater evaluated patients before and after treatment as well as 1 month post treatment. Primary outcomes were walking speed and Berg Balance Scale. Secondary outcomes were the Activities-specific Balance Confidence Scale, Sensory Organization Balance Test, Stabilometric Assessment, Fatigue Severity Scale, cadence, step length, single and double support time, Multiple Sclerosis Quality of Life-54.</p>
<p>
<bold>Results:</bold>
Between groups comparisons showed no significant differences on primary and secondary outcome measures over time. Within group comparisons showed significant improvements in both groups on the Berg Balance Scale (
<italic>P</italic>
= 0.001). Changes approaching significance were found on gait speed (
<italic>P</italic>
= 0.07) only in the RAGT group. Significant changes in balance task-related domains during standing and walking conditions were found in the SIBT group.</p>
<p>
<bold>Conclusion:</bold>
Balance disorders in patients with MS may be ameliorated by RAGT and by SIBT.</p>
</div>
</front>
<back>
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<name sortKey="Hausammann, R" uniqKey="Hausammann R">R. Hausammann</name>
</author>
<author>
<name sortKey="Foinant, D" uniqKey="Foinant D">D. Foinant</name>
</author>
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</biblStruct>
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<analytic>
<author>
<name sortKey="Weinshenker, B G" uniqKey="Weinshenker B">B. G. Weinshenker</name>
</author>
<author>
<name sortKey="Bass, B" uniqKey="Bass B">B. Bass</name>
</author>
<author>
<name sortKey="Rice, G P" uniqKey="Rice G">G. P. Rice</name>
</author>
<author>
<name sortKey="Noseworthy, J" uniqKey="Noseworthy J">J. Noseworthy</name>
</author>
<author>
<name sortKey="Carriere, W" uniqKey="Carriere W">W. Carriere</name>
</author>
<author>
<name sortKey="Baskerville, J" uniqKey="Baskerville J">J. Baskerville</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Zackowski, K M" uniqKey="Zackowski K">K. M. Zackowski</name>
</author>
<author>
<name sortKey="Cameron, M" uniqKey="Cameron M">M. Cameron</name>
</author>
<author>
<name sortKey="Wagner, J M" uniqKey="Wagner J">J. M. Wagner</name>
</author>
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