Background: Multiple sclerosis is a progressive neurodegenerative disease that affects myelin in the central nervous system. It is complex and unpredictable and occurs predominantly in young adults, causing increasing disability and a significantly lower quality of life. Recent studies investigated how rehabilitation training through the use of a robotic exoskeleton can influence walking recovery in patients with a serious neurological disease. Aim: The purpose of this study was to analyze the first approach of a multiple sclerosis patient to a robotic exoskeleton for the lower limbs, in order to assess the effectiveness of the protocol on walking ability, adaptability of the device, level of appreciation, variations in parameters related to walking, and fatigue perception. Methods: This study was conducted on a 71-year-old male diagnosed with primary progressive multiple sclerosis since 2012, with an EDSS score of 6. The patient underwent a cycle of 10 sessions of treatment with the exoskeleton for the lower limbs, the UAN.GO, lasting 1 h 30 min. Pre- and post-treatment evaluations were carried out with the 6 min walking test, the Fatigue Severity Scale, the Short Form-36 Health Survey, and a Likert scale for review. During each session, blood pressure, heart rate, and peripheral saturation were monitored; in addition, the perception of fatigue by the Borg scale was studied. Result: A comparison between the initial and final evaluations showed improvements in the walked distance at 6 MWT (T0 = 53 m/T1 = 61 m). There was a positive trend in saturation and heart rate values collected during each session. Further improvements were found by the Borg scale (T0 = 15/T1 = 11). Discussion: The data collected in this case report show promising results regarding the treatment of multiple sclerosis patients with the UAN.GO exoskeleton, with benefits on both motor performance and vital parameters.
Background: Ataxia is a neurological sign characterized by motor coordination during gait/voluntary limb movements impairment. Ataxic gait leads to disability and worsening of quality of life; physiotherapy intervention is recommended to improve motor function. Recent studies showed benefits due to repetitive robotized assisted gait training using a static exoskeleton in patients affected by acquired ataxias. The aim of the study was to perform a preliminary evaluation of the short-term effects of overground UAN.GO®-assisted gait training in an adult patient with ataxia but with no clear genetic pattern. Methods: This case report study was conducted on a single male adult patient, who presented ataxic spastic gait, posterior chain tightness, pes cavus, and unstable standing position. The patient underwent two preliminary sessions to take part in the study. Treatment protocol planned 10 sessions and each one lasted 80 min, 60 of which were spent in gait training using the mobile overground exoskeleton UAN.GO®. At T1 (start of the study) and T10 (final evaluation) assessments using the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, 6-Minute Walking Test, and Likert Scale were administered. Space-time parameters of gait cycle were also evaluated: left and right step length, stance and swing percentages. Results: improvements on the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and in the distance travelled at 6-Minute Walking Test emerged. The patient gave a positive opinion towards the treatment, showed by Likert Scale results. Kinematic gait analysis showed more physiological step length, stance and swing percentages, joint angles. The patient completed the training program with an excellent compliance. Discussion: Since these encouraging outcomes were obtained, it is possible to consider robot-assisted gait training performed with UAN.GO® as a therapeutic option to improve motor and functional performance in patients with ataxic gait.
Background: Spinal cord injury is characterized by the interruption of neural pathways of the spinal cord, with alteration of sensory, motor, and autonomic functions. Robotic-assisted gait training offers many possibilities, including the capability to reach a physiological gait pattern. Methods: A training protocol with UAN.GO®, an active lower limb exoskeleton, was developed. A participant having D10 complete SCI was recruited for this study. The training protocol was composed by 13 sessions, lasting 1.5 h each. The effectiveness of the protocol was evaluated through the mobility performance during the 6 MWT, the level of exertion perceived administrating Borg RPE at the end of each 6 MWT. Furthermore, time and effort required by the participant to earn a higher level of skills were considered. Results: A significant improvement was registered in the six MWT (t0 = 45.64 m t1 = 84.87 m). Data referring to the mean level of exertion remained stable. The patient successfully achieved a higher level of independence and functional mobility with the exoskeleton. Discussion: The findings from this preliminary study suggest that UAN.GO can be a valid tool for walking rehabilitation of spinal cord injury patients, allowing the achievement of greater mobility performances.
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