Influence of the Exoskeleton Training Course on the Energy Parameters of Walking in Patients with Multiple Sclerosis

Abstract

Aim. To identify the features of changes in the energy parameters of walking in patients with multiple sclerosis (MS) and their correction under the influence of the of the exoskeleton training course. Material and methods. Authors of this article investigated electrical activity of two symmetrical thigh muscles – both m. rectus femoris and both m. biceps femoris during walking at different cadences – the slowest one, slow, decelerated, voluntary and fast in 3 patients with multiple sclerosis (MS). In addition to these parameters, the energy parameters of walking were also studied, namely, the average electrical activity of the muscles, equivalent to the power of the muscles, and the total integral for 10 m of the path, equivalent to the work of the muscles, taking into account both the pace and the length of the step. Results. The authors revealed the characteristic features of the energy parameters of walking in patients with multiple sclerosis, namely, a very slight increase in muscle power with an increase of walking velovity and the absence of the parabola second branch in the curve of the total integral for the distance of 10 m. On the basis of the received data authors make conclusion, that rezonance pnenomena are considerably diminished in patients with MS. The training exoskeleton walking method was developed, which includes the total training time, net walking time (walking time without rest), speed, pace and step length when walking in an exoskeleton, the number of steps taken by patients during the session and for the entire course. Remarkable improvement of the innervative structure of walking takes place after the course of training in the exoskeleton, that is revealed in considerable activity maximuma growth and in a number of cases – in apperance of these maxima, in concentration of these maxima in the locomotor cycle adequate phases, in appearance of the second maximum of activity in rectus femoris muscle and biceps femoris muscle in the swing phase of the locomotor cycle. Conclusion. All these positive changes were accompanied by an increase in the random walking speed and remarkable improvement of the energy walking parameters, namely, by considerable increase of the average electrical muscle activity and appearance of two parabola branches in the curve of the summary integral for the distance of 10 m, what points to appearance of the rezonance phenomena during walking in this patient.