title: Efficacy and safety of a hip flexion assist orthosis in ambulatory multiple sclerosis patients.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of a hip flexion assist orthosis (HFAO) in ambulatory patients with multiple sclerosis (MS).
  
  
  METHODS
  Fourteen week pre- and postintervention uncontrolled trial.
  
  
  METHODS
  Outpatient rehabilitation clinic within an MS center.
  
  
  METHODS
  Ambulatory MS patients (N=21) with unilateral (or unilateral predominant) hip flexor weakness.
  
  
  METHODS
  Subjects were fitted with the HFAO on the weaker side, trained to use the device, and given a wear schedule. Subjects completed 2 baseline evaluations and follow-up testing at 8 and 12 weeks.
  
  
  METHODS
  Lower-extremity manual muscle testing, pain, and gait performance (Timed 25-Foot Walk, Timed Up & Go, 6-minute walk test, Mellen Center Gait Test). Subject satisfaction was evaluated by using a 9-item custom questionnaire.
  
  
  RESULTS
  There was a statistically significant improvement of strength in the affected lower extremity at 8 and 12 weeks (effect size [ES]=0.63; ES=1.32, respectively), of pain at 12 weeks only (ES=-0.64), and of all gait tests at 8 and 12 weeks (ES range, 0.38-1.33). The overall mean satisfaction score at 12 weeks was 39 (maximum score, 45). No serious adverse events were recorded during the study. The most frequent side effect of the HFAO was low back pain (19%). No side effects led to discontinuation of the HFAO use during the study.
  
  
  CONCLUSIONS
  The HFAO was safe and well tolerated. HFAO use was associated with significant improvement of gait performance as well as improvement of strength in the lower extremity fitted with the HFAO. Subjective reports suggest that there was an increase in daily life activity level.
authors.affiliation: Mellen Center for Multiple Sclerosis Treatment and Research, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. sutlifm@ccf.org
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Sutliff
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Naft
authors.forename: Darlene K
authors.initials: DK
authors.lastname: Stough
authors.forename: Jar Chi
authors.initials: JC
authors.lastname: Lee
authors.forename: Susana S
authors.initials: SS
authors.lastname: Arrigain
authors.forename: Francois A
authors.initials: FA
authors.lastname: Bethoux
mesh_terms: D000203:Activities of Daily Living; D004867:Equipment Design; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation*; D053580:Muscle Strength; D009989:Orthotic Devices; D017060:Patient Satisfaction; D016059:Range of Motion, Articular