The Armeo Spring as training tool to improve upper limb functionality in multiple sclerosis: a pilot study.
BACKGROUND
Few research in multiple sclerosis (MS) has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle strength and functional capacity in MS patients with evident paresis.


METHODS
A case series was applied, with provision of a training program (3×/week, 30 minutes/session), supplementary on the customary maintaining care, by employing a gravity-supporting exoskeleton apparatus (Armeo Spring). Ten high-level disability MS patients (Expanded Disability Status Scale 7.0-8.5) actively performed task-oriented movements in a virtual real-life-like learning environment with the affected upper limb. Tests were administered before and after training, and at 2-month follow-up. Muscle strength was determined through the Motricity Index and Jamar hand-held dynamometer. Functional capacity was assessed using the TEMPA, Action Research Arm Test (ARAT) and 9-Hole Peg Test (9HPT).


RESULTS
Muscle strength did not change significantly. Significant gains were particularly found in functional capacity tests. After training completion, TEMPA scores improved (p = 0.02), while a trend towards significance was found for the 9HPT (p = 0.05). At follow-up, the TEMPA as well as ARAT showed greater improvement relative to baseline than after the 8-week intervention period (p = 0.01, p = 0.02 respectively).


CONCLUSIONS
The results of present pilot study suggest that upper limb functionality of high-level disability MS patients can be positively influenced by means of a technology-enhanced physical rehabilitation program.
REVAL Rehabilitation Research Center, Hasselt University, Agoralaan Building A, BE-3590 Diepenbeek, Belgium. domien.gijbels@uhasselt.be
Domien
D
Gijbels
Ilse
I
Lamers
Lore
L
Kerkhofs
Geert
G
Alders
Els
E
Knippenberg
Peter
P
Feys
D000368:Aged; D004185:Disability Evaluation; D004867:Equipment Design; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D053580:Muscle Strength / Q000502:physiology; D010349:Patient Compliance; D010865:Pilot Projects; D055070:Resistance Training / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D034941:Upper Extremity / Q000502:physiology
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