title: Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: a randomized controlled trial.
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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Balance disorders in patients with MS may be ameliorated by RAGT and by SIBT.
authors.affiliation: Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy.
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Gandolfi
authors.affiliation: Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Geroin
authors.affiliation: Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Picelli
authors.affiliation: Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Munari
authors.affiliation: Department of Neurological Rehabilitation, Private Hospital Villa Melitta Bolzano, Italy.
authors.forename: Andreas
authors.initials: A
authors.lastname: Waldner
authors.affiliation: Neurology Section, Department of Neurological and Movement Sciences, University of Verona Verona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tamburin
authors.affiliation: Neurological Unit, Sacro Cuore-Don Calabria Hospital Verona, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Marchioretto
authors.affiliation: Department of Neurological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona Verona, Italy ; Neurological Rehabilitation Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Smania
keywords: motor skills disorders; physiological adaptations; postural balance; proprioception; sensory feedback