title: Robot-guided ankle sensorimotor rehabilitation of patients with multiple sclerosis.
abstract: BACKGROUND
  People with multiple sclerosis (MS) often develop symptoms including muscle weakness, spasticity, imbalance, and sensory loss in the lower limbs, especially at the ankle, which result in impaired balance and locomotion and increased risk of falls. Rehabilitation strategies that improve ankle function may improve mobility and safety of ambulation in patients with MS. This pilot study investigated effectiveness of a robot-guided ankle passive-active movement training in reducing motor and sensory impairments and improving balance and gait functions.
  
  
  METHODS
  Seven patients with MS participated in combined passive stretching and active movement training using an ankle rehabilitation robot. Six of the patients finished robotic training 3 sessions per week over 6 weeks for a total of 18 sessions. Biomechanical and clinical outcome evaluations were done before and after the 6-week treatment, and at a follow-up six weeks afterwards.
  
  
  RESULTS
  After six-week ankle sensorimotor training, there were increases in active range of motion in dorsiflexion, dorsiflexor and plantar flexor muscle strength, and balance and locomotion (p<0.05). Proprioception acuity showed a trend of improvement. Improvements in four biomechanical outcome measures and two of the clinical outcome measures were maintained at the 6-week follow-up. The study showed the six-week training duration was appropriate to see improvement of range of motion and strength for MS patients with ankle impairment.
  
  
  CONCLUSIONS
  Robot-guided ankle training is potentially a useful therapeutic intervention to improve mobility in patients with MS.
authors.affiliation: Rehabilitation Institute of Chicago, 345 E Superior Street, Chicago, IL 60611, United States.
authors.forename: Yunju
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Rehabilitation Institute of Chicago, 345 E Superior Street, Chicago, IL 60611, United States.
authors.forename: Kai
authors.initials: K
authors.lastname: Chen
authors.affiliation: Rehabilitation Institute of Chicago, 345 E Superior Street, Chicago, IL 60611, United States.
authors.forename: Yupeng
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Rehabilitation Institute of Chicago, 345 E Superior Street, Chicago, IL 60611, United States.
authors.forename: Jongsang
authors.initials: J
authors.lastname: Son
authors.affiliation: Northwestern University, 710 N Lake Shore Drive, Chicago, IL 60611, United States.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cohen
authors.affiliation: Rehabilitation Institute of Chicago, 345 E Superior Street, Chicago, IL 60611, United States; Northwestern University, 710 N Lake Shore Drive, Chicago, IL 60611, United States.
authors.forename: James A
authors.initials: JA
authors.lastname: Sliwa
authors.affiliation: Rehabilitation Institute of Chicago, 345 E Superior Street, Chicago, IL 60611, United States; Northwestern University, 710 N Lake Shore Drive, Chicago, IL 60611, United States; NorthShore University HealthSystem, 2650 Ridge Rd., Evanston, IL 60201, United States. Electronic address: l-zhang@northwestern.edu.
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zhang
mesh_terms: D000842:Ankle / Q000503:physiopathology; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation*; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D026201:Musculoskeletal Manipulations / Q000295:instrumentation / Q000379:methods*; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology; D011434:Proprioception; D016059:Range of Motion, Articular; D012371:Robotics; D016896:Treatment Outcome
keywords: 6-week intervention; Ankle; Multiple sclerosis; Robot-guided rehabilitation; Sensorimotor