Multiple Sclerosis (MS) poses challenges to balance and mobility, impacting the daily lives of affected individuals. The RAPPER IV study is a clinical trial to evaluate a balance and mobility training intervention supported by a powered Rex robotic exoskeleton for people living with MS. Aims and objectives: This study aims to gain an insight into the potential health benefits of using a Rex robot to assist in a neuro-rehabilitation intervention program focused on improving balance and functional mobility with supervision from a specialist clinician. Objectives * to evaluate the feasibility of using the Rex robotic walking device for rehabilitation with people who have mobility restrictions due to Multiple Sclerosis (MS) * to assess and evaluate the clinical effectiveness of a 5-week robotic assisted exercise program focused on core stability exercises, balance and walking using patient related outcome measures * to gain an insight into the experiences of participants and their spouses of using the robotic walking device for rehabilitation and how this has impacted on their lives A single cohort group of 20 people who were living with MS who met trial eligibility criteria were recruited. A variety of clinical outcome measurements were taken pre, during and post trial and results were analysed by a statistician.
The key research questions: * Is it feasible for a person with balance and mobility impairment caused by MS to use a robotic walking device to exercise in standing and walking with supervision safely? * What are the key outcome measures most sensitive to measurable change in this study population sample, which may reflect potential improvement during the trial period? (Clinical outcome scales and self-reported questionnaires) * Is this robotic assisted balance and mobility training program feasible, safe and effective? * Does the completion of this balance and mobility exercise treatment intervention result in measurable improvements in balance, mobility, spasticity, lower limb joint range of movement and achievable individual patient goals? To answer these questions, we invited 20 people diagnosed with MS (as defined by "McDonald" criteria, Polman et al, 2011) to undertake a 5-week balance exercise intervention program supported by the use of the Rex robotic walking device, designed to strengthen their postural body and leg muscles and improve their balance. Participants were monitored and progressed on an individual basis throughout the treatment program as appropriate and a range of standardised assessments, questionnaires and relevant clinical outcome scales were used to capture and measure change related to this trial. Prospective, open label, single arm, non-randomized, non-comparative feasibility study of Rex robot assisted training to improve balance, mobility and cardiovascular fitness for people living with MS. A purposive sample of 20 adults, who have a primary diagnosis of MS, aged between 18 and 80 years old, with an Expanded Disability Status Scale (EDSS) as defined by Kurtzke (1983), with scores between 4 and 6.5 were recruited into this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Individual is supported by a Rex robotic exoskeleton which enables assisted and supervised practise of balance exercises. This intervention took place as a supported and supervised series of 5 sessions over 5 weeks as an Out-patient.
East Kent Hospitals University NHS Trust
Canterbury, Kent, United Kingdom
Timed transfer into the Rex device
Timed transfer into the Rex device with appropriate level of assistance
Time frame: Time point 1 - Week 1
Completion of sit to stand and stand to sit within the Rex device
Completion of sit to stand and stand to sit within the Rex device with hands on assistance from trial therapist
Time frame: Time point 1 - Week 1
Completion of 1 Rex robotic assisted balance rehabilitation exercise session
Completion of 1 Rex robotic assisted balance rehabilitation exercise session with hands on assistance from trial therapist
Time frame: Time point 1 - Week 1
Screening loss analysis
Number of individuals screened and those eligible who entered the trial and those who completed the trial
Time frame: End of recruitment period - Week 30
Timed up and Go
Timed up and Go
Time frame: Time point 1 - Week 1
Berg Balance Scale
Berg Balance Scale
Time frame: Measured at 3 time points: Weeks 1, 6 and 10
Visual Analog Scale (Pain)
Visual Analog Scale (Pain)
Time frame: Measured at 2 time points: Weeks 1 and 6
Modified Falls Efficacy Scale
Balance and falls risk
Time frame: Measured at 2 time points: Weeks 1 and 6
Activities-specific Balance Confidence scale
Balance and confidence in balance
Time frame: Measured at 2 time points: Weeks 1 and 6
Spasticity Impact Scale
Perception of impact of spasticity on life
Time frame: Measured at 2 time points: Weeks 1 and 6
EQ-5D-5L
Perceived Health Related Quality of Life
Time frame: Measured at 2 time points: Weeks 1 and 6
MSIS-29
Perceived impact of MS on life
Time frame: Measured at 2 time points: Weeks 1 and 6
Joint range of movement
Joint range of movement
Time frame: Measured at 2 time points: Weeks 1 and 6
Goal Attainment Scale
Goal Attainment Scale
Time frame: Set at Week 1 and measured and reviewed at Week 25
Modified Ashworth Scale
Modified Ashworth Scale for muscle spasticity
Time frame: Measured at 2 time points: Weeks 1 and 6
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