This article and any supplementary material should be cited as follows: Wier LM, Hatcher MS, Triche EW, Lo AC. Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. J Rehabil Res Dev. 2011;48(4):483–92. DOI:10.1682/JRRD/2010.03.0035

Effect of robot-assisted versus conventional body-weight-supportedtreadmill training on quality of life for

people with multiple sclerosis

Lauren M. Wier, MPH; Mary S. Hatcher, MD; Elizabeth W. Triche, PhD; Albert C. Lo, MD, PhD

This article and any supplementary material should be cited as follows: Wier LM, Hatcher MS, Triche EW, Lo AC. Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. J Rehabil Res Dev. 2011;48(4):483–92. DOI:10.1682/JRRD/2010.03.0035

Study Aim• Determine whether body-weight-supported treadmill training

(BWSTT) improves quality of life (QOL) for people with multiple sclerosis (MS).

Relevance • MS impairs QOL because of its early onset, range of

impairments, unpredictable course, progressive nature, and lack of cure/effective treatment.

• Past studies have shown that exercise improves QOL for patients with MS.

This article and any supplementary material should be cited as follows: Wier LM, Hatcher MS, Triche EW, Lo AC. Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. J Rehabil Res Dev. 2011;48(4):483–92. DOI:10.1682/JRRD/2010.03.0035

Methods

Participants with MS and gait problems (n = 13) randomly received 2 blocks of 6 twice-a-week training sessions:

• Robot-assisted BWSTT then BWSTT alone. or• BWSTT alone then robot-assisted BWSTT.

QOL was assessed by 3 self-report questionnaires:

•MS Quality of Life Inventory (SF-36 + 9 symptom-based scales).•Fatigue Severity Scale (FSS).•Single-item measure of general Life Satisfaction (LS).

This article and any supplementary material should be cited as follows: Wier LM, Hatcher MS, Triche EW, Lo AC. Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. J Rehabil Res Dev. 2011;48(4):483–92. DOI:10.1682/JRRD/2010.03.0035

Methods• Participants with MS and gait problems (n = 13) randomly

received 2 blocks of 6 twice-a-week training sessions:– Robot-assisted BWSTT then BWSTT alone.

or– BWSTT alone then robot-assisted BWSTT.

• QOL was assessed by 3 self-report questionnaires: – MS Quality of Life Inventory (SF-36 + 9 symptom-based scales).– Fatigue Severity Scale (FSS).– Single-item measure of general Life Satisfaction (LS).

This article and any supplementary material should be cited as follows: Wier LM, Hatcher MS, Triche EW, Lo AC. Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. J Rehabil Res Dev. 2011;48(4):483–92. DOI:10.1682/JRRD/2010.03.0035

Results• Randomized Treatment

Comparison– Midpoint (before crossover):

• No significant difference in QOL measures between unassisted and robot-assisted BWSTT.

– Study Start vs End:• Significantly improved PCS

(SF-36) for participants receiving robot-assisted BWSTT 1st (15.6% increase) vs 2nd (2.0% increase) (p = 0.008).

• Longitudinal Treatment Effects– Midpoint:

• Significantly improved FSS (p = 0.01), fatigue impact (p = 0.03), pain effects (p = 0.04).

– Study Start vs End:• Significant within-participant lon-

gitudinal improvements: PCS (p = 0.03), fatigue impact (p = 0.03), pain effects (p = 0.02), perceived deficits (p = 0.03), LS (p = 0.03).

• Significant 1-point improvement in EDSS (p = 0.003).

This article and any supplementary material should be cited as follows: Wier LM, Hatcher MS, Triche EW, Lo AC. Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis. J Rehabil Res Dev. 2011;48(4):483–92. DOI:10.1682/JRRD/2010.03.0035

Conclusions

• Both robot-assisted and unassisted BWSTT improved QOL, but did not significantly differ.

• Limited evidence of treatment order effect favored sequencing robot-assisted BWSTT before unassisted BWSTT

• Improvements possibly due to endorphin release, improved physical health, excitement about potential treatment benefits, opportunity for proactive MS management, and social interactions inherent to participation.