Article

Robot-assisted gait training (RAGT) has been suggested as an
intervention to improve walking capacity in patients with multiple sclerosis
(MS). This study aimed to evaluate whether RAGT (Lokomat) is superior
to over-ground walking training in terms of quality of life, activity level, and
gait. METHODS: A total of 67 patients with MS with the Expanded Disability Status
Scale (EDSS) 3.0 to 6.5 were randomized to walking or RAGT, in addition to
multimodal rehabilitation. Primary outcomes were walking speed, activity level
(estimated metabolic equivalent, metabolic equivalents [METs], using an
accelerometer), and quality of life (Well-Being Visual Analogue Scale (VAS) and
EQ-5D European VAS. RESULTS: In all, 49 patients finished the interventions. Mean
age was 56 years (range 36-74 years), mean EDSS was 5.8 (3.0-6.5), and the
preferred walking speed at baseline was 0.56 m/s (0.06-1.43 m/s). Before
rehabilitation, participants spent on average 68 min/d at an MET >/= 3. The
walking group improved gait speed nonsignificantly more than the RAGT; the upper
bound of the confidence interval (CI) did not exclude a clinically relevant
benefit (defined as a difference of 0.05 m/s) in favor of the walking group; the
lower bound of the CI did exclude a clinically important benefit in favor of the
Lokomat. Quality of life improved in both groups, with a nonsignificant
between-group difference in favor of the walking group. Both groups had reduced
their activity by 8 weeks after the rehabilitation. CONCLUSION: It is unlikely
that RAGT is better than over-ground walking training in patients with an EDSS
between 3.0 and 6.5.

Langue : ANGLAIS