Pilot Study of Powered Exoskeleton Use for Gait Rehabilitation in Individuals With Multiple Sclerosis

Exclusion Criteria

• •• MS exacerbation, severe acute comorbidity or surgery less than 90 days prior to enrollment
• •* Diagnosed with osteoporosis or history of long bone fractures since diagnosis
• •* Safety concern due to neurologic impairments (e.g. upper extremity weakness, visual loss) or comorbidities (e.g. cardiac, respiratory)
• •* Other neurologic or non-neurologic condition interfering with walking
• •* \< 1 month since previous intensive gait training regimen or initiation of treatment that can affect walking (e.g. medication for spasticity)
• •* Planned change in medications that may affect walking during the study period
• •* Uncontrolled or severe orthostatic hypotension that limits standing tolerance
• •* Active heterotrophic ossification (HO), hip dysplasia, or uncontrolled hip/knee axis abnormalities
• •* Score \<22 on the Mini-Mental State Examination or deemed to have cognitive impairment precluding safe training with the device during the screening and training process
• •* Colostomy
• •* Pregnancy
• •* Unresolved deep vein thrombosis
• •* Uncontrolled autonomic dysreflexia
• •* Currently involved in another rehabilitation study
• •Assessed by physical therapy:
• •Severe spasticity that prevents joint motion (severe stiffness or rigidity) in proximal lower extremity muscles, including hip adductors and knee flexors/extensors.
• •Hip flexion contracture greater than \~17°
• •Knee flexion contracture greater than 12°
• •Unable to achieve neutral ankle dorsiflexion with passive stretch (achieve neutral with up to 12° knee flexion)
• •Leg length discrepancy greater than 0.5" for upper leg, greater than 0.75" for lower leg
• •Spinal instability
• •Severe muscular or skeletal pain
• •Open skin ulcerations on buttocks or other body surfaces in contact with exoskeleton or harness
• •Shoulder extension range of motion(ROM) \< 50° excludes using crutches during sit to stand or vice versa. (Walking with crutches permitted, sit \<\> stand would be done with walker