2021 CMSC Annual Meeting

The Use of Ekso GT Exoskeleton Yields Functional Gait Improvement in Patients with Multiple Sclerosis


Background: Multiple Sclerosis is characterized by lesions in various locations of the central nervous system that can result in impairments to sensation, motor control, balance, coordination, all negatively influencing gait mechanics. The Ekso GT is an exoskeleton clinically used for gait training and FDA approved for use with persons with spinal cord injury below the C7 level or deficits due to a cerebrovascular accident. The Ekso GT is programmable to stabilize as well as augment the action of the knee and hip joints to assist in ambulation. This case report aims to explore the utility of Ekso GT with persons with gait disorders due to Multiple Sclerosis. It is hypothesized that the participants will experience an improvement in gait speed and subjective gait quality after therapeutic use of the Ekso GT. Objectives: To conduct a case report exploring the efficacy of Ekso GT use to influence functional improvement in gait related impairments in a small group of persons with Multiple Sclerosis. Methods: The participants (x5) agreed and underwent functional gait training with Ekso GT for one time per week for sixty minutes for a minimum of five weeks. The Timed Up & Go test (TUG), 10 Meter Walk Test (10MWT) and Multiple Sclerosis Walking Scale (MSWS-12) were utilized to determine functional improvement of gait. Results are based upon the changes in these outcomes prior to and after minimum of five training sessions with the exoskeleton. Results: After 5 (or more) sessions with Ekso GT use, 5 patients demonstrated improvement to functional gait based on the aforementioned outcomes including improved gait speed (average increase of 0.06 m/s), Timed Up and Go time (average decrease of 2.24 seconds), MSWS-12 report (average decrease of 3.33 percentage points). Conclusions: Use of the Ekso GT system has influenced improvement in functional gait in patients with impaired gait due to Multiple Sclerosis. The use of the exoskeleton offers a possible novel treatment modality to contribute to functional gait recovery. Additional work in the form of a research study appears justified to further determine if exoskeleton use is appropriate for persons with Multiple Sclerosis.