Walking and balance disturbances and fatigue are key symptoms in patients with multiple sclerosis (MS), and major causes of discomfort, even in patients with mild disability since the early stages of the disease. The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and proprioceptive sensory-motor exercises on unstable platforms in improving walking and balance performance. We enrolled 41 patients with relapsing-remitting MS at early stage and low or mild disability: patients in group A underwent a robotic gait rehabilitation treatment which involved the use of SPAD (Dynamic Antigravity Postural System), patients in group B underwent a cycle of sensory-motor training in our laboratory of performance enhancement; patients in both groups were subjected to neuromuscular manual therapy. All treatment was provided with 3 sessions per week for 6 weeks (for a total of 18 sessions). Patients were evaluated by administration of the Functional Independence Measure (FIMTM), the Expanded Disability Status Scale (EDSS), the Berg Balance Scale (BBS), the Fatigue Severity Scale (FSS), and the Modified Fatigue Impact Scale (MFIS), and by performing stabilometric and gait analysis. Results show statistically significant improvement of the FIMTM and the BBS average score in all patients, reduction of the EDSS average score in all patients (but in a statistically significant manner only in group A), reduction in average scores obtained in both evaluation questionnaires of fatigue (non-significant improvement of the FSS average score in the overall sample and in both groups, statistically significant reduction of the MFIS average scores), improvement in stabilometric parameters in all patients (but in a statistically significant manner only in group B) and statistically significant improvement in temporal parameters of gait in all patients. So body weight supported gait training and sensory-motor exercises on unstable platforms are feasible and could be safely used as additional therapeutic.
Biography
Professor Raoul Saggini was born in 1953 in Florence, where he graduated in Medicine and Surgery in 1979. Later he specialized in Orthopedics and Traumatology, Physical and Rehabilitation Medicine, Sports Medicine, always obtaining the highest grades and honors. At the University of Florence, Institute of Orthopedic Clinic, he performed activities initially as medical doctor (1979-’81) and later as an Assistant Professor. In this period he carried out scientific activities taking care of foot surgery, orthopedic and biomechanics aspects of some genetic diseases and knee surgery and arthroscopy. Since 1991, he has continued the academic research and teaching at the “Gabriele d’Annunzio” University of Chieti-Pescara, Italy. Today in the same University he is Full Professor of P.R.M., President of the degree course in Physiotherapy, Director of the School of Specialty in Physical and Rehabilitation Medicine.
