BACKGROUND: In multiple sclerosis (MS) exercise improves upper limb functions, but it is unclear what training types are more effective. OBJECTIVE: This study compares robot-assisted training based on haptic or sensorimotor exercise. METHODS: 41 clinically definite MS subjects with upper limb impairment were randomised into two groups: (i) haptic and (ii) sensorimotor. Subjects in the haptic performed a robot-assisted training protocol designed to counteract incoordination and weakness. The task -interaction with a virtual mass-spring system against a resistive load- requires coordination skills. Task difficulty and magnitude of resistive load were automatically adjusted to the individual impairment. Subjects in the sensorimotor performed reaching movements under visual control; the robot generated no forces. Both groups underwent eight training sessions (40 min/session, 2 sessions/week). Treatment outcome were 9HPT and ARAT scores. RESULTS: The average 9HPT score decreased from 74 +/- 9 s to 61 +/- 8 s for the haptic and from 49 +/- 6 s to 44 +/ -6 s. We found a significant treatment (p = 0.0453) and time differences (p = 0.005), but no significant treatment x time interactions although we found that the absolute change was only significant in the haptic group (p = 0.011). We observed no significant changes in the ARAT score. Participants tolerated treatments well with a low drop-out rate. In the subjects evaluated at after 12 week (11 subject in sensory-motor and 17 in haptic group) no retention of the effect was found. CONCLUSIONS: Task oriented training may improve upper limb function in persons with MS especially in prevalent pyramidal impaired subjects without maintain the effects after three months. CLINICAL TRIAL REGISTRATION NUMBER: NCT02711566 (ClinicalTrials.gov).
With permission from Excerpta Medica Inc.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher