Multiple Sclerosis (MS), the most common non-traumatic cause of neurologic disability in
young adults, affects mobility and ambulation in the majority of patients. Nearly 50% of
persons with MS will require an assistive device to ambulate within 10 years of diagnosis. A
subgroup of MS is Primary Progressive MS, which manifests with gait disturbances over 80% of
patients in the long term. In addition to altered gait, nearly 70% of patients will
experience cognitive deficits during the course of the disease. Therefore, actions that
facilitate patient involvement in finding solutions for personalized management of disease
and disability are needed.
Although immunomodulatory drugs offer some benefit in other types of Multiple Sclerosis,
there is currently no effective treatment for Primary Progressive MS. A fundamental goal in
the management of persons with MS is to maximize their ability to ambulate and perform safe
and effective transfers in everyday life.
In the last decade, research has increasingly centered on the effects of robot devices in the
rehabilitation of patients with neurological diseases. This has led to the development of new
robot-assisted gait devices engendered by virtual-reality systems, and several studies have
demonstrated the positive effects that these devices have on gait endurance and quality of
life in patients with neurological diseases and disability.
The aim of this project is to develop and study the effects of a novel, cognitively intensive
virtual-reality -based rehabilitation software application that simulates a real-world
environment where a person can walk. The virtual-reality application is an upgrade version
synchronized to a robotic device, the GEO System. The second aim is to compare the cognitive
and motor effects of robot-assisted gait training with this application against training with
robot-assisted gait training without virtual reality.
The experimental group will receive robot-assisted gait training with the virtual-reality
application and the control group will receive robot-assisted gait training All subjects will
undergo training for 6 weeks (2 sessions/week) for a total of 12 sessions. Assessments before
training, after training, and at follow-up will be performed using clinical and instrumental
tests to compare the effects of training.
Successful completion of the study may help patients to alleviate the impact of disability,
increase their independence in activities of daily life, and improve their quality of life.
Through new rehabilitative strategies that combine cognitive and motor training involving
higher brain functions and motivation, patients will be stimulated to walk in a reality-based