Feasibility and Limitations of Exoskeletons for Multiple Sclerosis Rehab: Francois Bethoux, MD

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"[Hypothetically speaking,] after making sure that safety is preserved, people could go] and use the devices as their exercise device, the same way they would use a specialized treadmill or any other exercise device. That’s a very interesting concept because it would make these devices available in the community close to where people live without raising the cost issue of owning such a device because they are expensive."

Often troubled by issues with fatigue and walking, patients with multiple sclerosis (MS) were met with good news in early June 2022, as the FDA approved the first robotic exoskeleton to be used in rehabilitative settings specific to the disease. The device, EksoNR robotic exoskeleton, was previously approved in June 2020 for those with acquired brain injury and in April 2016 for the rehabilitation of patients with stroke and traumatic brain injury.

To date, there have only been a handful of studies assessing the exoskeleton’s impact, including one presented at the 2022 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, June 1-4, in National Harbor, Maryland. Led by Francois Bethoux, MD, a group of patients with MS who underwent at least 3 gait sessions of training with EksoNR demonstrated statistically significant increases in walk time (P = .008), number of steps (P = .011), and programmed step length (P <.001).¹

Although it is indicated for clinic settings, the promising results beg to question what other potential the exoskeleton has for patients with MS. Bethoux, chair of Cleveland Clinic’s Department of Physical Medicine, sat down for a brief interview to discuss the feasibility of widescale implementation of the device, along with its current limitations in clinical care.

REFERENCE
1. Bethoux F, Stallkamp S, Thompson N, Linder SM. Feasibility and outcomes of gait training with a powered exoskeleton in individuals with multiple sclerosis. Presented at: CMSC Annual Meeting, 2022; June 1-4; National Harbor, MD. REH03