ASSISTarmMS

Summary of the original project An adequate upper-limb function is essential to interact with the environment. Upper-limb impairments can occur in patients with Multiple Sclerosis (MS) with different disorders involving hand sensation, strength, tactile sensibility, active range of motion, tremor, and difficulties in inter-joint coordination. These impairments lead to reduced manual dexterity and difficulties in carrying out Activities of Daily Living (ADLs). Nevertheless, much attention has focused on impaired mobility in MS, while upper-limb impairment is understudied (Kraft et al. 2014). Several pilot studies demonstrated the positive effect of robotic programs on upper-limb impairment reduction in MS. Specifically, the effectiveness of upper-limb weight- support seems to be promising as preliminary demonstrated in a rehabilitation program based on the use of an exoskeleton to assist patients during the execution of virtual tasks (Gijbels et al. 2011). The aim of this project is to preliminary verify on a group of 26 MS patients with a high level of upper-limb impairment whether an intervention based on the use of an exoskeleton (ASSISTarmMS), which supports the upper-limb weight allowing the execution of complex functional movements, could be beneficial for MS patients. The rehabilitative program is made of 12 sessions of 45 minutes (3 times a week for 4 weeks). At each session, patients will perform functional tasks involving reaching and manipulation of real objects, (e.g., bottles, jars, padlocks, keys, small containers, pegs, beads, coin slots) taken from typical activities of daily living. Bimanual tasks will also be considered. Once results would show the efficacy of the proposed intervention and the benefits of using ASSISTarmMS in MS, a randomized, double-blind control trial involving a larger group of patients will be done.