'Unique' rehabilitation exercise trial seeks participants with MS

Karen Saunders, a consultant clinical and research neuro-physiotherapist, is the co-investigator on a feasibility trial that is evaluating the use of a balance exercise programme that makes use of a Rex robotic exoskeleton.

During the trial, the robotic exoskeleton will be used to enable people to practice standing with less effort, as well as allowing them to stand in a position of optimal postural alignment.

Meanwhile, the balance exercise programme will focus on increasing core body and leg muscle strength, raising awareness of posture and the practice of weight transfer (with support from the exoskeleton device).

Ms Saunders told Frontline: ‘The trial is based in Canterbury, Kent and we are inviting people living with MS, who are able to walk at least eight metres with or without a walking aid, to contact us if interested in taking part in this unique rehabilitation exercise trial.

‘We would like to recruit eight more participants before September, so any therapists, who may know or have contact with people who may be interested in applying to take part, can contact me at karen.saunders10@nhs.net .’

Potential participants will be screened during an outpatient appointment to assess their eligibility for the trial.

The trial will run to the end of the year and has been authorised by Health Research Authority and approved by the National Institute for Health Research. 

It is being led by Dr Mohamed Sakel, a consultant physician in neuro-rehabilitation medicine and service director at East Kent Hospitals University NHS Trust.

Robotic support

Participants wearing the exoskeleton device will be securely supported and able to exercise their core muscles without having to hold onto any external support, Ms Saunders explained. 

‘This enables them to relax their arms and focus on strengthening their core abdominal and back muscles, which reduces over-reliance on vision and often enables them to start to look forwards rather than down when they are walking.’

The trial has already started and appears to be producing positive results. One of the participants who is already completed the balance programme said: ‘The exercise sessions lasted for five weeks and were an hour long, and after the sessions I immediately felt rejuvenated, confident in walking and more upright and balanced.

‘Over the next day or two after, my muscles felt tired as they’d been worked, but as they recovered I felt stronger in my legs and more toned.

‘There was an improvement in my balance and strength in my leg muscles which consequently has had a positive effect on my walking ability.’

I would encourage others who fit the criteria to take part

Required research

Ms Saunders hopes the research will help to address a current lack of evidence about effective rehabilitation for people living with MS and other long-term neurological conditions.

‘People with MS have a much higher risk of falls compared to older people, so there is an urgent critical need to evaluate interventions, which could improve balance and reduce the risk of falls,’ she explained.

‘And a recent Cochrane review reported that there is a need for more research to identify the effectiveness of specific rehabilitation modalities in reducing disability for people with MS.’

‘There is also a national shortage of neuro-rehabilitation services, which can make it challenging for people living in the community, who have identified balance and mobility issues to gain access to effective neuro-rehabilitation treatments.’

Therapists who would like to refer or encourage people they know with MS, who may fit the criteria for the study, can contact Ms Saunders directly.

Email: karen.saunders10@nhs.net

Or telephone 07920 785768.