A Passive Exoskeleton Can Push Your Life Up: Application on Multiple Sclerosis Patients

In the present study, we report the benefits of a passive and fully articulated exoskeleton on multiple sclerosis patients by means of behavioral and electrophysiological measures, paying particular attention to the prefrontal cortex activity. Multiple sclerosis is a neurological condition characterized by lesions of the myelin sheaths that encapsulate the neurons of the brain, spine and optic nerve, and it causes transient or progressive symptoms and impairments in gait and posture. Up to 50% of multiple sclerosis patients require walking aids and 10% are wheelchair-bound 15 years following the initial diagnosis. We tested the ability of a new orthosis, the “Human Body Posturizer”, designed to improve the structural and functional symmetry of the body through proprioception, in multiple sclerosis patients. We observed that a single Human Body Posturizer application improved mobility, ambulation and response accuracy, in all of the tested patients. Most importantly, we associated these clinical observations and behavioral effects to changes in brain activity, particularly in the prefrontal cortex.

[1]  R. Ilmoniemi,et al.  Models of source currents in the brain , 2005, Brain Topography.

[2]  Sara López-Martín,et al.  Spatiotemporal characterization of response inhibition , 2013, NeuroImage.

[3]  Fuster Joaquin,et al.  Cognitive functions of the prefrontal cortex , 2010 .

[4]  A. Dale,et al.  Improved Localizadon of Cortical Activity by Combining EEG and MEG with MRI Cortical Surface Reconstruction: A Linear Approach , 1993, Journal of Cognitive Neuroscience.

[5]  Donatella Spinelli,et al.  Similar Cerebral Motor Plans for Real and Virtual Actions , 2012, PloS one.

[6]  L. Goldstein,et al.  The anatomy of cognitive impairment in amyotrophic lateral sclerosis: More than frontal lobe dysfunction , 2012, Cortex.

[7]  E Donchin,et al.  A new method for off-line removal of ocular artifact. , 1983, Electroencephalography and clinical neurophysiology.

[8]  Aaron M. Dollar,et al.  Lower Extremity Exoskeletons and Active Orthoses: Challenges and State-of-the-Art , 2008, IEEE Transactions on Robotics.

[9]  D. Goodin,et al.  Long-latency Cerebral Event-related Potentials in Multiple Sclerosis , 2001, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[10]  Jeffrey A. Cohen,et al.  Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls , 2008, Multiple sclerosis.

[11]  Marika Berchicci,et al.  The neurophysiology of central and peripheral fatigue during sub-maximal lower limb isometric contractions , 2013, Front. Hum. Neurosci..

[12]  Daniel P. Ferris,et al.  Powered lower limb orthoses for gait rehabilitation. , 2005, Topics in spinal cord injury rehabilitation.

[13]  R. Seliktar,et al.  Design and Testing of a Functional Arm Orthosis in Patients With Neuromuscular Diseases , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[14]  J. Kurtzke Rating neurologic impairment in multiple sclerosis , 1983, Neurology.

[15]  H. Albrecht,et al.  Day-to-day variability of maximum walking distance in MS patients can mislead to relevant changes in the Expanded Disability Status Scale (EDSS): average walking speed is a more constant parameter , 2001, Multiple sclerosis.

[16]  R. C. Oldfield The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[17]  Francesco Lacquaniti,et al.  Distributed plasticity of locomotor pattern generators in spinal cord injured patients. , 2004, Brain : a journal of neurology.

[18]  Seppo P. Ahlfors,et al.  Assessing and improving the spatial accuracy in MEG source localization by depth-weighted minimum-norm estimates , 2006, NeuroImage.

[19]  H. Nolan,et al.  A high-density ERP study reveals latency, amplitude, and topographical differences in multiple sclerosis patients versus controls , 2010, Clinical Neurophysiology.

[20]  Marika Berchicci,et al.  Benefits of Physical Exercise on the Aging Brain: The Role of the Prefrontal Cortex , 2013, The journals of gerontology. Series A, Biological sciences and medical sciences.

[21]  Donatella Spinelli,et al.  Prefrontal hyperactivity in older people during motor planning , 2012, NeuroImage.

[22]  Donatella Spinelli,et al.  The Effects of Aging on Conflict Detection , 2013, PloS one.

[23]  W. Brown,et al.  Callosal Function in Multiple Sclerosis: Bimanual Motor Coordination , 2002, Cortex.

[24]  D. Spinelli,et al.  Awareness affects motor planning for goal-oriented actions , 2012, Biological Psychology.

[25]  Theodore W Berger,et al.  A cortical neural prosthesis for restoring and enhancing memory , 2011, Journal of neural engineering.

[26]  H. Gendelman,et al.  The cellular immunology of multiple sclerosis , 1999, Journal of leukocyte biology.