A novel and adaptive robotics rehabilitation approach to improve upper limb function in people with MS


Study Title: A novel and adaptive robotics rehabilitation approach to improve upper limb function in people with MS
Rationale: The purpose of this research proposal is to use of a state-of-the-art rehabilitation robot to generate individualized training that leads to cross-education, improved outcomes for the more affected limb in persons with MS and reduced asymmetry.
Study Description: The purpose of this proposal is to examine the effects of an adaptive upper limb robotic training program on clinical and functional outcomes in both the trained and untrained limbs in individuals with MS. This proposal has three objectives:

1) Develop new insights into adaptive training using a novel haptic robot as the primary treatment modality. By exploiting a novel haptic wrist robot as the repetitive therapy modality, robotics can deliver tailored, individualized treatment. The force and the adaptive velocity changes are individually tailored to each participant throughout the sessions.

2) Complete a training study with pre/post/follow-up robotic and neurophysiological assessments to understand adaptations. There is only one study to explore CE in PwMS (while minimal in stroke and abundant in healthy populations) and this work will contribute greatly to MS rehabilitation research.

3) Link quantitative measures (robotic sensorimotor assessments) to subjective clinical scales for improved functional assessment. Findings from this proposal will provide new knowledge and encourage robotics research in MS (which lacks compared to other neurological disorders). This research design will provide knowledge for clinicians to help decide on optimal treatment using direct training of the more affected limb or to focus treatment on the less affected limb.

There will be three groups, randomly assigned with consideration for age and severity of impairment and will include 15 participants in each group (30 total participates with MS):
1) CE intervention
2) direct training
3) healthy control group.
The intervention group (MS group) will receive robotic training on the less affected limb. The direct training group (MS group) will receive robotic training on the more affected limb and the healthy control group will receive training on their dominant limb
Starting Date: 2022-10-25
Ending Date: 2023-12-31
Who can participate: Individuals with any phenotype of MS, with some function in at least one of the wrist and upper limb.
Trial Institution: Brock University
Trial Investigator: Kailynn Mannella and Dr. Michael Holmes
Contact Information: Kailynn Mannella
Trial Funding: MS Society of Canada - Catalyst Research Grant