A Novel and Adaptive Robotics Rehabilitation Approach to Improve Upper Limb Function in People with MS

Summary:

• Impairments in hand function are common for people with MS and the inability to perform basic day-to-day activities can result in loss of independence and decreased quality of life. Many people with MS also report having a more affected or immobilized upper limb and a less symptomatic limb.
• This research will use a state-of-the-art robotic device to provide repetitive movement therapy to the less affected limb of individuals with MS, and with a cross over effect, the untrained immobilized limb will experience improvements in muscular strength and functional tasks.

• The knowledge generated from this study will open opportunities for researchers studying non-pharmacological approaches to managing MS and enhance the rehabilitative process for upper limb impairments among people living with MS.

Project Description:

Impairments in hand function are common for people with MS. Most activities of daily living require the use of both hands and range from complex tasks (such as typing or doing up buttons) to rudimentary tasks (such as propping oneself up in bed). Many people with MS report having a more affected or immobilized upper limb and a less symptomatic preferred limb. The less affected hand is often heavily relied on to complete everyday tasks. Cross-education is a phenomenon where the less affected limb undergoes repetitive movement therapy and with a cross over effect, the untrained limb improves in muscular strength and functional tasks. This phenomenon is important when the most affected limb cannot perform movements typical of rehabilitation or resistance training. Cross-education is well understood in healthy populations and stroke, but is vastly understudied in MS.

In this research study, Dr. Mike Holmes will use a state-of-the-art robotic device and cross-education to provide rehabilitation training for the immobilised limb of individuals with MS. Study participants will undergo a robotic training protocol of the hand and wrist. Training will occur three times a week for six consecutive weeks and pre/post/follow-up assessments will include clinical evaluations of function, muscular strength, and physiology of the nervous system to determine how the training translates to real-life benefits. The robotic device will provide a safe, interactive experience and individualized training for people with MS.

Potential Impact:

This is the first study to investigate an adaptive robotics training program to improve clinical outcomes and function in the untrained limb of people with MS. In the shorter-term, this research will inform clinicians and researchers on the importance of implementing individualized training to maximize outcomes when the most affected limb cannot be directly trained. In the longer-term, this work will contribute to MS robotic rehabilitation research, which constitutes a new and innovative approach to repetitive movement therapy. If proven effective in people living with MS, it has the potential to enhance the rehabilitative process and greatly improve overall function and quality of life for people living with MS.

Project Status: In progress