Robotic Technology Can Help Preserve Mobility in Patients with MS

A new robotic “exoskeleton” has been shown to help stroke patients, and now its developers say they expect it to benefit patients with multiple sclerosis (MS), too.

Researchers from Boston University and Harvard University have published a study showing that a soft-suit exoskeleton developed at Harvard’s Wyss Institute for Biologically Inspired Engineering provided significant assistance to patients with impaired walking due to stroke.

In tests on treadmills and on the ground, the suit “reduced interlimb propulsion asymmetry, increased ankle dorsiflexion, and reduced the energy required to walk,” the authors wrote.

“Exosuits” have already been approved by the US Food and Drug Administration (FDA) to assist paraplegics, but the new study suggests the system could have benefits for patients across a wide variety of therapeutic areas.

The exosuit works by transmitting power to key joints in the legs. The cables that power the system are built into a fabric-based design that minimizes bulkiness and discomfort.

The prototype used in the study is being commercialized by ReWalk Robotics Ltd., which has headquarters in the US, Israel, and Germany. The 16-year-old company that was originally launched with the goal of helping patients with spinal cord injuries.

Larry Jasinski (pictured), chief executive officer of ReWalk, said that after commercializing the product for patients recovering from stroke, the company’s next target will be the MS market.

“We have identified MS as a second target application through the guidance of multiple physicians who reviewed the technology,” Jasinski said. “Our collaboration with the Wyss Institute is primarily focused on fundamental research regarding clinical need and design approaches for each of these areas. ReWalk will seek to develop the most promising elements from this research into commercial designs.”

Jasinski said other potential applications include Parkinson’s disease, cerebral palsy, and assistance for the elderly.

The research has had an interdisciplinary flavor, with engineers, designers, and biomechanists working alongside physical therapists, physicians, and patients to develop and optimize the technology.

In launching the stroke study, the authors noted that many stroke patients are prescribed ankle-foot orthoses that offer passive assistance but often leave patients with considerable impairment. The study aimed to find out whether a more active system that supplements the body’s own remaining strength and movement could improve walking more quickly. The data showed that it could.

As for MS patients, Jasinski said an initial clinical assessment indicates that the current design created for stroke patients will also benefit patients with MS.

“We also have the technical ability to make this bilateral and to actuate motion at both the hips and ankles,” Jasinski said. “We believe this may have be a technology that can be used as an ongoing aid for many years during the progression of the disease.”

It’s not known whether the use of such a device could actually slow the progression of disease or reduce disease-associated impairment, but Jasinski said those questions will be a key element of the company’s research going forward.

The study, “A soft robotic exosuit improves walking in patients after stroke,” was published online in Science Translational Medicine last month.

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