PTOTPilotJournal of neuroengineering and rehabilitation2025

Investigating the orthotic effect of a passive gravity-compensated exoskeletal device on upper-limb function in people with multiple sclerosis: a pilot cross-sectional study.

Thomas Bowman, Alessandro Torchio, Ilaria Carpinella and 6 others

PMID 40859381

WHAT IT FOUND

In thirteen people with severe multiple sclerosis disability, a passive arm exoskeleton improved functional scores and endurance.

In those with mild impairment, it slowed movements and reduced performance. The device helps only when gravity is a major barrier to movement.

Key findings

01Participants with severe upper-limb impairment who could not complete tasks without assistance showed significant gains in movement range and functional scores when using the exoskeleton.

02Participants with mild impairment performed worse with the exoskeleton, taking more time and showing reduced movement smoothness during functional tasks.

03Usability scores were acceptable overall, with participants who experienced clinical benefits rating the device more favourably than those who did not.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The sample size was very small (13 participants), limiting the generalizability of the findings. The study only measured immediate effects, not long-term rehabilitation benefits. The device is bulky and requires a central stand, making it unsuitable for home use or community settings. The counterweight system adds inertia, which can slow down movements for users with better motor control. The device does not support hand grasp, limiting its utility for patients with severe fine motor impairment.

Declared interests

The study was funded by Fondazione Italiana Sclerosi Multipla and Ministero della Salute. No other conflicts of interest are reported.

The easy way to misread this

Do not assume this device helps all people with MS upper-limb impairment. It improved function only in those with severe weakness who could not move their arm against gravity. For those with mild impairment, it slowed movements and reduced performance.

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