Disclosures: Angeli Mayadev, MD: allergan (Products/Services: No) (Speaker/Honoraria includes speakers bureau, symposia, and expert witness)

Objective: To establish the safety and effectiveness of intervention using the HAL® exoskeleton in the SPMS, NMO, and non-MS disease populations in functional outcomes after training, post 6, and 12 months.

Design: Ongoing single-center prospective pilot Setting : Multiple Sclerosis Center Gym Participants : 14 Patients – Progressive ((n=8; SPMS (n=7), NMO (n=1)) and non-MS patients (n=6)

Interventions: Patients underwent 48-60 sessions of treadmill training over an average of 15 weeks in a body weight-supporting harness using the HAL® exoskeleton under the supervision of physical therapists. Training sessions were customized for each individual and could include stretching, vibration, strengthening, pre-gait, and training with alternate assistive devices. Training in HAL® had a goal of 30 minutes of skilled gait training integrating form, speed, balance, decreased visual reliance and dual task attention of the 2 hr session.

Main Outcome Measures: 10 Meter Walk Test (10MWT), Timed Up & Go (TUG), 6 Minute Walk, and the BERG Balance Scale.

Results: Patients completed sessions of treadmill training with no serious adverse events noted. Both SPMS and non-MS patients demonstrated a mean improvement in all functional outcomes. Patients in both groups improved from baseline at least 20% in all functional outcomes (range, 22%-41%). Patients from the SPMS group on average tended to improve more with a 34%, 41%, 35% and 24% improvement in the TUG, BERG, 10MWT, and 6MWT, respectively. Those in the Non-MS group improved 22%, 26%, 28%, and 35% in these same measures. The gains continued to remain the same or improve over the 6 and 12 month post training periods. The SPMS patients had a higher rate of improvement. Conclusions: HAL® treadmill training improves the rehabilitation of patients with SPMS, NMO, and non- MS patient populations. This continues in follow-up testing at 6 and 12 months. The intervention is safe, and patients demonstrated improved walking performances over the course of training and follow-up.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/experience-of-the-hybrid-assistive-limb-hal-robotic-device-to-improve-rehabilitation-in-patients-with-progressive-multiple-sclerosis-spms-and-non-ms-an-interim-analysis-of-14-patients/