Robot-assisted gait training for limb-girdle muscular dystro-phy: a pathway to improved functional independence

Abstract

Limb-Girdle Muscular Dystrophy (LGMD) encompasses a group of rare genetic muscle disorders characterized by progressive weakness and wasting of the proximal limb muscles, mainly impacting the proximal limb-girdle musculature. The aim of the study was to assess the effects of complex medical rehabilitation, including robotic exoskeleton training, on muscle strength and functional independence in adult patients with LGMD. This case-series study included 8 patients hospitalized for rehabilitation treatment. They received a personalized training plan that included robot-assisted gait training, which was applied 3 times, at 6 months intervals, each rehabilitation session lasting 12 days. Functional independence was assessed with the Barthel Index and Functional Independence Measure. Baseline measurements were taken at the first admission to the hospital, second assessment after 6 months, and the third assessment after 1 year. Our results revealed that robotic therapy improved muscle strength and motor control, significantly improving hip flexion, bilaterally, in adult LGMD patients. Speed change, body weight support, distance change, and duration change showed important gains in seven out of the eight cases. Robotic-assisted training also improved functional independence, but statistically non-significantly. Based on our results, we consider that robotic devices have potential to be further used in rehabilitation of LGMD patients.