{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T09:59:24Z","timestamp":1780912764919,"version":"3.54.1"},"reference-count":101,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Project H2020-779963 EUROBENCH FSTP-2","award":["PNC0000007"],"award-info":[{"award-number":["PNC0000007"]}]},{"name":"Italian Ministry of University and Research","award":["PNC0000007"],"award-info":[{"award-number":["PNC0000007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Multiple Sclerosis (MS) is a chronic neurological disorder affecting the central nervous system that significantly impairs postural control and functional abilities. Robotic-assisted gait training mitigates this functional deterioration. This preliminary study aims to investigate the effects of a four-week gait training with the ExoAtlet II exoskeleton on static balance control and functional mobility in five individuals with MS (Expanded Disability Status Scale \u2264 2.5). Before and after the training, they were assessed in quiet standing under Eyes Open (EO) and Eyes Closed (EC) conditions and with the Timed Up and Go (TUG) test. Center of Pressure (CoP) Sway Area, Antero\u2013Posterior (AP) and Medio\u2013Lateral (ML) CoP displacement, Stay Time, and Total Instability Duration were computed. TUG test Total Duration, sit-to-stand, stand-to-sit, and linear walking phase duration were analyzed. To establish target reference values for rehabilitation advancement, the same evaluations were performed on a matched healthy cohort. After the training, an improvement in static balance with EO was observed towards HS values (reduced Sway Area, AP and ML CoP displacement, and Total Instability Duration and increased Stay Time). Enhancements under EC condition were less marked. TUG test performance improved, particularly in the stand-to-sit phase. These preliminary findings suggest functional benefits of exoskeleton gait training for individuals with MS.<\/jats:p>","DOI":"10.3390\/bioengineering12080826","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:00:41Z","timestamp":1753884041000},"page":"826","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Four-Week Exoskeleton Gait Training on Balance and Mobility in Minimally Impaired Individuals with Multiple Sclerosis: A Pilot Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Micaela","family":"Schmid","sequence":"first","affiliation":[{"name":"Bioengineering Laboratory, Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Sozzi","sequence":"additional","affiliation":[{"name":"Bioengineering Laboratory, Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5169-4431","authenticated-orcid":false,"given":"Bruna Maria Vittoria","family":"Guerra","sequence":"additional","affiliation":[{"name":"Bioengineering Laboratory, Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3896-0459","authenticated-orcid":false,"given":"Caterina","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Department of Sport, LUNEX, 4671 Differdange, Luxembourg"},{"name":"Luxembourg Health and Sport Sciences Research Institute A.s.b.l., 4671 Differdange, Luxembourg"},{"name":"Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3405-9364","authenticated-orcid":false,"given":"Matteo","family":"Vandoni","sequence":"additional","affiliation":[{"name":"Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4862-6742","authenticated-orcid":false,"given":"Alessandro Marco","family":"De Nunzio","sequence":"additional","affiliation":[{"name":"Department of Sport, LUNEX, 4671 Differdange, Luxembourg"},{"name":"Luxembourg Health and Sport Sciences Research Institute A.s.b.l., 4671 Differdange, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5932-186X","authenticated-orcid":false,"given":"Stefano","family":"Ramat","sequence":"additional","affiliation":[{"name":"Bioengineering Laboratory, Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1515\/revneuro-2017-0011","article-title":"Cognitive impairment in multiple sclerosis\u2014A review of current knowledge and recent research","volume":"28","author":"Grzegorski","year":"2017","journal-title":"Rev. Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/153331750201700104","article-title":"Cognitive impairments in multiple sclerosis: A review","volume":"17","author":"DeSousa","year":"2002","journal-title":"Am. J. Alzheimers Dis. Dement. \u00ae"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sanchez-Dalmau, B., Martinez-Lapiscina, E.H., Pulido-Valdeolivas, I., Zubizarreta, I., Llufriu, S., Blanco, Y., Sola-Valls, N., Sepulveda, M., Guerrero, A., and Alba, S. (2018). Predictors of vision impairment in multiple sclerosis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195856"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1177\/1352458513479840","article-title":"Persistent visual impairment in multiple sclerosis: Prevalence, mechanisms and resulting disability","volume":"19","author":"Jasse","year":"2013","journal-title":"Mult. Scler. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.rehab.2019.11.005","article-title":"The importance of lower-extremity muscle strength for lower-limb functional capacity in multiple sclerosis: Systematic review","volume":"63","author":"Ramari","year":"2020","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jns.2017.03.022","article-title":"Muscle strength and power in persons with multiple sclerosis\u2013a systematic review and meta-analysis","volume":"376","author":"Dalgas","year":"2017","journal-title":"J. Neurol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1191\/1352458504ms1085oa","article-title":"Prevalence and treatment of spasticity reported by multiple sclerosis patients","volume":"10","author":"Rizzo","year":"2004","journal-title":"Mult. Scler. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1053\/apmr.2002.32825","article-title":"Risks of falls in subjects with multiple sclerosis","volume":"83","author":"Cattaneo","year":"2002","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.neulet.2012.07.020","article-title":"Postural control strategy during standing is altered in patients with multiple sclerosis","volume":"524","author":"Huisinga","year":"2012","journal-title":"Neurosci. Lett."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7224\/1537-2073-11.1.1","article-title":"Assessment of postural balance in multiple sclerosis","volume":"11","author":"Fjeldstad","year":"2009","journal-title":"Int. J. MS Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s11910-010-0128-0","article-title":"Postural Control in Multiple Sclerosis: Implications for Fall Prevention","volume":"10","author":"Cameron","year":"2010","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/1352458508096874","article-title":"Sensory impairments in quiet standing in subjects with multiple sclerosis","volume":"15","author":"Cattaneo","year":"2009","journal-title":"Mult. Scler. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.gaitpost.2017.06.020","article-title":"Somatosensory impairment and its association with balance limitation in people with multiple sclerosis","volume":"57","author":"Jamali","year":"2017","journal-title":"Gait Posture"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0079-6123(03)43012-4","article-title":"Generating the walking gait: Role of sensory feedback","volume":"143","author":"Pearson","year":"2004","journal-title":"Prog. Brain Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0079-6123(08)62882-4","article-title":"Group II spindle afferent fibers in humans: Their possible role in the reflex control of stance","volume":"123","author":"Schieppati","year":"1999","journal-title":"Prog. Brain Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1113\/jphysiol.1994.sp020240","article-title":"Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans","volume":"478","author":"Fitzpatrick","year":"1994","journal-title":"J. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1152\/jn.2002.88.3.1097","article-title":"Sensorimotor Integration in Human Postural Control","volume":"88","author":"Peterka","year":"2002","journal-title":"J. Neurophysiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0966-6362(01)00134-5","article-title":"Attentional demands for postural control: The effects of aging and sensory reintegration","volume":"14","author":"Teasdale","year":"2001","journal-title":"Gait Posture"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1517\/03009734000000016","article-title":"General Features of Vibration-Induced Effects on Balance","volume":"77","author":"Eklund","year":"1972","journal-title":"Ups. J. Med. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0304-3940(99)00302-X","article-title":"Specific whole-body shifts induced by frequency-modulated vibrations of human plantar soles","volume":"266","author":"Kavounoudias","year":"1999","journal-title":"Neurosci. Lett."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1007\/BF01960120","article-title":"Postural effects of neck muscle vibration in man","volume":"36","author":"Lund","year":"1980","journal-title":"Experientia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/S0079-6123(08)62204-9","article-title":"Eye, head and skeletal muscle spindle feedback in the elaboration of body references","volume":"80","author":"Roll","year":"1989","journal-title":"Prog. Brain Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1152\/jn.00764.2006","article-title":"Stance- and Locomotion-Dependent Processing of Vibration-Induced Proprioceptive Inflow from Multiple Muscles in Humans","volume":"97","author":"Courtine","year":"2007","journal-title":"J. Neurophysiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/BF00242910","article-title":"Availability of visual and proprioceptive afferent messages and postural control in elderly adults","volume":"108","author":"Hay","year":"1996","journal-title":"Exp. Brain Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S0304-3940(02)00999-0","article-title":"Postural sway under muscle vibration and muscle fatigue in humans","volume":"333","author":"Vuillerme","year":"2002","journal-title":"Neurosci. Lett."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1097\/00005768-199812000-00008","article-title":"Effect of lower extremity muscular fatigue on motor control performance","volume":"30","author":"Howard","year":"1998","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1053\/apmr.2002.28032","article-title":"Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits","volume":"83","author":"Yaggie","year":"2002","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0306-4522(03)00439-1","article-title":"Neck muscle fatigue affects postural control in man","volume":"121","author":"Schieppati","year":"2003","journal-title":"Neuroscience"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0924-980X(97)00040-4","article-title":"Fatigue effects on body balance","volume":"105","author":"Nardone","year":"1997","journal-title":"Electroencephalogr. Clin. Neurophysiol. Electromyogr. Mot. Control"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.neulet.2007.03.036","article-title":"Postural control after a strenuous treadmill exercise","volume":"418","author":"Bove","year":"2007","journal-title":"Neurosci. Lett."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Fling, B.W., Dutta, G.G., Schlueter, H., Cameron, M.H., and Horak, F.B. (2014). Associations between proprioceptive neural pathway structural connectivity and balance in people with multiple sclerosis. Front. Hum. Neurosci., 8.","DOI":"10.3389\/fnhum.2014.00814"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101901","DOI":"10.1016\/j.msard.2019.101901","article-title":"Relative importance of vision and proprioception in maintaining standing balance in people with multiple sclerosis","volume":"39","author":"Yang","year":"2020","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12984-015-0001-0","article-title":"Spatial and temporal characteristics of gait as outcome measures in multiple sclerosis (EDSS 0 to 6.5)","volume":"12","author":"Novotna","year":"2015","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_34","first-page":"711","article-title":"Neurorehabilitation in multiple sclerosis: An overview","volume":"163","year":"2007","journal-title":"Rev. Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1080\/10833196.2016.1263415","article-title":"Physiotherapy and walking outcomes in adults with multiple sclerosis: Systematic review and meta-analysis","volume":"21","author":"Learmonth","year":"2016","journal-title":"Phys. Ther. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.apmr.2015.02.011","article-title":"Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: A meta-analysis","volume":"96","author":"Pearson","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/0269215516637202","article-title":"Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: A randomized controlled trial","volume":"31","author":"Kalron","year":"2017","journal-title":"Clin. Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1016\/j.apmr.2016.05.024","article-title":"Two different types of high-frequency physical therapy promote improvements in the balance and mobility of persons with multiple sclerosis","volume":"97","author":"Davies","year":"2016","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.1016\/j.apmr.2017.08.127","article-title":"Changes in temporal-spatial parameters after six sessions of robotic exoskeleton gait training in acute stroke","volume":"98","author":"Mejia","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1007\/s13760-022-02011-1","article-title":"Wearable powered exoskeletons for gait training in tetraplegia: A systematic review on feasibility, safety and potential health benefits","volume":"122","author":"Doumas","year":"2022","journal-title":"Acta Neurol. Belg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"101674","DOI":"10.1016\/j.rehab.2022.101674","article-title":"Effect of wearable exoskeleton on post-stroke gait: A systematic review and meta-analysis","volume":"66","author":"Hsu","year":"2022","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1177\/15459683231167850","article-title":"Effect of Robot-Assisted Gait Training on Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials","volume":"37","author":"Yang","year":"2023","journal-title":"Neurorehabil. Neural Repair."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Androwis, G.J., Tapia, G.R., Doumas, I., Lejeune, T., and Previnaire, J.-G. (2019, January 23\u201327). Mobility and cognitive improvements resulted from overground robotic exoskeleton gait-training in persons with MS. Proceedings of the 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany.","DOI":"10.1109\/EMBC.2019.8857029"},{"key":"ref_44","first-page":"555","article-title":"Does robot-assisted gait training ameliorate gait abnormalities in multiple sclerosis? A pilot randomized-control trial","volume":"33","author":"Straudi","year":"2013","journal-title":"NeuroRehabilitation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/978-3-031-63755-1_12","article-title":"The Effects of One Month of Lower Limb Powered Exoskeleton Gait Training Compared to the Conventional Gait Training on Treadmills in People with Multiple Sclerosis: A Pilot Study","volume":"Volume 162","author":"Montanari","year":"2024","journal-title":"Engineering Methodologies for Medicine and Sports"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Gandolfi, M., Geroin, C., Picelli, A., Munari, D., Waldner, A., Tamburin, S., Marchioretto, F., and Smania, N. (2014). Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: A randomized controlled trial. Front. Hum. Neurosci., 8.","DOI":"10.3389\/fnhum.2014.00318"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"7141","DOI":"10.1007\/s00415-024-12715-4","article-title":"Effectiveness of robotic rehabilitation for gait and balance in people with multiple sclerosis: A systematic review","volume":"271","author":"Facciorusso","year":"2024","journal-title":"J. Neurol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.apmr.2020.10.122","article-title":"Effects of robotic exoskeleton-aided gait training in the strength, body balance, and walking speed in individuals with multiple sclerosis: A single-group preliminary study","volume":"102","author":"Guzik","year":"2021","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s12984-021-00906-3","article-title":"Review of control strategies for lower-limb exoskeletons to assist gait","volume":"18","author":"Baud","year":"2021","journal-title":"J. Neuro Eng. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1109\/TNSRE.2016.2521160","article-title":"State of the art and future directions for lower limb robotic exoskeletons","volume":"25","author":"Young","year":"2016","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"102936","DOI":"10.1016\/j.msard.2021.102936","article-title":"A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis","volume":"51","author":"Androwis","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1152\/jn.00143.2004","article-title":"Role of Voluntary Drive in Encoding an Elementary Motor Memory","volume":"93","author":"Sawaki","year":"2005","journal-title":"J. Neurophysiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2512","DOI":"10.1152\/jn.00949.2010","article-title":"Spatially selective enhancement of proprioceptive acuity following motor learning","volume":"105","author":"Wong","year":"2011","journal-title":"J. Neurophysiol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Beets, I.A., Mac\u00e9, M., Meesen, R.L., Cuypers, K., Levin, O., and Swinnen, S.P. (2012). Active versus passive training of a complex bimanual task: Is prescriptive proprioceptive information sufficient for inducing motor learning?. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0037687"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Aman, J.E., Elangovan, N., Yeh, I.-L., and Konczak, J. (2015). The effectiveness of proprioceptive training for improving motor function: A systematic review. Front. Hum. Neurosci., 8.","DOI":"10.3389\/fnhum.2014.01075"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"5","DOI":"10.2478\/v10237-011-0036-5","article-title":"Review of Methods for the Evaluation of Human Body Balanc","volume":"19","author":"Panjan","year":"2010","journal-title":"Sport. Sci. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e15067","DOI":"10.14814\/phy2.15067","article-title":"A review of center of pressure (COP) variables to quantify standing balance in elderly people: Algorithms and open-access code","volume":"9","author":"Quijoux","year":"2021","journal-title":"Physiol. Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1038\/ncpneuro0886","article-title":"A weak balance: The contribution of muscle weakness to postural instability and falls","volume":"4","author":"Horlings","year":"2008","journal-title":"Nat. Clin. Pract. Neurol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3468","DOI":"10.1589\/jpts.28.3468","article-title":"Correlation among proprioception, muscle strength, and balance","volume":"28","author":"Wang","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Witchel, H.J., Oberndorfer, C., Needham, R., Healy, A., Westling, C.E., Guppy, J.H., Bush, J., Barth, J., Herberz, C., and Roggen, D. (2018). Thigh-derived inertial sensor metrics to assess the sit-to-stand and stand-to-sit transitions in the timed up and go (TUG) task for quantifying mobility impairment in multiple sclerosis. Front. Neurol., 9.","DOI":"10.3389\/fneur.2018.00684"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1016\/j.apmr.2017.04.003","article-title":"Effects of Muscle Strength and Balance Control on Sit-to-Walk and Turn Durations in the Timed Up and Go Test","volume":"98","author":"Chen","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"7","DOI":"10.18786\/2072-0505-2020-48-009","article-title":"Robotic mechanotherapy: The possibility to use an exoskeleton for lower limb rehabilitation in patients with multiple sclerosis and impaired walking function","volume":"48","author":"Gevorkyan","year":"2020","journal-title":"Alm. Clin. Med."},{"key":"ref_63","first-page":"148","article-title":"Clinico-physiological foundation of application of exoskeleton \u201cexoatlet\u201d during walking of patients with disseminated sclerosis","volume":"24","author":"Kotov","year":"2020","journal-title":"Russ. J. Biomech."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12984-021-00815-5","article-title":"Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments","volume":"18","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"101494","DOI":"10.1016\/j.msard.2019.101494","article-title":"Cortical M1 plasticity and metaplasticity in patients with multiple sclerosis","volume":"38","author":"Baione","year":"2020","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.brs.2022.02.007","article-title":"The degree of cortical plasticity correlates with cognitive performance in patients with Multiple Sclerosis","volume":"15","author":"Balloff","year":"2022","journal-title":"Brain Stimul."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"100849","DOI":"10.1016\/j.mex.2020.100849","article-title":"Method for positioning and rehabilitation training with the ExoAtlet\u00ae powered exoskeleton","volume":"7","author":"Allahdad","year":"2020","journal-title":"MethodsX"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1123\/mcj.8.3.292","article-title":"The sway-density curve and the underlying postural stabilization process","volume":"8","author":"Jacono","year":"2004","journal-title":"Mot. Control"},{"key":"ref_69","first-page":"450","article-title":"Timed Up-and-Go and 2-Minute Walk Test in patients with multiple sclerosis with mild disability: Reliability, responsiveness and link with perceived fatigue","volume":"55","author":"Valet","year":"2018","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1063\/1.166086","article-title":"Upright, correlated random walks: A statistical-biomechanics approach to the human postural control system","volume":"5","author":"Collins","year":"1995","journal-title":"Chaos Interdiscip. J. Nonlinear Sci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.edurev.2010.12.001","article-title":"Eta squared and partial eta squared as measures of effect size in educational research","volume":"6","author":"Richardson","year":"2011","journal-title":"Educ. Res. Rev."},{"key":"ref_72","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Routledge."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.gaitpost.2013.03.005","article-title":"The effect of vision elimination during quiet stance tasks with different feet positions","volume":"38","author":"Loefler","year":"2013","journal-title":"Gait Posture"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/B978-0-444-63916-5.00002-1","article-title":"Sensory integration for human balance control","volume":"159","author":"Peterka","year":"2018","journal-title":"Handb. Clin. Neurol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1007\/s00221-005-0053-7","article-title":"Sensory re-weighting in human postural control during moving-scene perturbations","volume":"167","author":"Mahboobin","year":"2005","journal-title":"Exp. Brain Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/BF00237488","article-title":"Suppression of visually evoked postural responses","volume":"63","author":"Bronstein","year":"1986","journal-title":"Exp. Brain Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2334","DOI":"10.1152\/jn.1996.75.6.2334","article-title":"Unified theory regarding A\/P and M\/L balance in quiet stance","volume":"75","author":"Winter","year":"1996","journal-title":"J. Neurophysiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0966-6362(96)82849-9","article-title":"Human balance and posture control during standing and walking","volume":"3","author":"Winter","year":"1995","journal-title":"Gait Posture"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/S0167-9457(99)00039-1","article-title":"Computing the COM from the COP in postural sway movements","volume":"18","author":"Morasso","year":"1999","journal-title":"Hum. Mov. Sci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1007\/s00221-014-3875-3","article-title":"Understanding balance differences in individuals with multiple sclerosis with mild disability: An investigation of differences in sensory feedback on postural control during a Romberg task","volume":"232","author":"Mandalfino","year":"2014","journal-title":"Exp. Brain Res."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.gaitpost.2018.02.018","article-title":"Postural control deficits in people with Multiple Sclerosis: A systematic review and meta-analysis","volume":"61","author":"Comber","year":"2018","journal-title":"Gait Posture"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/08990220802131127","article-title":"Imbalance in multiple sclerosis: A result of slowed spinal somatosensory conduction","volume":"25","author":"Cameron","year":"2008","journal-title":"Somatosens. Mot. Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.gaitpost.2011.11.026","article-title":"Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed","volume":"35","author":"Spain","year":"2012","journal-title":"Gait Posture"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jneumeth.2013.10.020","article-title":"Frequency analysis approach to study balance control in individuals with multiple sclerosis","volume":"222","author":"Kanekar","year":"2014","journal-title":"J. Neurosci. Methods"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1146\/annurev-neuro-060909-153135","article-title":"Error Correction, Sensory Prediction, and Adaptation in Motor Control","volume":"33","author":"Shadmehr","year":"2010","journal-title":"Annu. Rev. Neurosci."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"3642","DOI":"10.1523\/JNEUROSCI.5317-05.2006","article-title":"An implicit plan overrides an explicit strategy during visuomotor adaptation","volume":"26","author":"Mazzoni","year":"2006","journal-title":"J. Neurosci."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1109\/TVCG.2018.2794072","article-title":"Locomotive Recalibration and Prism Adaptation of Children and Teens in Immersive Virtual Environments","volume":"24","author":"Adams","year":"2018","journal-title":"IEEE Trans. Vis. Comput. Graph."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/B978-0-444-63437-5.00004-2","article-title":"Multisensory integration in balance control","volume":"Volume 137","author":"Bronstein","year":"2016","journal-title":"Handbook of Clinical Neurology"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.apmr.2009.09.013","article-title":"Multiple sclerosis and postural control: The role of spasticity","volume":"91","author":"Sosnoff","year":"2010","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"833","DOI":"10.23736\/S1973-9087.16.04134-4","article-title":"Relationship between neuromuscular and perceived fatigue and locomotor performance in patients with multiple sclerosis","volume":"53","author":"Hameau","year":"2017","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.jbmt.2020.06.014","article-title":"Timed Up and Go in men and women with Multiple Sclerosis: Effect of muscular strength","volume":"24","author":"Pau","year":"2020","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e895","DOI":"10.1212\/NXI.0000000000000895","article-title":"Serum neurofilament light chains in MS: Association with the Timed Up and Go","volume":"7","author":"Allali","year":"2020","journal-title":"Neurol. Neuroimmunol. Neuroinflamm."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1123\/mc.2021-0129","article-title":"Functional Performance, Leg Muscle Strength, and Core Muscle Endurance in Multiple Sclerosis Patients with Mild Disability: A Cross-Sectional Study","volume":"26","author":"Ozkul","year":"2022","journal-title":"Mot. Control"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1177\/1352458512444497","article-title":"The relationship between upper leg muscle strength and walking capacity in persons with multiple sclerosis","volume":"19","author":"Broekmans","year":"2013","journal-title":"Mult. Scler. J."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.gaitpost.2016.09.026","article-title":"Gait deficits in people with multiple sclerosis: A systematic review and meta-analysis","volume":"51","author":"Comber","year":"2017","journal-title":"Gait Posture"},{"key":"ref_96","first-page":"419","article-title":"Effect of two different rehabilitation training with a robotic gait system in body weight support and a proprioceptive sensory-motor exercises on unstable platforms in rehabilitation of gait and balance impairment and fatigue in multiple sclerosis","volume":"5","author":"Saggini","year":"2017","journal-title":"Int. J. Phys. Med. Rehabil."},{"key":"ref_97","first-page":"271","article-title":"Improving Gait and Balance in Multiple Sclerosis Using Partial Body Weight Supported Treadmill Training","volume":"50","author":"Mansour","year":"2013","journal-title":"Egypt. J. Neurol. Psychiatry Neurosurg."},{"key":"ref_98","first-page":"53","article-title":"Treadmill exercise in early multiple sclerosis: A case series study","volume":"45","author":"Benedetti","year":"2009","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1177\/1545968318798938","article-title":"Integrative CNS Plasticity With Exercise in MS: The PRIMERS (PRocessing, Integration of Multisensory Exercise-Related Stimuli) Conceptual Framework","volume":"32","author":"Sandroff","year":"2018","journal-title":"Neurorehabil. Neural Repair."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1007\/s00415-018-8859-y","article-title":"Effects of motor rehabilitation on mobility and brain plasticity in multiple sclerosis: A structural and functional MRI study","volume":"265","author":"Tavazzi","year":"2018","journal-title":"J. Neurol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"104066","DOI":"10.1016\/j.lpm.2021.104066","article-title":"Rehabilitation in multiple sclerosis in 2021","volume":"50","author":"Massot","year":"2021","journal-title":"Presse M\u00e9d."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/8\/826\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:19:01Z","timestamp":1760033941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/8\/826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":101,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["bioengineering12080826"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering12080826","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]}}}