Use and subjective experience of the impact of a motor-assisted movement exerciser in people with amyotrophic lateral sclerosis: a multicentre observational study

Abstract Objective: Motor-assisted movement exercisers (MME) enable device-assisted physical therapy delivered in domestic settings. This observational study captures the frequency of MME use, subjective experience of the therapy provided and MME recommendation. Method: The prospective cohort study was implemented at ten ALS centres (02/2019-10/2020) and coordinated by the research platform Ambulanzpartner. Participants assessed symptom severity, frequency of use and subjective benefit of therapy on a numerical rating scale (NRS, 0 to 10 points). The likelihood of recommending the MME was determined by the Net Promotor Score (NPS). Results: Data for 144 participants were analysed. Weekly MME applications ranged from 1 to 4 in 41%, 5 to 7 in 42% and >7 in 17% of participants. Particularly positive results were achieved in the following domains: amplification of a sense of achievement (67%), diminution of the feeling of having rigid limbs (63%), diminution of the feeling of being immobile (61%), improvement of general wellbeing (55%) and reduction of muscle stiffness (52%). Participants with more pronounced self-rated muscle weakness were more likely to note a beneficial effect on preservation and improvement of muscle strength under MME treatment (p<0.05). The NPS for the MME was high (+61). Conclusion: High-frequency MME-assisted treatment (defined as a minimum of five sessions a week) was administered in the majority of participants (59%) in addition to physical therapy. Most patients stated to have achieved their individual objectives of MME intervention as evidenced by a high level of satisfaction. The results underline the justification for extended MME treatment as part of the ALS care concept.