Early Brock research shows potential therapy for multiple sclerosis

Not even a pandemic could stop Kailynn Mannella from discovering a potential therapy for people living with multiple sclerosis (MS).

In January, the then-master’s student in the Faculty of Applied Health Sciences recruited people living with MS to participate in her thesis study.

Mannella, now a PhD student in Health Biosciences, was testing out whether a robot called a ‘wristbot’ could be used as a therapy tool to strengthen forearm muscles and improve neural control of the hand. The wristbot, a made-to-order haptic devise used to study arm and wrist biomechanics and motor control, is the only one of its kind in a Canadian university.

It’s housed in the laboratory of Mannella’s supervisor, Associate Professor of Kinesiology Michael Holmes, who is also Canada Research Chair in Neuromuscular Mechanics and Ergonomics.

The stakes are personal for Mannella. Her beloved aunt lives with a progressive form of MS, which motivates Mannella to study the disease and what can be done to reduce the suffering that her aunt and others experience.

“There might not be a cure, but we can help their day-to-day life, and that’s just as impactful and important to them,” she says.

By early February, Mannella gathered 15 people living with MS and began to train the group on how to use the wristbot. In three-times-a-week sessions that spanned a month, the research participants manipulated the devise to strengthen their arm muscles.

It was a type of adaptive training where the machine automatically altered the level of how it helped enable or ‘assist’ participants to handle the joystick on the devise, or change the level of difficulty, called ‘resistance.’

“This technique is novel and is the first robotic training program to our knowledge that incorporates two opposing forces, assistance and resistance, that is able to update in real-time,” says Mannella.

She says this method “challenges the neuromuscular system to enhance and accelerate the recovery process,” and that combining assistance and resistance leads to stronger muscles, reduction of muscular fatigue and other positive outcomes.

The robot used real-time feedback of the participants’ performance on a hand tracing task to alter the demands placed on the user, effectively delivering an individualized protocol to maximize performance and adaptation.

The sessions were supposed to last for two months; however, COVID-19 struck while Mannella and her participants were only halfway through their work, ceasing the in-person sessions.

All was not lost. From her early results, Mannella knew that she was on the right track.

“Even though it was cut in half, we did see significant improvement in the neuromechanical control of the hand,” she says. “We also found improvements in muscular strength and muscular endurance at the wrist.”

Although no firm conclusions can be made with the small sample size and short time, she says the results are encouraging enough to create a “proof of concept,” or a solid research proposal moving forward.

“I’m using this as a learning opportunity to fix any errors and tweak our protocol,” says Mannella, who is now using this preliminary research as a basis for her PhD studies with Holmes.

“Kailynn has been passionate about MS research since I first met her,” says Holmes. “She worked incredibly hard to finalize data collection before research at Brock was halted. The findings are exciting and I can’t wait to see what Kailynn does in her PhD. Her passion for the work and her ability to connect with persons with MS has made for an exciting future of discovery in rehabilitation robotics.”

Mannella says her research so far has been a deeply satisfying experience that goes beyond finding promising results.

“One participant told me she is now able to squeeze lemons when she bakes, which is something she couldn’t do before,” says Mannella. “That really changed her life, because she loves to bake. Improvements in muscular strength can be translated into improvements in activities of daily living.

“It was a really humbling experience. It’s an honour to be part of the MS community because they’re welcoming people, very dedicated and wanting to help.”

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