Task-oriented Upper Limb Training in MS

Intensity Dependent Clinical Effects of a Task-oriented Upper Limb Training in Multiple Sclerosis

An adequate upper limb function is crucial to independently perform Activities of Daily Living (ADL). Persons with neurological diseases often experience upper limb dysfunction. Upper limb function in Multiple Sclerosis (MS) is highly prevalent, increasing with overall disability level, while the detrimental impact on ADL is higher than in stroke, given that symptoms often occur bilaterally. In contrast to stroke, it is unknown whether similar rehabilitation principles and effect sizes apply in MS given that this progressive neurodegenerative disease is characterized by multiple lesions and atrophy of brain structures. To date, optimal therapy dosage of upper limb rehabilitation programs are not known in the MS literature neither were characteristics of responders identified.

The aim of this explorative study is to investigate the intensity dependent clinical effects of a task-oriented upper limb training in persons with MS with different upper limb disability levels.

Inclusion Criteria:

• Age > 18 years
• Diagnosis of MS (McDonald criteria)
• Progressive type of MS (primary or secondary progressive MS)
• A score 1 or more on the performance scale: item hand function

Exclusion Criteria:

• A relapse or relapse-related treatment within the last 3 months prior to the study
• Complete paralysis of both upper limbs
• Marked or severe intention tremor (Fahn's tremor rating scale > 3)
• Other medical conditions interfering with the upper limb function (ortopaedic or rheumatoid impairment)
• Severe cognitive or visual deficits interfering with testing and training