Real-life arm performance is decreased in wheelchair-bound MS patients and can be best predicted by measures on 'body functions & structures' level and fine motor control. Hand dominance influenced the magnitude of relationships.

The aim was to compare the effectiveness of dual-task training (DTT) compared to single mobility training (SMT) on dual-task walking, mobility and cognition, in persons with Multiple Sclerosis (pwMS). Forty pwMS were randomly assigned to the DTT or SMT groups. The DTT-group performed dual-task exercises using an interactive tablet-based application, while the SMT-group received conventional walking and balance exercises. Both interventions were supervised and identical in weeks (8) and sessions (20). Nine cognitive-motor dual-task conditions were assessed at baseline, after intervention and at 4-weeks follow-up (FU). The dual-task cost (DTC), percentage change of dual-task performance compared to single-task performance, was the primary outcome. Mobility and cognition were secondarily assessed. Mixed model analyses were done with group, time and the interaction between group and time as fixed factors and participants as random factors. Significant time by group interactions were found for the digit-span walk and subtraction walk dual-task conditions, with a reduction in DTC (gait speed) for the DTT maintained at FU. Further, absolute dual-task gait speed during walking over obstacles only improved after the DTT. Significant improvements were found for both groups in various motor and cognitive measures. However, the DTT led to better dual-task walking compared to the SMT.

Number of figures: 5 Supplementary material: 2 tables Number of references: 37 Declaration of Interest Ilse Lamers has received teaching honoraria from Sanofi Genzyme Europe. Peter Feys is steering committee member of Neurocompass, participated to advisory board meetings of BIOGEN IDEC, and received teaching honoraria for EXCEMED and PARADIGMS. The devices used in this study were given in loan by the Tyromotion and Symbio Therapy. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Research data Raw data of the pre and post testing can be shared (coded) on request and after approval of Medical Ethics and privacy committee of the involved parties. The personal data collected in this study remains confidential and would not be shared.

Hand function is often impaired after neurological injuries such as stroke. In order to design patient-specific rehabilitation, it is essential to quantitatively assess those deficits. Current clinical scores cannot provide the required level of detail, and most assessment devices have been developed for the proximal joints of the upper limb. This paper presents a new robotic platform for the assessment of proprioceptive, motor, and sensorimotor hand impairments. A detailed technical evaluation demonstrated the capabilities to render different haptic environments required for a comprehensive assessment battery, and showed that the device is suitable for human interaction due to its ergonomic design. A preliminary study on proprioceptive assessment using a gauge position matching task with one healthy, one stroke, and one multiple sclerosis subject showed that the robotic system is able to rapidly and sensitively quantify proprioceptive deficits, and has the potential to be integrated into the clinical settings.