Neuroplasticity-Based Technologies and Interventions for Restoring Motor Functions in Multiple Sclerosis

Straudi, Sofía; Basaglia, Nino

doi:10.1007/978-3-319-47861-6_11

Cited by 21 publications

(12 citation statements)

References 79 publications

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“…Alongside changes in our understanding of motor control theory, the application of methods, such as the Bobath concept, has evolved [3]. Newer methods have also emerged, such as the use of constraint-induced movement therapy, robotics and virtual reality [3,32]. These are based on evidence which has demonstrated that intensive and task-specific practice are key factors for restoration of functions and brain recovery [32].…”

Section: Discussionmentioning

confidence: 99%

“…Newer methods have also emerged, such as the use of constraint-induced movement therapy, robotics and virtual reality [3,32]. These are based on evidence which has demonstrated that intensive and task-specific practice are key factors for restoration of functions and brain recovery [32]. In light of this, it was anticipated that the majority of respondents might have placed a greater emphasis on employing task oriented interventions which utilized technologies.…”

Section: Discussionmentioning

confidence: 99%

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Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey

Řasová

Freeman

Cattaneo

et al. 2020

IJERPH

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Background: Guidelines and general recommendations are available for multiple sclerosis rehabilitation, but no specific guidance exists for physical therapists. Describing aspects of physical therapy content and delivery in multiple sclerosis and its determinants and analysing whether general recommendations connected with physical therapy are implemented in practice is important for interpreting clinical and research evidence. Methods: An online cross-sectional survey of physical therapists specialized in multiple sclerosis (212 specialists from 26 European countries) was used. Results: There was distinct diversity in service delivery and content across Europe. Perceived accessibility of physical therapy varied from most accessible in the Western region, and least in the Southern region. Sixty-four physical therapists adjusted their approach according to different disability levels, less so in the Eastern region. Duration, frequency and dose of sessions differed between regions, being highest in Southern and Western regions. “Hands on treatment” was the most commonly used therapeutic approach in all apart from the Northern regions, where “word instruction” (providing advice and information) prevailed. Conclusions: The content and delivery of physical therapy differs across Europe. Recommendations concerning access to treatment and adjustment according to disability do not appear to be widely implemented in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey

Řasová

Freeman

Cattaneo

et al. 2020

IJERPH

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“…In addition, our previous case-study reported that 4-weeks of RE-assisted ER (REAER) was associated with improved mobility as well as improved cognitive performance relative to CGT in 4 PwMS (Androwis et al, 2019). We further hypothesized that the aforementioned functional changes may have been attributable to adaptive neuroplasticity (Pascual-Leone, et al, 2005;Straudi, and Basaglia, 2017), whereby REAER might have changed brain functioning which led to improvements in both mobility and cognitive performance (Sandroff et al, 2020). As that study (Androwis et al, 2019) did not include neuroimaging outcomes, we speculated that such a neural mechanism might involve adaptations in thalamocortical resting-state functional connectivity (RSFC), given previous evidence of associations among increased thalamocortical RSFC, walking-based measures of cardiorespiratory fitness, and cognitive performance with 12-weeks of treadmill walking ER in 10 fully-ambulatory PwMS .…”

Section: Introductionmentioning

confidence: 98%

A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis

Androwis

Sandroff

Niewrzol

et al. 2021

Multiple Sclerosis and Related Disorders

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Background: Co-occurring mobility and cognitive impairments are common, debilitating, and poorly-managed with pharmacological therapies in persons with multiple sclerosis (MS). Exercise rehabilitation (ER), particularly walking ER, has been suggested as one of the best approaches for managing these manifestations of MS. However, there is a focal lack of efficacy of ER on mobility and cognitive outcomes in persons with MS who present with substantial neurological disability. Such severe neurological disability oftentimes precludes the ability for participation in highly-intensive and repetitive ER that is necessary for eliciting adaptations in mobility and cognition. To address such a concern, robotic exoskeleton-assisted ER (REAER) might represent a promising intervention approach for managing co-occurring mobility and cognitive impairments in those with substantial MS disability who might not benefit from traditional ER. Methods: The current pilot single-blind, randomized controlled trial (RCT) compared the effects of 4-weeks of REAER with 4-weeks of conventional gait training (CGT) as a standard-of-care control condition on functional mobility (timed up-and-go; TUG), walking endurance (six-minute walk test; 6MWT), cognitive processing speed (CPS; Symbol Digit Modalities Test; SDMT), and brain connectivity (thalamocortical resting-state functional connectivity (RSFC) based on fMRI) outcomes in 10 persons with substantial MS-related neurological disability. Results: Overall, compared with CGT, 4-weeks of REAER was associated with large improvements in functional mobility (η p 2 =.38), CPS (η p 2 =.53), and RSFC between the thalamus and ventromedial prefrontal cortex (η p 2 =.72),but not walking endurance (η p 2 =.01). Further, changes in RSFC were moderately associated with changes in TUG, 6MWT, and SDMT performance, respectively, whereby increased thalamocortical RSFC was associated with improved functional mobility, walking endurance, and CPS (|ρ|>.36). Conclusion:The current pilot RCT provides initial support for REAER as an approach for improving functional mobility and CPS, perhaps based on adaptive and integrative central nervous system plasticity, namely increases in RSFC between the thalamus and ventromedial prefrontal cortex, in a small sample of persons with substantial MS disability. Such a pilot trial provides proof-of-concept data for the design and implementation of an appropriately-powered RCT of REAER in a larger sample of persons with MS who present with co-occurring impairments in both mobility and cognitive functioning.

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“…In this perspective, the importance of rehabilitation is growing because of its ability to increase the quality of life of individuals in the aged population [6,7]. However, the implementation of targeted and cost-effective strategies, tailored to both clinical and individual needs, is still unsatisfactory [8], not to mention the need to monitor the effectiveness of rehabilitation both in terms of individual changes of physical condition, social and psychological welfare [9,10] In this framework, the present work focuses on methods able to follow the outcomes of interventions to restore physical impairments, in which neuroplasticity (i.e., the ability of nervous system to reorganize its structural and functional aspects following a repetitive intrinsic or extrinsic stimulation) represents one of the main mechanisms called into play [11,12]. In principle, this mechanism allows us to indirectly relate the progression of the disease with actual modifications occurring in the brain [13] and objective instrumental measurements can more effectively drive the planning of individualized rehabilitation interventions.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Cerebral Functional Near-Infrared Spectroscopy in Chronic Neurological Diseases—Actual Applications and Future Perspectives

et al. 2020

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Background: The management of people affected by age-related neurological disorders requires the adoption of targeted and cost-effective interventions to cope with chronicity. Therapy adaptation and rehabilitation represent major targets requiring long-term follow-up of neurodegeneration or, conversely, the promotion of neuroplasticity mechanisms. However, affordable and reliable neurophysiological correlates of cerebral activity to be used throughout treatment stages are often lacking. The aim of this systematic review is to highlight actual applications of functional Near-Infrared Spectroscopy (fNIRS) as a versatile optical neuroimaging technology for investigating cortical hemodynamic activity in the most common chronic neurological conditions. Methods: We reviewed studies investigating fNIRS applications in Parkinson’s Disease (PD), Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI) as those focusing on motor and cognitive impairment in ageing and Multiple Sclerosis (MS) as the most common chronic neurological disease in young adults. The literature search was conducted on NCBI PubMed and Web of Science databases by PRISMA guidelines. Results: We identified a total of 63 peer-reviewed articles. The AD spectrum is the most investigated pathology with 40 articles ranging from the traditional monitoring of tissue oxygenation to the analysis of functional resting-state conditions or cognitive functions by means of memory and verbal fluency tasks. Conversely, applications in PD (12 articles) and MS (11 articles) are mainly focused on the characterization of motor functions and their association with dual-task conditions. The most investigated cortical area is the prefrontal cortex, since reported to play an important role in age-related compensatory mechanism and neurofunctional changes associated to these chronic neurological conditions. Interestingly, only 9 articles applied a longitudinal approach. Conclusion: The results indicate that fNIRS is mainly employed for the cross-sectional characterization of the clinical phenotypes of these pathologies, whereas data on its utility for longitudinal monitoring as surrogate biomarkers of disease progression and rehabilitation effects are promising but still lacking.

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Neuroplasticity-Based Technologies and Interventions for Restoring Motor Functions in Multiple Sclerosis

Cited by 21 publications

References 79 publications

Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey

Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey

A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis

A Systematic Review of Cerebral Functional Near-Infrared Spectroscopy in Chronic Neurological Diseases—Actual Applications and Future Perspectives

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