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"Multiple sclerosis"

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"Multiple sclerosis"

Original Article

Neuromuscular disorders

Effect of Telerehabilitation Exercise Program on Sleep Quality and Fatigue in Individuals With Multiple Sclerosis
Abdulkerim Kaya, Evrim Karadağ-Saygı, Zeynep Kucukosmanoglu, Özge Keniş-Coşkun, Kadriye Ağan Yıldırım
Ann Rehabil Med 2025;49(5):302-309.   Published online October 31, 2025
DOI: https://doi.org/10.5535/arm.250010
Objective
To examine the effect of the telerehabilitation program on sleep quality and fatigue level in patients with multiple sclerosis (MS) was aimed in this study. MS is a demyelinating disease defined by various signs and symptoms that affects physical, emotional, social, and cognitive functioning. Fatigue, depression, sleep disturbance and cognitive impairment are the among common symptoms of MS.
Methods
The study implemented an individual exercise program for twice a week for 12 weeks via telerehabilitation. In the home-based video exercise group, the same exercises were given as video recordings and the patients were asked to do the exercises twice a week for 12 weeks. Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Multiple Sclerosis Quality of Life Scale-54 and Timed 25 Foot Walk Test were used in the evaluation. The trial is registered with the number of NCT04979845 on ClinicalTrials.gov.
Results
PSQI scores changed from 5.6 (2.1) to 3.66 (2.09) in telerehabilitation group (p=0.03) while no significant change were seen in the video exercise group. Similarly FSS scores decreased from 4.37 (1.42) to 3.67 (1.68) in telerehabilitation group (p=0.04) while no significant changes were seen in the video based exercise group.
Conclusion
The telerehabilitation program is thought to be an effective and accessible non-pharmacological application that can be used in the treatment of sleep quality and fatigue in individuals with MS.

Citations

Citations to this article as recorded by  
  • Comparative efficacy of non- pharmacological interventions on sleep quality in patients with multiple sclerosis: a systematic review and network meta-analysis
    Yanping Liu, Xiaoli Zhao, Congying Luo, Ai Chen, Xiaopeng Zeng
    PeerJ.2026; 14: e20900.     CrossRef
  • FATIGUE IN MULTIPLE SCLEROSIS – MECHANISMS, DIAGNOSIS, AND TREATMENT OPTIONS
    Kornelia Kaźmierkiewicz-Makanga, Weronika Spychalska, Emilia Piotrowicz, Filip Witowicz, Julia Glińska, Aleksandra Krawczyk, Wiktoria Waldon, Paulina Sumlet, Maria Gofron, Michał Duliński
    International Journal of Innovative Technologies in Social Science.2025;[Epub]     CrossRef
  • 1,775 View
  • 51 Download
  • 1 Web of Science
  • 2 Crossref

Review Article

Neuromuscular disorders

Effectiveness of Non-Pharmacological Interventions for Spasticity Management in Multiple Sclerosis: A Systematic Review
Bhasker Amatya, Fary Khan, Krystal Song, Mary Galea
Ann Rehabil Med 2024;48(5):305-343.   Published online October 31, 2024
DOI: https://doi.org/10.5535/arm.240064
This systematic review aims to determine the effectiveness of non-pharmacological interventions for the management of spasticity in people with multiple sclerosis (pwMS). A comprehensive literature search in health science databases (MEDLINE, Embase, CENTRAL, CINHAL) was performed to identify randomized controlled trials (RCTs) (up to April 2024). Manual searching in journals and screening of the reference lists of identified studies were conducted. Two authors independently selected the studies, assessed the methodological quality, and summarized the evidence. A meta-analysis was not feasible due to the methodological, clinical, and statistical diversity of the included studies. Overall, 32 RCTs (n=1,481 participants) investigated various types of non-pharmacological interventions including: physical activity, transcranial magnetic stimulation (intermittent theta burst stimulation [iTBS], repetitive transcranial magnetic stimulation [rTMS]), electromagnetic therapy, transcutaneous electrical nerve stimulation, vibration therapy, shock wave therapy, self-management educational programs, and acupuncture. All studies scored ‘low’ on the methodological quality assessment, implying a high risk of bias. The findings suggest ‘moderate to low certainty’ evidence for physical activity programs used in isolation or combination with other interventions (pharmacological or non-pharmacological), and for iTBS/rTMS with or without adjuvant exercise therapy in improving spasticity in adults with MS. There is ‘very low certainty’ evidence supporting the use of other modalities for treating spasticity in this population. Despite a wide range of non-pharmacological interventions used for the management of spasticity in pwMS, there is a lack of conclusive evidence for many. More robust trials with larger sample sizes and longer-term follow-ups are needed to build evidence for these interventions.

Citations

Citations to this article as recorded by  
  • Development and validation of a practical documentation of inpatient rehabilitation goals, therapy content and outcomes for improving mobility in people with multiple sclerosis in Austria: A multicentre single-arm pragmatic clinical trial
    Andreas Wanitschek, Barbara Seebacher, Barbara Linert, Andreas Mühlbacher, Robert Hatschenberger, Nicole Kranawetter, Lisa Tischler, Monika Scarpatetti, Verena Walder, Alexandra Holzinger, Bernhard Haider, Doris Hörtenhuber, Eva Kronberger-Schaffer, Vikto
    Multiple Sclerosis and Related Disorders.2026; 109: 107100.     CrossRef
  • The effect of the EXOPULSE Mollii suit on motor functions in patients with multiple sclerosis – a randomized sham-controlled crossover trial
    Samar S Ayache, Joseph G Mattar, Alain Créange, Mohamed Abdellaoui, Mickael Zedet, Jean-Pascal Lefaucheur, Hana Megherbi, Hayfa Khaled, Georges Naïm Abi Lahoud, Moussa A Chalah
    Multiple Sclerosis Journal – Experimental, Translational and Clinical.2025;[Epub]     CrossRef
  • Efeito agudo do ultrassom no padrão espástico do bíceps braquial em indivíduos com distúrbios neurológicos
    João Sávio Carneiro Silva, Letícia Costa Mengoni, Gabriel Pádua da Silva, Wellington Marcelo Queixas Moreira, Oswaldo Luiz Stamato Taube, Bruno Ferreira
    RCMOS - Revista Científica Multidisciplinar O Saber.2025;[Epub]     CrossRef
  • Balancing innovation and affordability in relapsing-remitting multiple sclerosis: a budget impact analysis from Saudi Arabia
    Ahmed Al-Jedai, Hajer Almudaiheem, Faisal Al-Suweidan, Mohamed al Jumah, Ahmed al-Thobaiti, Fahad Alzureiqan, Wejdan Abu Ras, Fahad M. Al-Dosari, Yaser Al Malik, Pratik Dhopte, Rita Ojeil
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Trigeminal neuralgia in multiple sclerosis patients: a systematic review and meta-analysis of minimally invasive surgical procedures, decompression, and the pain outcomes
    Daniel Encarnación-Santos, Gennady Chmutin, Nazmin Ahmed, Egor Chmutin, Emmanuel Batista-Geraldino, Bipin Chaurasia
    Headache Medicine.2025; 16(4): 244.     CrossRef
  • 16,562 View
  • 227 Download
  • 3 Web of Science
  • 5 Crossref

Original Articles

Influence of RehaCom Therapy on the Improvement of Manual Skills in Multiple Sclerosis Subjects
Wioletta Pawlukowska, Natalia Dobrowolska, Aleksandra Szylinska, Dorota Koziarska, Agnieszka Meller, Iwona Rotter, Przemysław Nowacki
Ann Rehabil Med 2020;44(2):142-150.   Published online April 29, 2020
DOI: https://doi.org/10.5535/arm.2020.44.2.142
Objective
To assess the influence of cognitive therapy, in combination with cognitive software, on manual dexterity in individuals with multiple sclerosis (MS).
Methods
The Nine-Hole Peg Test (NHPT) was used to establish the eligibility of individuals with MS for testing and to assess their upper limb performance. In addition to standard upper limb rehabilitation, 20 participants received RehaCom-based visual-motor therapy, administered three times a week in 20-minute routines.
Results
A significant relationship was found between the use of manual therapy that utilized the cognitive function platform and the improvement of the non-dominant hand (p=0.037). Compared to controls, the experimental group scored higher on the NHPT, when using the dominant hand (p=0.007). All members of the experimental group, aged ≤60 years, needed considerably less time to do the NHPT with the dominant hand (p=0.008).
Conclusion
Application of manual therapy using the cognitive function platform improves performance of the hand. However, further research is needed to analyze the correlation between cognitive function and motor performance in patients with MS.

Citations

Citations to this article as recorded by  
  • Enhancing Neuroplasticity Post Stroke: The Role of Cognitive–Behavioral Training
    Mohamed Rasmy Moursy, Abdulalim A. Atteya, Hoda M. Zakaria, Zizi M. Ibrahim, Olfat Ibrahim Ali, Nouf H. Alkhamees, Mye A. Basheer, Noura A. Elkafrawy
    Brain Sciences.2025; 15(4): 330.     CrossRef
  • Nörodejeneratif hastalıklarda bilgisayar tabanlı bilişsel rehabilitasyon
    Zühal Şeflek, Ülkü Saygılı Düzova, Savaş Karpuz, Tuğçe Duran
    KTO Karatay Üniversitesi Sağlık Bilimleri Dergisi.2025; 6(2): 359.     CrossRef
  • Effects of virtual reality on upper limb outcomes and quality of life in people with multiple sclerosis: a systematic review
    Barbora Miznerova, Marja Äijö, Jindra Reissigova, Tom Philipp, Kamila Rasova
    European Journal of Physiotherapy.2025; : 1.     CrossRef
  • Enhancing working memory after traumatic brain injury using tDCS and computer-assisted cognitive rehabilitation
    Saeid Abbasi Sarajehlou, Fatemeh Afsharian, Razieh Khorram Abadi, Hosseinali Khalili
    Applied Neuropsychology: Adult.2025; : 1.     CrossRef
  • Comparison of the Clinical Effectiveness of Telerehabilitation with Traditional Rehabilitation Methods in Multiple Sclerosis Patients: A Systematic Review
    Fatemeh Sarpourian, Roxana Sharifian, Maryam Poursadeghfard, Seyed Raouf Khayami, Leila Erfannia
    Telemedicine and e-Health.2024;[Epub]     CrossRef
  • Effect of cognitive training on selected gait parameters in patients with stroke
    Asmaa Tahoon, Nahed Salem, Enas Elsayed, Ebtesam Fahmy, Rasha M Hegazy, Ahmed M. Aboeleneen, Ryan Jastania, Ayman A Alhammad, Shereen S. Mohamed
    Fizjoterapia Polska.2024; 24(4): 25.     CrossRef
  • Effectiveness of computer-based telerehabilitation software (RehaCom) compared to other treatments for patients with cognitive impairments: A systematic review
    Fatemeh Sarpourian, Kambiz Bahaadinbeigy, Seyed Ali Fatemi Aghda, Farhad Fatehi, Saeid Ebrahimi, Meysam Fallahnezhad
    DIGITAL HEALTH.2024;[Epub]     CrossRef
  • Effect of RehaCom cognitive rehabilitation software on working memory and processing speed in chronic ischemic stroke patients
    Sanaz Amiri, Peyman Hassani-Abharian, Salar Vaseghi, Rouzbeh Kazemi, Mohammad Nasehi
    Assistive Technology.2023; 35(1): 41.     CrossRef
  • Modern Technologies in the Rehabilitation of Patients with Multiple Sclerosis and Their Potential Application in Times of COVID-19
    Ewa Zasadzka, Tomasz Trzmiel, Anna Pieczyńska, Katarzyna Hojan
    Medicina.2021; 57(6): 549.     CrossRef
  • Rehabilitation in multiple sclerosis in 2021
    Cécile Donzé, Caroline Massot
    La Presse Médicale.2021; 50(2): 104066.     CrossRef
  • 9,629 View
  • 198 Download
  • 9 Web of Science
  • 10 Crossref
Objective
To investigate dosage changes in intrathecal baclofen during long-term treatment of patients with severe leg spasticity.
Methods
We performed a retrospective chart review of 49 patients treated with an intrathecal baclofen pump (ITB) because of severe leg spasticity, for a minimum of 7 years. Eight patients were excluded due to catheter/pump failure or factors aggravating spasticity. Of the remaining 41 patients, 19 had spinal cord injury (SCI) and 22 were diagnosed with multiple sclerosis (MS). Among the SCI patients, 15 had cervical and 4 thoracic SCI, with 7 patients showing the American Spinal Injury Association impairment scale (AIS) A and 12 patients with AIS B–D. The dose was regulated by discussion among the patients and their physicians, usually 4–10 times annually, to reduce leg spasticity and also avoid leg/trunk weakness.
Results
After 1 year patients on ITB needed a median dose of 168 mg/24 hr (range, 30–725 mg) for an optimal effect. After 7 to 10 years the dosage needed to reduce leg spasticity in the MS patients was significantly increased compared with the initial dose (mean 157%, n=22 and mean 194%, n=18). In contrast, the SCI patients needed only a modest increase (mean 113% and 121%). The difference between MS and SCI patients was significant (t-test p=0.006 and p=0.004).
Conclusion
The increased dosage in MS patients compared with patients diagnosed with SCI probably reflects the progressive disease course. The need for a large dosage increase in patients with SCI suggests possible pump failure, triggering factors for spasticity or progressive spinal disease.

Citations

Citations to this article as recorded by  
  • Quality of life of individuals with intrathecal baclofen pump therapy
    Abdulaziz Al Mosallam, Ahmad Zaheer Qureshi, Anas J. AlSaleh
    The Journal of the International Society of Physical and Rehabilitation Medicine.2025; 8(2): 50.     CrossRef
  • Intrathecal baclofen therapy in patients with spastic paraplegia: retrospective evaluation of pretreatment drugs, test dosage, dose increments and final therapy
    Stephan Kurz, Linda Maria Marth, Christoph-Heinrich Hoffmann, Jonas Hermann Maria Kummerant, Frederik Wilhelm Schneckmann
    Brain and Spine.2025; 5: 104323.     CrossRef
  • Intrathecal baclofen therapy in spinal cord injury: Referral patterns, dosing trends, and long-term complications
    Radha Korupolu, Melanie Quoilin, Benjamin Ballard, Jacob Frentzen
    The Journal of Spinal Cord Medicine.2025; : 1.     CrossRef
  • Scar Tissue Catheter Tip Occlusion From an Intrathecal Baclofen Delivery: A Case Report and Review of the Literature
    James W Leiphart, Thaddeus J Leiphart
    Cureus.2024;[Epub]     CrossRef
  • Spasticity Management after Spinal Cord Injury: The Here and Now
    Zackery J. Billington, Austin M. Henke, David R. Gater
    Journal of Personalized Medicine.2022; 12(5): 808.     CrossRef
  • Results of Intrathecal Baclofen Treatment in Sixteen Spasticity Patients According to Four Different Measurement Scales: A Retrospective Analysis
    Hasan Burak Gündüz
    Cureus.2022;[Epub]     CrossRef
  • 9,399 View
  • 171 Download
  • 5 Web of Science
  • 6 Crossref

Case Report

Concurrence of Multiple Sclerosis and Brain Tumor: A case report.
Jang, Dae Hyun , Pyun, Sung Bom , Khang, Shin Kwang
J Korean Acad Rehabil Med 2005;29(5):521-526.
The concurrence of multiple sclerosis and primary intracranial neoplasm is uncommon. We reported a 15-year old girl known to have multiple sclerosis (MS), who later developed cerebral glioma. The tumor was documented on the brain magnetic resonance imaging during the work up for an apparent relapsing MS, and subsequently confirmed pathologically by stereotactic biopsy. Because no singleclinical feature or diagnostic test was sufficient for the diagnosis of MS, a combination of both clinical and paraclinical studies should be included. If clinical and paraclincal studies are atypical, additional studies, such as brain biopsy, may help differential diagnosis of other MS mimicking diseases. (J Korean Acad Rehab Med 2005; 29: 521-526)
  • 1,861 View
  • 7 Download
Original Article
Effects of Dexamethasone on Neurogenic Bladder in Experimental Autoimmune Encephalomyelitis Rat.
Park, Joo Hyun , Ko, Young Jin , Choi, Eun Seok , Kim, Hye Won , Kim, Jong Hyun , Park, Se Hoon
J Korean Acad Rehabil Med 2003;27(5):682-687.
Objective
We studied effects of dexamethasone on neurogenic bladder and paralysis in experimental autoimmune encephalomyelitis (EAE) rat model for multiple sclerosis.

Method: Thirty-five female Lewis rats were used in the study. Thirteen rats used as normal cystometrogram controls. Twenty-two rats induced EAE were divided into two groups: ten rats as control and twelve rats as dexamethasone injection group. Bladder dysfunction by cystometrogram, severity of weakness, and duration of paralysis were evaluated every other day after the onset of paralysis.

Results: Dexamethasone injection group compared to control group presented short duration of bladder dysfunction (2.5 vs. 4.2 day, p<0.05) and paralysis (4.5 vs. 7.3 day, p<0.05). There was a trend for lesser paralysis in the dexamethasone injection group, than control group (weakness scores were 2.4 vs. 3.6, p>0.05), but it was not statistically significant.

Conclusion: Dexamethasone ameliorates the course of paralysis and bladder dysfunction in EAE. We suggest that dexamethasone treatment is an effective method in treating neurogenic bladder and paralysis in multiple sclerosis.

  • 1,887 View
  • 8 Download
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