rehabilitation

Difficulties with walking and balance are common among people with multiple sclerosis and strongly affect their quality of life — even when disease progression may not be evident on scans or other measures of MS advance, according to research presented at a meeting last fall and recently reviewed by the National…

Spasticity in multiple sclerosis patients can be eased through a combination of botulinum toxin type A (BoNT-A) injections and rehabilitation. However, caregiver support is required to keep patients on this treatment, according to results of a retrospective analysis. Spasticity, a muscle control disorder characterized by tight or stiff muscles, is a major MS symptom. The condition is significantly detrimental to patients’ quality of life, affecting their general mobility and balance. Several oral anti-spasticity drugs are available. However, “treatment of spasticity in MS is frequently challenging because of the complex clinical picture and the undesired effects associated with oral therapy, such as fatigue, dizziness, and hypotension,” the researchers wrote. Previous studies show that BoNT-A, a toxin that blocks nerve activity in muscles, is an effective therapy for the management of MS-related spasticity. The long-term effectiveness and persistence of BoNT-A use in patients with MS-related spasticity, however, remains poorly investigated. The research team in Italy proposed “to investigate the long-term persistence to treatment with BoNT-A for MS-related spasticity and the determinants of BoNT-A discontinuation in daily clinical setting.” In total, the researchers reviewed data from 185 patients, out of which 121 were considered in their final analysis. They observed that, at the end of the follow-up period, 44% of the patients in the analysis were still being treated with BoNT-A, but 56% had discontinued treatment. Overall, these results “confirm the beneficial effect of combining BoNT-A injections with rehabilitation and highlights the crucial role of caregivers for achieving better long-term outcomes in people with MS suffering from spasticity,” the team concluded.

Resistance training like weight lifting can protect or even regenerate the nerve cells of relapsing-remitting multiple sclerosis patients, slowing the progression of the disease, according to a clinical trial. A hallmark of MS is the brain shrinking faster than normal, and findings from this trial indicates that resistance training can slow the shrinking or even make some brain areas grow. Research has shown that physical training benefits MS patients, helping them alleviate many symptoms, including excessive fatigue and balance control problems. Recent studies suggest that exercise can have a disease-modifying role in MS. This means physical activity can be an important adjuvant, or add-on therapy, for standard-of-care regimens. Researchers followed 35 patients with relapsing-remitting MS for 24 weeks. Eighteen patients did resistance training twice a week, consisting of four lower- and two upper-body exercises. The other 17 patients struck with their normal routines. Before and after the 24 weeks, doctors took magnetic resonance imaging scans, or MRIs, to evaluate patients' brain structures. After the 24 weeks, the scans showed less brain shrinkage in those who had resistance training. Some of their cortical brain regions were also thicker — an indication they were growing. It is not clear why exercise benefits MS patients' brains, nor if exercise has the same effect on all patients. Additional studies are needed to clarify its therapeutic effect, the researchers said. That knowledge could help improve current MS therapies.

In a pilot study with patients with multiple sclerosis, high-intensity interval training combined with resistance training improved physical capacity and quality of life in a pilot study of multiple sclerosis (MS) patients — whether or not they were disabled. French researchers at the University of Strasbourg assessed physical capacity, strength and quality of life before the training started, and then again after completing a 12-week exercise program. They divided participants into two groups: one of 18 patients with no disabilities, and a group of eight with disabilities. Participants followed a personalized exercise program involving both high-intensity interval training — a kind of cardiovascular exercise strategy alternating short periods of intense anaerobic exercise with less intense recovery periods — and resistance training to improve muscular strength and endurance. Scientists used a French version of the Multiple Sclerosis Quality Of Life-54 test — a questionnaire filled out by MS patients to measure health-related quality of life — with five additional questions. After the exercise program, women improved significantly in vitality, general well-being and physical health composite scores in the quality of life assessment, while men showed no significant improvements. Vitality and general well-being only improved in the group with no disability. Peak oxygen consumption improved by 13.5 percent, and maximum tolerated power — a measure of maximum energy that can be expended — by 9.4 percent. Muscle strength increased in both quadriceps and hamstrings. Women showed better improvements than men in peak oxygen consumption, maximal tolerated power, strength in both quadriceps and hamstrings, and quality of life. Both groups showed increased peak oxygen consumption and strength. “Our study has shown that high-intensity interval training combined with resistance exercise training induced an improvement in physical capacity and quality of life. Moreover, this study allowed patients, irrespective of their sex or EDSS [Expanded Disability Status Scale] score, to resume exercise autonomously,” the team wrote. "High-intensity interval training is well tolerated too and can be used in clinical rehabilitation with resistance training, in both men and women with and without disabilities."

The National Multiple Sclerosis (MS) Society has selected research highlights from a recent MS conference in an effort to help make living with the disease less burdensome. Presentations from the May 24-27 annual meeting of the Consortium of Multiple Sclerosis Centers (CMSC) in New Orleans — which ranged from advice on smartphone apps to diet…

The online BrainHQ adaptive training program developed by Posit Science is better than any computer game at helping multiple sclerosis (MS) patients improve their cognitive skills, according to a study by researchers at New York University (NYU). The study, “Cognitive function in multiple sclerosis improves with telerehabilitation: Results from…

People with multiple sclerosis (MS) and others with spinal cord injuries and disorders will speak at the United Spinal Association’s upcoming 6th Annual Roll on Capitol Hill, which takes place June 11-14 in Washington, D.C. Andrea Dalzell, Ms. Wheelchair New York 2015, will be among those advocating for greater access to complex rehabilitation technology.

A clinical test of whether bionic robotics can improve mobility in people with relapsing or progressive forms of multiple sclerosis (MS) and considerable disability is now recruiting participants, after being approved by the U.K. National Health Service’s Health Research Authority (HRA) ethics committee. The trial, called RAPPER 3 (Robot Assisted Physiotherapy Exercises with Rex…

The U.S. Food and Drug Administration (FDA) has authorized the use of Bioness’ L300 Go System electrical-stimulation rehabilitation device for multiple sclerosis (MS) patients and others with walking impairment. It is the first electrical stimulation device to offer 3D motion detection of gait and muscle activation, the company says. The L300…

Multiple sclerosis (MS) patients given gentle electrical stimulation to their tongues during physical and cognitive rehabilitation training benefited more than those who did not have the stimulation, a small pilot study demonstrated. Those who received the weak stimulation had significant improvements in balance and better scores than controls in cognition and other…

At the time of my MS diagnosis I was a full-time graduate student with plans to obtain a joint Masters of Public Administration/Juris Doctor degree. After six years as a stay-at-home mom and military spouse, I was anxious to complete this next stage of my education and return to…

Posture control is a complex skill, requiring different areas of the nervous system to work well and to work together — but the damage caused by multiple sclerosis complicates such nervous system multi-tasking, leading to postural problems and the well-established tendency for MS patients to fall. Several neurological systems are known…

The 32nd annual congress of the European Committee for Treatment and Research in Multiple Sclerosis, widely referred to as ECTRIMS, will kick off on Wednesday, Sept. 14, in London. The four-day event is partnering this year with the Annual Conference of Rehabilitation in MS  (RIMS), the European network for best…

The 37th annual congress of The European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) will take place in London between 14 – 17 September 2016.

People with multiple sclerosis, especially those with cognitive disabilities, have more problems managing their personal finances — paying bills on time or using a credit card — than those without this disease, researchers report in the study, “Money Management Activities in Persons With Multiple Sclerosis,” published in the…

The National Multiple Sclerosis Society reported that the Patient-Centered Outcomes Research Institute (PCORI) has granted nearly $20 million in funding to four research projects assessing various multiple sclerosis (MS) therapies for their clinical effectiveness. Two of the grants will cover studies comparing disease-modifying treatments, looking to identify differences…

The Consortium of Multiple Sclerosis Centers (CMSC) has awarded Susan E. Bennett one of its highest honors, the Lifetime Achievement Award. Bennett, a clinical professor of rehabilitation science at the University at Buffalo and pioneer in the field of MS rehabilitation, was honored for her achievements in advancing care…

There is a greater number of older people with multiple sclerosis than ever before, and the number is likely to continue growing. That combination, of old age with MS, puts people at risk of significantly reduced physical function than those without the disease. This was a key finding of a…

Two case reports from the Sheltering Arms Physical Rehabilitation Centers presented at the Consortium of Multiple Sclerosis Centers (CMSC) 2016 Annual Meeting demonstrated how a multiple sclerosis (MS) clinical practice guideline for rehabilitation was implemented through the rehab path, highlighting the importance of consistency of practice and continuity of care for…

Most research in multiple sclerosis (MS) has focused on the impact of the disease on the lower extremities. To balance this, researchers at Mount Sinai Rehabilitation Hospital in Connecticut thoroughly characterized upper arm and hand functions in MS patients, finding that disease duration and disability level differently affected various…

Identifying multiple sclerosis (MS) patients who suffer from dysphagia — swallowing difficulties — early on allows the prevention of aspiration pneumonia, a leading cause of death in MS. Researchers at Baylor College of Medicine in Texas developed a screening tool to detect dysphagia and presented encouraging preliminary data on…

Researchers at the Shepherd Center in Atlanta are developing a prototype that addresses physical and cognitive parameters, daily routines, and homes of patients to better implement rehabilitation within the home environment. The study was presented in “Functional Home Evaluation: Missing Pieces in Treatment and Transition Processes” during the Consortium…

Susan E. Bennett, a specialist in multiple sclerosis (MS) rehabilitation, reinforced the importance of exercise for MS patients to improve quality of life, during the June 1-4  2016 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), in National Harbor, Md. “Everybody should be exercising. If you have MS it…

Robot-assisted training may be an effective therapy to improve motor function in the lower limbs of patients with multiple sclerosis (MS), and help in rehabilitation, according to the study “Robot-Guided Rehabilitation Improves Sensorimotor Functions in Lower-Limb Impairments of Individuals with Multiple Sclerosis,” presented at the Consortium of Multiple Sclerosis Centers…

Dr. Hannah Gullo, a University of Queensland (UQ) School of Health and Rehabilitation Sciences researcher, is several steps closer to achieving her goal of using smartwatches to combat the effects of multiple sclerosis (MS), thanks to an $8,000 Ian Ballard Travel Award for 2016 that will fund her flying from…

Silvana L. Costa, PhD from the Kessler Foundation, was recently awarded a Switzer Research Fellowship by the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR). Dr. Costa is a Hearst Fellow in Neuropsychology & Neuroscience Research at Kessler, where she investigates cognitive deficits in multiple sclerosis (MS). The Merit Fellowship,…

Two scientists at Northwestern University, Anne Marie Piper and Brenna Argall, recently received the Faculty Early Career Development (CAREER) Award from the National Science Foundation (NSF). The work of Dr. Argall, in particular, might be relevant for people with disabilities caused by diseases such as multiple sclerosis or brain trauma resulting from accidents…

Wearable robotic exoskeletons may soon help people with advanced multiple sclerosis (MS) walk more efficiently and confidently again. Exoskeleton technology reduces the amount of energy and muscle exertion needed to initiate and control the process of walking, according to research presented last week at the Association for Academic Physiatrists (AAP)…

A new  multiple sclerosis (MS) clinical trial being led by Case Western Reserve University investigators is now recruiting 215 individuals, across 10 U.S. states to assess whether the fatigue management and physical activity interventions often provided by rehabilitation centers can effectively be offered by telehealth, through a series of teleconferences and phone interviews. An National MS…

The National Multiple Sclerosis Society announced that a panel of experts led a comprehensive review of 142 published studies addressing rehabilitation in multiple sclerosis (MS), and found evidence suggesting that weekly in-home or outpatient physical therapy offers benefits — but, mostly, it found a lack of well-designed studies into…