Multiple Sclerosis, Neurorehabilitation, Rehabilitation, Rehabilitation Exercise
Conditions
Keywords
multiple sclerosis, rehabilitation, physiotherapy, psychotherapy, psychological support, exercise, neurorehabilitation, facilitation and inhibition
Brief summary
This study investigates the effectiveness of an intensive multidisciplinary rehabilitation program for people with multiple sclerosis (PwMS). The program integrates intensive outpatient physiotherapy, psychotherapeutic consultations, and nutritional counseling to enhance motor and cognitive functions, promote neuroplasticity, and improve overall well-being as well as physical performance in PwMS. Through clinical assessments and standardized questionnaires, the study aims to provide scientific evidence on the benefits of comprehensive, non-pharmacological therapy as a core element in MS treatment.
Detailed description
Multiple sclerosis (MS) is a chronic neurological disease predominantly affecting young adults and often leads to significant limitations in both professional and social life. Current therapeutic approaches apart from pharmacotherapy, emphasize non-pharmacological interventions, rehabilitation, and holistic lifestyle modifications (Duan, 2023). This study provides individuals with MS the opportunity to participate in an intensive 4-month single-arm therapeutic program that combines specialized outpatient physiotherapy, psychotherapy, and nutritional counseling. The physiotherapy component is based on a scientifically validated approach-Motor Program Activating Therapy-which directly targets motor control and central nervous system function (Řasová, 2015).The program was developed by two physiotherapists specializing in MS during their doctoral studies (Procházková, 2020; Prokopiusová, 2020), whose research focused on factors influencing disease progression and the efficacy of physiotherapeutic interventions. In this prospective study participants will undergo outpatient program aiming to enhance neuroplasticity, improve physical and psychological functions, physical performance and contribute to long-term health maintenance.
Interventions
PROCEDUREOutpatient physiotherapy
Physiotherapy sessions will be individually tailored according to each participant's goals. Soft tissue and joint techniques will be used as needed to prepare the body for optimal posture activation in sitting, standing, walking, and other movements. Therapists will use reflex, mobilization, and soft-tissue techniques. The Motor Program Activating Therapy method will be the primary approach, complemented by Dynamic Muscular Stabilization and movement self-awareness techniques.
PROCEDUREgroup psychotherapy
In addition, all participants will attend three 90-minute group psychotherapy sessions led by a psychologist. These sessions will support mental well-being, stress management, and motivation throughout the physiotherapy process. Participants will learn practical coping strategies for emotions, pain, and psychological strain. Relaxation techniques will be demonstrated and practiced, and basic nutritional recommendations will be provided in written or online form.
Sponsors
Ministry of Health, Czech Republic
Charles University, Czech Republic
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 75 Years
Healthy volunteers
No
Inclusion criteria
* Confirmed clinical diagnosis of MS * Age ≤ 75 years * Predominantly motor impairment * EDSS 2-8 * Ability and motivation to attend outpatient physiotherapy regularly
Exclusion criteria
• Contraindications such as severe orthopedic or cardiovascular dysfunction, or presence of another neurological disorder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Nine Hole Peg test (NHPT) | Baseline and 4 months | measures speed (in seconds) of this fine hand movement task |
| The Four Square Step Test (FSST) | baseline and endpoint at 4 months | Time (in seconds) to reach clockwise and counterclockwise stepping task |
| The 2-Minute Walking Test (2MWT) | baseline and endpoint at 4 months | The distance one is able walk in two minutes, including noting stops needed and mobility aids (e.g., crutches, canes, or walkers) |
| The Symbol Digit Modalities Test (SDMT) | baseline and endpoint at 4 months | A brief neuropsychological test assessing attention, visual scanning, processing speed, and working memory. Participants match symbols to numbers according to a reference key within a limited time - 90 seconds - the final score is result |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Multiple Sclerosis Impact Scale (MSIS-29) | baseline and end-point at 4 months | Questionnaires to measure the physical and the psychological impact of multiple sclerosis form the patient's perspective. |
| tremor assessment | baseline and 4 months | Assessment of tremor of upper limbs while holding one arm forward for 60 seconds. Measured with closed and opened eyes by accelerometer. he spectral characteristic of postural tremor measured by the 3-axis accelerometer and 3-axis gyroscope chip (Motion Tracking sensor MPU-6050) - lower value, lower tremor. |
| Modified Fatigue Impact Scale (MFIS) | baseline and end-point at 4 months | Questoionnaire to assess impact of fatigue on namely tasks and life situations in PwMS. |
| Activities-Specific Balance Confidence Scale (ABC scale) | baseline and end-point at 4 months | Participants: For each of the following activities, please indicate your level of confidence in doing the activity without losing balance. The confidence is assessed in percentage, and all results are finally averaged. |
| International Classification of Functioning, Disability and Health (ICF) assessment | baseline and 4 months | Brief core set for Multiple Sclerosis is used to assess the participant's situation with use of the ICF |
Countries
Czechia
Contacts
Primary ContactKamila Rasova, prof.
Backup ContactBarbora Miznerova, MD
Outcome results
None listed