An adequate upper limb function is crucial to independently perform Activities of Daily Living (ADL). Persons with neurological diseases often experience upper limb dysfunction. Upper limb function in Multiple Sclerosis (MS) is highly prevalent, increasing with overall disability level, while the detrimental impact on ADL is higher than in stroke, given that symptoms often occur bilaterally. In contrast to stroke, it is unknown whether similar rehabilitation principles and effect sizes apply in MS given that this progressive neurodegenerative disease is characterized by multiple lesions and atrophy of brain structures. To date, optimal therapy dosage of upper limb rehabilitation programs are not known in the MS literature neither were characteristics of responders identified. The aim of this explorative study is to investigate the intensity dependent clinical effects of a task-oriented upper limb training in persons with MS with different upper limb disability levels.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
21
Participants in the experimental groups (high-intensity and low-intensity) receive for 8 weeks, 60 min/day, 5 days/week a task-oriented upper limb rehabilitation training at a high or low intensity, respectively, instead of their regular occupational therapy hours provided in the conventional multidisciplinary rehabilitation program. The task-oriented training involves practicing of functional daily tasks, with the intention to acquire or reacquire a skill. Most functional upper limb tasks require following essential movement components: reaching, moving, positioning, transporting, lifting the upper limb and/or an object and grasping, releasing, stabilizing, manipulating an object. The Tagtrainer of SymbioTherapy is used to support the independent training of tasks with real objects with different sizes and weights. The Diego of Tyromotion is used in patients who require assistance (gravity support) during the performance of different upper limb tasks.
The participants in the control group receive for 8 weeks the conventional multidisciplinary rehabilitation program (physiotherapy, occupational therapy and speech or cognitive therapy if needed). The training sessions are scheduled for 60 min/day, 5 days/week for the duration of 8 weeks.
Revalidatie en MS centrum
Overpelt, Limburg, Belgium
Hasselt University
Diepenbeek, Belgium
Nine Hole peg test
Manual dexterity
Time frame: 8 weeks
Manual Ability Measure-36
Questionnaire about perceived ADL performance
Time frame: 8 weeks
Isometric hand grip
Isometric hand grip
Time frame: 8 weeks
Training tolerance
Questionnaire of training tolerance and possible adverse effects
Time frame: daily through study compeletion
pinch grip strength
pinch grip strength
Time frame: 8 weeks
Motricity Index
General isometric muscle strength
Time frame: 8 weeks
Muscle fatigue indices
Indices calculated based on a 30 seconds sustained maximal isometric hand grip contraction
Time frame: 8 weeks
Tactile sensitivity in the fingers Semmens-Weinstein monofilaments
Tactile sensitivity in the thumb and index
Time frame: 8 weeks
Rydel Seiffer Tuning fork
Vibration in the upper limb
Time frame: 8 weeks
Symbol digit modalities test
Cognitive function, processing speed
Time frame: 8 weeks
Box and block test
Manual dexterity
Time frame: 8 weeks
Action Research Arm Test
Proximal and distal upper limb function
Time frame: 8 weeks
Test d'Évaluation des Membres Supérieurs des Personnes Âgées (TEMPA)
Proximal and distal upper limb function
Time frame: 8 weeks
Virtual Peg Insertion Test
manual dexterity
Time frame: 8 weeks
Accelerometers (Actigraph)
actual upper limb performance in daily life
Time frame: 8 weeks
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