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.
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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
26
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.
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.
Assossiation for Body in Balance
Prague, Czechia
The Nine Hole Peg test (NHPT)
measures speed (in seconds) of this fine hand movement task
Time frame: Baseline and 4 months
The Four Square Step Test (FSST)
Time (in seconds) to reach clockwise and counterclockwise stepping task
Time frame: baseline and endpoint at 4 months
The 2-Minute Walking Test (2MWT)
The distance one is able walk in two minutes, including noting stops needed and mobility aids (e.g., crutches, canes, or walkers)
Time frame: baseline and endpoint at 4 months
The Symbol Digit Modalities Test (SDMT)
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
Time frame: baseline and endpoint at 4 months
Multiple Sclerosis Impact Scale (MSIS-29)
Questionnaires to measure the physical and the psychological impact of multiple sclerosis form the patient's perspective.
Time frame: baseline and end-point at 4 months
Modified Fatigue Impact Scale (MFIS)
Questoionnaire to assess impact of fatigue on namely tasks and life situations in PwMS.
Time frame: baseline and end-point at 4 months
Activities-Specific Balance Confidence Scale (ABC scale)
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.
Time frame: baseline and end-point at 4 months
International Classification of Functioning, Disability and Health (ICF) assessment
Brief core set for Multiple Sclerosis is used to assess the participant's situation with use of the ICF
Time frame: baseline and 4 months
tremor assessment
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.
Time frame: baseline and 4 months
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