In-phase Bilateral Exercises in People With Relapsing Remitting Multip
Investigation of In-phase Bilateral Exercise Effects on Corticospinal Plasticity in Relapsing Remitting Multiple Sclerosis: a Registered Report Single-case Concurrent Multiple Baseline Design Across Five Subjects
What it found
A paper reports the results; we have not read it yet. See Papers below.
What was tested
Treatment tested
- In-phase Bilateral Exercises of the upper limbs
What it measured
Main measures
Corticospinal Plasticity
Through study completion, an average 35 weeks
Myelin repairNerve conduction testsSafety
Other measures (6)
Mini Balance Evaluation Systems Test
Through study completion, an average 35 weeks
Walking and mobilitySix Spot Step Test
Through study completion, an average 35 weeks
VisionThinking and memoryWalking and mobilityPhysical functionSpasticityAction Research Arm Test
Through study completion, an average 35 weeks
Arm and hand functionIsometric Dynamometer
Through study completion, an average 35 weeks
Physical functionSymbol Digit Modalities Test
Through study completion, an average 35 weeks
Thinking and memoryModified Fatigue Impact Scale
Through study completion, an average 35 weeks
Fatigue
Who could take part
Relapsing MS · 30 to 70
Show the full criteria
Inclusion criteria
* Diagnosed with relapsing remitting multiple sclerosis * Expanded Disability Status Scale score between three and five * Aged between 30 and 70 years * Relapse within 30 days * Mini Mental State of Examination score between 24 and 30 (no cognitive impairment)
Exclusion criteria
* Metal implants * History of any disease affecting the central nervous system other than multiple sclerosis * History of cardiovascular disease * Mental disorders * Severe orthopedic disorders * Pregnancy * Visual deficit * Hearing impairments, * Εpileptic seizures * Spasticity level on upper or lower limbs more than 1+ (slight increase in muscle tone) according to Modified Ashworth Scale
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
Relapsing-remitting multiple sclerosis (RRMS) is associated with changes of the corticospinal tract integrity, which is quantified by means of corticospinal plasticity. Several factors, such as exercise and interlimb coordination can influence such corticospinal plasticity. Previous work in healthy and in stroke participants showed that the greatest improvement of corticospinal plasticity occurred during in-phase bilateral arm exercises. Here, the investigators propose a concurrent multiple baseline design study which has the advantage to verify the cause-effect inference by the staggered duration through separate baseline phases. The proposed study includes five people with RRMS, who will follow an intervention protocol which includes in-phase bilateral movements of the upper limbs, adapted to different sports activities and to functional training. The aim of the study is to investigate the effects of in-phase bilateral exercises on corticospinal plasticity and on clinical measures, using transcranial magnetic stimulation and standardized clinical assessment. To meet quality standards, the present study has been designed and will be conducted according to the "What Works Clearinghouse" criteria for single case studies.
Papers
Results
A 12-week in-phase bilateral upper limb exercise protocol promoted neuroplastic and clinical changes in people with relapsing remitting multiple sclerosis: A registered report randomized single-case concurrent multiple baseline study.PLoS One · 2024
Results
Sokratous D, Charalambous CC, Papanicolaou EZ, Michailidou K, Konstantinou N. Investigation of in-phase bilateral exercise effects on corticospinal plasticity in relapsing remitting multiple sclerosis: A registered report single-case concurrent multiple baseline design across five subjects. PLoS One. 2023 Mar 2;18(3):e0272114. doi: 10.1371/journal.pone.0272114. eCollection 2023.Background
Neva JL, Lakhani B, Brown KE, Wadden KP, Mang CS, Ledwell NH, Borich MR, Vavasour IM, Laule C, Traboulsee AL, MacKay AL, Boyd LA. Multiple measures of corticospinal excitability are associated with clinical features of multiple sclerosis. Behav Brain Res. 2016 Jan 15;297:187-95. doi: 10.1016/j.bbr.2015.10.015. Epub 2015 Oct 20.Background
Pascual-Leone A, Tarazona F, Keenan J, Tormos JM, Hamilton R, Catala MD. Transcranial magnetic stimulation and neuroplasticity. Neuropsychologia. 1999 Feb;37(2):207-17. doi: 10.1016/s0028-3932(98)00095-5.Background
Whitall J, Waller SM, Sorkin JD, Forrester LW, Macko RF, Hanley DF, Goldberg AP, Luft A. Bilateral and unilateral arm training improve motor function through differing neuroplastic mechanisms: a single-blinded randomized controlled trial. Neurorehabil Neural Repair. 2011 Feb;25(2):118-29. doi: 10.1177/1545968310380685. Epub 2010 Oct 7.Background
Smith AL, Staines WR. Cortical and behavioral adaptations in response to short-term inphase versus antiphase bimanual movement training. Exp Brain Res. 2010 Sep;205(4):465-77. doi: 10.1007/s00221-010-2381-5. Epub 2010 Aug 14.Background
Neva JL, Legon W, Staines WR. Primary motor cortex excitability is modulated with bimanual training. Neurosci Lett. 2012 Apr 18;514(2):147-51. doi: 10.1016/j.neulet.2012.02.075. Epub 2012 Mar 3.Background
Zhan S, Ottenbacher KJ. Single subject research designs for disability research. Disabil Rehabil. 2001 Jan 15;23(1):1-8. doi: 10.1080/09638280150211202.Background
Lobo MA, Moeyaert M, Baraldi Cunha A, Babik I. Single-Case Design, Analysis, and Quality Assessment for Intervention Research. J Neurol Phys Ther. 2017 Jul;41(3):187-197. doi: 10.1097/NPT.0000000000000187.
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History
Started
Mar 2023
Main results due
Oct 2023
Finished
Oct 2023