The Effects of In-phase Bilateral Exercise in People with Progressive Multiple Sclerosis

Treatment tested

• In-phase Bilateral Exercise

Compared with

• Conservative exercises

Other measures (6)

Inclusion Criteria: * diagnosis of progressive multiple sclerosis (MS) (primary or/and secondary progressive MS) * Expanded Disability Status Scale score between three and six * no relapse within 30 days * aged between 30 and 70 years * Mini Mental State of Examination score between 20 and 30 (mild to no cognitive impairment) Exclusion Criteria: * history of any disease affecting the central nervous system other than MS (e.g., stroke, Parkinson's disease, cerebral palsy) * history of cardiovascular disease (e.g., known aneurism, myocardial infarction, hyper/hypotension, heart failure) * severe orthopaedic disorders (e.g., knee or hip replacement, spondylosurgery, disk herniation, recent bone fracture) * mental disorders (e.g., depression, schizophrenia, bipolar syndrome) * pregnancy during the implementation of the study timeline * hearing impairments (i.e., deafness) * visual deficit (e.g., optic neuritis, blindness, diplopia, glaucoma, blurred vision) * history of epileptic seizures * spasticity level on upper or lower limbs more than 1+ (slight increase in muscle tone) according to Modified Ashworth Scale

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. MS, typical presents with progression of clinical symptoms which mainly include motor and cognitive impairment, as well as reduction of patients' quality of life. Exercise is an effective approach in the management of the symptoms in people with progressive MS. Previous studies in healthy and in people with MS, reported a close relationship between cognitive functions and upper limb performance. Since patients with progressive MS facing difficulties with performing complex exercises due to cognitive dysfunctions and given the close relationship between cognitive functions and manual dexterity, a reasonable question arises whether a type of upper limbs exercises with less cognitive demands will improve the information processing speed in people with progressive MS. The aim of the current study is to investigate the effects of in-phase bilateral upper limbs exercises on the information processing speed, in patients with progressive MS, given that in-phase bilateral movements needs less attentional load than the other types of bilateral coordination. The intervention protocol lasted for 12 consecutive weeks (30-60 minutes /session x 3 sessions/week) and included in-phase bilateral exercises of the upper limbs, adapted to different sports activities and to functional training. Results from the statistical analysis indicated improvement of the experimental group compared to the control group, on the information processing speed alongside with improvement of motor skills.