Intensity-dependent clinical effects of an individualized technology-supported task-oriented upper limb training program in Multiple Sclerosis: A pilot randomized controlled trial

Mult Scler Relat Disord. 2019 Sep:34:119-127. doi: 10.1016/j.msard.2019.06.014. Epub 2019 Jun 17.

Abstract

Background: Task-oriented training promotes functional recovery in Multiple Sclerosis (MS). Know-how to determine an individualized training intensity and intensity-dependent effects are, however, unknown. The objective of the study was to investigate the feasibility and the clinical effects of a task-oriented upper limb training program at different individualized training intensities with conventional occupational therapy.

Methods: People with MS (n = 20, EDSS range 4-8) were divided into three groups, receiving task-oriented training at 100% (n = 7) or 50% (n = 8) of their individual maximal number of repetitions, or conventional occupational therapy (n = 5). Effects were evaluated using different upper limb capacity and perceived performance measures on activity level, and measures on body functions and structures level.

Results: Mixed model analyses revealed significant improvements (p < 0.05) over time on the Box and block test (BBT), Action Research Arm Test and the Manual Ability Measure-36. Significant interaction effects (group*time) in favor of the task-oriented group training at the highest intensity were found for BBT and static fatigue index during a maximal sustained handgrip strength test.

Conclusion: All participants were able to perform the task-oriented training at their individualized intensity without any adverse effects. Several improvements over time were found for all intervention groups, however the results suggest a superiority of task-oriented training at 100%. CLINICAL TRIAL REGISTRATION NUMBER ON CLINICALTRIALS.GOV: = NCT02688231.

Keywords: Intensity; Multiple Sclerosis; Rehabilitation; Task-oriented; Technology-supported; Upper extremity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Disability Evaluation
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Movement
  • Multiple Sclerosis / rehabilitation*
  • Pilot Projects
  • Precision Medicine*
  • Treatment Outcome
  • Upper Extremity*

Associated data

  • ClinicalTrials.gov/NCT02688231