Integrated Cognitive and Neuromotor Rehabilitation in Multiple Sclerosis: A Pragmatic Study

Barbarulo, Anna Maria; Lus, Giacomo; Signoriello, Elisabetta; Trojano, Luigi; Grossi, Dario; Esposito, Mariateresa; Costabile, Teresa; Lanzillo, Roberta; Saccà, Francesco; Morra, Vincenzo Brescia; Conchiglia, Giovannina

doi:10.3389/fnbeh.2018.00196

Cited by 35 publications

(22 citation statements)

References 74 publications

(79 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, these results are in accordance with previous results showing that EE had an anti-anhedonic effect via induction of BDNF in the prefrontal cortex during the early life (Angelucci et al, 2005;Chu et al, 2018;Yu and Chen, 2011). Furthermore, MS patients that received and integrated cognitive and motor rehabilitation presented positive effects in emotional aspects such as depression in addition to cognitive and motor rehabilitation (Barbarulo et al, 2018;Jimenez-Morales et al, 2017). In addition, in this study, EE enhanced short term memory as demonstrated by improvement of the performance in the NOR test.…”

Section: Discussionsupporting

confidence: 91%

“…. Related to MS patients, it was demonstrated that physical exercise and cognitive rehabilitation enhanced cognitive function in patients (Barbarulo et al, 2018;Jimenez-Morales et al, 2017). This work provides evidence that EE could be regarded as an intervention to improve cognitive function and reduce anxiety-like behaviour.…”

Section: Discussionmentioning

confidence: 99%

“…However, combined rehabilitation interventions might simultaneously improve walking and cognition, perhaps due to cognitive motor pathways interaction. The combination of physical exercise and cognitive training was demonstrated to improve the cognitive and motor performance in MS patients (Barbarulo et al, 2018;Jimenez-Morales et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Environmental enrichment improves cognitive symptoms and pathological features in a focal model of cortical damage of multiple sclerosis

et al. 2020

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Environmental enrichment improves cognitive symptoms and pathological features in a focal model of cortical damage of multiple sclerosis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…An integrated approach with cognitive and motor training has demonstrated to be associated with improvements not only in cognitive and motor performance but also in mood ( 66 ). Constant repetition of the same movements, as occurs in CR, might result in the patient being less engaged and motivated, which will affect therapy adherence and ultimately reduce rehabilitation effectiveness.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study to Explore Patient Satisfaction With a Virtual Rehabilitation Program in Multiple Sclerosis: The RehabVR Study Protocol

Meca-Lallana

Prefasi

Alabarcez³

et al. 2020

Front. Neurol.

View full text Add to dashboard Cite

Background: Virtual reality (VR) has emerged as a promising treatment approach in rehabilitation for patients with multiple sclerosis (MS) due to its potential to increase patient motivation and rehabilitation adherence. One of the key features for rehabilitation adherence is patient satisfaction with the VR rehabilitation (VRR) program, and information on user satisfaction and not only effectiveness is required to systematically include VRR in routine clinical practice. Given that information on patient satisfaction with VRR is scarce, the primary objective of this study is to assess long-term patient satisfaction with a novel VRR program. This program has been specifically designed for MS patients by a multidisciplinary team of specialists, based on an effective conventional rehabilitation (CR) program. Secondarily, discomfort with VRR will be evaluated, and therapy adherence and changes in a variety of domains typically affected by MS will be compared between patients receiving VRR and patients receiving CR. Methods: In this prospective single-center 6-months follow-up study, 32 and 16 MS patients will receive VRR or CR, respectively. Patients will attend twice weekly rehabilitation sessions on site during 4 weeks, and they will continue with rehabilitation at home for five additional months. Satisfaction, assessed by the User Satisfaction Evaluation Questionnaire (USEQ), at 6 months of the VRR program initiation will be the primary outcome. Secondary outcomes include adherence, disability, spasms and spasticity, balance, fatigue, activities of daily living (ADLs), depression, anxiety, work status, cognition, demographic, and clinical characteristics (in the VRR and CR groups), and discomfort (in the VRR group). Outcome measures will be assessed at baseline, and at 1 and 6 months of rehabilitation initiation. Discussion: The study is intended to provide a better understanding of long-term patient satisfaction with a VRR program specifically designed for MS patients. Additionally, the study will provide information on long-term adherence, changes in motor symptoms, cognitive functions and patient-reported outcomes after the rehabilitation program. The results from this study will help to gather valuable knowledge on the use of rehabilitation with a new VR tool in MS patients.

show abstract

“…Such an approach often reflects the clinical reality of PMS where multiple neurological difficulties rather than an isolated problem must be addressed simultaneously. While a powered joint CR and exercise clinical trial has yet to be done in people with MS of any disease course there is tentative evidence from three small studies in people with RRMS that this approach may be more beneficial than either intervention alone [15][16][17]. Thus, a methodologically rigorous, well-powered study is needed now in PMS specifically in an effort to inform clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Study protocol: improving cognition in people with progressive multiple sclerosis: a multi-arm, randomized, blinded, sham-controlled trial of cognitive rehabilitation and aerobic exercise (COGEx)

et al. 2020

View full text Add to dashboard Cite

Background: Cognitive dysfunction affects up to 70% of people with progressive MS (PMS). It can exert a deleterious effect on activities of daily living, employment and relationships. Preliminary evidence suggests that performance can improve with cognitive rehabilitation (CR) and aerobic exercise (EX), but existing data are predominantly from people with relapsing-remitting MS without cognitive impairment. There is therefore a need to investigate whether this is also the case in people with progressive forms of the disease who have objectively identified cognitive impairment. It is hypothesized that CR and EX are effective treatments for people with PMS who have cognitive impairment, in particular processing speed (PS) deficits, and that a combination of these two treatments is more effective than each individual treatment given alone. We further hypothesize that improvements in PS will be associated with modifications of functional and/or structural plasticity within specific brain networks/ regions involved in PS measured with advanced MRI techniques. Methods: This study is a multisite, randomized, double-blinded, sham controlled clinical trial of CR and aerobic exercise. Three hundred and sixty subjects from 11 sites will be randomly assigned into one of four groups: CR plus aerobic exercise; CR plus sham exercise; CR sham plus aerobic exercise and CR sham plus sham exercise. Subjects will participate in the assigned treatments for 12 weeks, twice a week. All subjects will have a cognitive and physical assessment at baseline, 12 weeks and 24 weeks. In an embedded sub-study, approximately 30% of subjects will undergo structural and functional MRI to investigate the neural mechanisms underlying the behavioral response. The primary outcome is the Symbol Digit Modalities Test (SDMT)

show abstract

Integrated Cognitive and Neuromotor Rehabilitation in Multiple Sclerosis: A Pragmatic Study

Cited by 35 publications

References 74 publications

Environmental enrichment improves cognitive symptoms and pathological features in a focal model of cortical damage of multiple sclerosis

Environmental enrichment improves cognitive symptoms and pathological features in a focal model of cortical damage of multiple sclerosis

A Pilot Study to Explore Patient Satisfaction With a Virtual Rehabilitation Program in Multiple Sclerosis: The RehabVR Study Protocol

Study protocol: improving cognition in people with progressive multiple sclerosis: a multi-arm, randomized, blinded, sham-controlled trial of cognitive rehabilitation and aerobic exercise (COGEx)

Contact Info

Product

Resources

About