Effects of Peripheral Cooling on Upper Limb Tremor Severity and Functional Capacity in Persons with MS.

Upper limb intention tremor in persons with multiple sclerosis (pwMS) affects the ability to perform activities of daily life and is difficult to treat. The study investigated the effect of peripheral upper limb cooling on tremor severity and functional performance in MS patients with intention tremor. In experiment 1, 17 patients underwent two 15 min cooling conditions for the forearm (cold pack and cryomanchet) and one control condition.

Performance of Activities of daily living in people with multiple sclerosis.

Objective: Multiple sclerosis (MS) may result in activity and participation limitations, including the performance of activities of daily living (ADL). This study aims at systematically investigate ADL performance by using Assessment of Motor and Process Skills (AMPS) in people with MS (PwMS) of all disease types and within the Kurtzke Expanded Disability Status Scale (EDSS) range from 1.0 - 8.

Continuous 12 min walking to music, metronomes and in silence: Auditory-motor coupling and its effects on perceived fatigue, motivation and gait in persons with multiple sclerosis.

Background: In Persons with Multiple Sclerosis (PwMS), coupling walking to beats/pulses in short bursts is reported to be beneficial for cadence and perceived fatigue. However it is yet to be investigated if coupling and its effects can be sustained for longer durations, required for task-oriented training strategy in PwMS.

Aims: To investigate if PwMS compared to healthy controls (HC) sustain synchronization for 12 min when walking to music and metronome, and its effects on perceived physical and cognitive fatigue, motivation and gait compared to walking in silence.

What is the opinion of patients with multiple sclerosis and their healthcare professionals about lower limb orthoses? A qualitative study using focus group discussions.

Objective: The aim of this study was to collect patients' and healthcare professionals' opinions about lower limb orthoses (LL-orthoses): 1) the positive and negative aspects; 2) the differences in wearing them according to location; and 3) their recommendations for future modifications.

Methods: Four focus group discussions were performed, with in total twenty patients with MS with a prescribed LL-orthosis and seven healthcare professionals. Audiotaped discussions were transcribed and qualitatively processed (NVivo11).

Male and female opinions about orthotic devices of the lower limb: A multicentre, observational study in patients with central neurological movement disorders.

Background And Objective: Because user-satisfaction and acceptance may partly determine the grade of compliance to an orthotic device (OD), the aim of this multicentre observational study was to inquire the reasons for acceptance and the user-satisfaction of an OD of the lower limb in male and female central neurological movement disorders (CNMD) patients.

Methods: Persons with CNMD having at least one prescribed OD of the lower limb were included. Two questionnaires were used: the MIRAD-ACCORT-II (reasons for acceptance) and a modified version of the D-QUEST 2.

The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial.

Purpose to evaluate the effectiveness of an individual self-management occupational therapy intervention program (SMOoTh) versus relaxation on the performance of and satisfaction with relevant daily activities in individuals with multiple sclerosis (MS)-related fatigue. in a single-blind randomized-controlled trial, 31 patients with MS (SMOoTh: n=17, relaxation: n=14) were randomly allocated to three individual sessions focusing on pacing, prioritizing, ergonomics, and self-management (SMOoTh) or on stress management and relaxation (relaxation). Outcomes (blind assessor): Canadian Occupational Performance Measure (COPM) (primary), Modified Fatigue Impact Scale, Checklist Individual Strength and Short-Form Health Measure.

Measuring participation as defined by the World Health Organization in the International Classification of Functioning, Disability and Health. Psychometric properties of the Ghent Participation Scale.

Objective: To examine the internal consistency, test-retest reliability, construct validity, discriminant validity and responsiveness of the Ghent Participation Scale.

Design: Cross-sectional study with a test-retest sample.

Setting: Six outpatient rehabilitation centres in Belgium.

Neurological patients and their lower limb orthotics: An observational pilot study about acceptance and satisfaction.

Background: Although an orthotic device of the lower limb improves the functionality of neurological patients, anecdotally clinical experience suggests that the compliance is rather limited.

Objectives: The aim was to determine the satisfaction and acceptance of a lower limb orthotic device.

Study Design: A qualitative observational pilot study with a mix-method design.

Trunk kinematics during walking in persons with multiple sclerosis: the influence of body weight support.

Background: Although body weight supported (BWS) treadmill training (TT) leads to some improvements in walking ability, it has not been proven that it is more effective than other walking therapies in persons with multiple sclerosis (PwMS). One possible explanation could be that BWSTT focuses on the cyclic movement of the lower extremities while the trunk is passively suspended in the harness.

Objective: This study aimed to assess the 3 dimensional trunk and pelvis movements during BWS treadmill walking.

Trunk muscle activity during walking in persons with multiple sclerosis: the influence of body weight support.

Background: Although the trunk is important for maintaining balance during walking only very limited information about the trunk muscle activity during walking with body weight support (BWS) is reported in literature.

Objective: The aim of this study was to measure the effect of BWS on the trunk muscle activity during treadmill walking.

Methods: 14 persons with multiple sclerosis and 14 healthy persons walked on a treadmill with 0%, 10%, 20%, 30%, 50% and 70% BWS.

From "wheelchair circuit" to "wheelchair assessment instrument for people with multiple sclerosis": reliability and validity analysis of a test to assess driving skills in manual wheelchair users with multiple sclerosis.

Objectives: To assess the reliability and validity of the Wheelchair Assessment Instrument for people with Multiple Sclerosis (WAIMS), a test to measure driving skills in manual wheelchair users with multiple sclerosis (MS).

Design: Three test trials per subject were conducted by 2 raters to examine reliability (inter- and intrarater) and validity (concurrent and construct).

Setting: A national multiple sclerosis rehabilitation center.

Is MS Intention Tremor Amplitude Related to Changed Peripheral Reflexes?

Intention tremor is related to lesions in the cerebellum or connected pathways. Intention tremor amplitude decreased after peripheral arm cooling in patients with multiple sclerosis (MS), likely caused by a reduction of muscle spindle afferent inflow, while amplitude increased when muscle spindles were artificially stimulated by tendon vibration. This study investigated the contribution of peripheral reflexes to the generation of MS intention tremor.

Measurement of physical quantities in upper-limb tele-rehabilitation.

A total of 50 patients (affected by traumatic brain injury, stroke or multiple sclerosis) were treated for one month using a rehabilitation protocol. Rehabilitation could be monitored using a Portable Unit (PU) which could be installed in a patient's home allowing the measurement of kinetic and kinematic variables during exercise. In a preliminary analysis, the variables related to four rehabilitation exercises were examined for two patients at baseline and at the end of the one-month treatment.

Clinical assessment of the HELLODOC tele-rehabilitation service.

Within the EU project HELLODOC, the clinical effectiveness was investigated of the home care activity desk (H-CAD). Eighty-one patients with chronic stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) were recruited; 50 out of 81 received 1 month of H-CAD intervention, with one training session a day lasting 30 minutes for 5 days a week. The overall satisfaction of both patients and therapists was high.

Tele-rehabilitation and e-learning: the HELLODOC educational experience.

A web-based learning activity in the field of tele-rehabilitation was conducted by Istituto Superiore di Sanità (ISS), the Italian National Institute of Health, within the EU project HELLODOC. The activity aimed at training professionals to effectively manage the tele-rehabilitation service. ISS adapted the Moodle e-learning platform and implemented the problem-based learning (PBL) methodology.

Tele-rehabilitation: present and future.

During the last decade we assisted to relevant progress in rehabilitation studies and in technological development. From the combination of these issues rises the tele-rehabilitation--a subfield of telemedicine consisting of a system to control rehabilitation "at distance"--as an actual possibility of application and a promising development in the future. The present paper offers a short review of the state of the art in the field of tele-rehabilitation, with a special focus on upper limb tele-rehabilitation.

Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis.

We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervention would be at least the same as those measured after a period of usual care for patients with stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) with respect to their arm/hand function.

Measuring activity patterns using actigraphy in multiple sclerosis.

Multiple sclerosis (MS) is a demyelinating disease resulting in impairments in motor and mental performance and restrictions in activities. Self-report instruments are commonly used to measure activity patterns; alternatively, actigraphs can be placed on several parts of the body. The aims of this study were to evaluate the superiority and specificity of actigraph placement (wrist vs.

Digitised spirography as an evaluation tool for intention tremor in multiple sclerosis.

This study investigated validity and reliability of digitised circle and square spiral drawing for quantifying intention tremor severity and related disability in patients with multiple sclerosis (MS). The tremor amplitude was measured as the standard deviation of the drawing velocity of the arm in the radial and tangential direction for circle spiral drawing, and in the horizontal and vertical direction for square spiral drawing. Results were compared with those of MS patients without tremor and healthy controls, and correlated with clinical assessments of tremor severity and arm functionality including Fahn's tremor rating scale, Test d'Evaluation des Membres supérieurs des Personnes Agées (TEMPA) and the nine-hole-peg test to examine validity.