Intensity-dependent clinical effects of an individualized technology-supported task-oriented upper limb training...

Area of Science:

• Neurorehabilitation
• Physical Therapy
• Clinical Research

Background:

• Task-oriented training (TOT) is crucial for functional recovery in Multiple Sclerosis (MS).
• Optimal training intensity and its effects on recovery remain unclear.
• This study addresses the need for individualized intensity determination in TOT for MS.

Purpose of the Study:

• To investigate the feasibility of a task-oriented upper limb training program at different individualized intensities in MS patients.
• To compare the clinical effects of high-intensity (100%) TOT, low-intensity (50%) TOT, and conventional occupational therapy.
• To determine intensity-dependent effects of TOT on upper limb function in MS.

Main Methods:

• A randomized controlled trial involving 20 MS patients (EDSS 4-8) divided into three groups: 100% TOT (n=7), 50% TOT (n=8), and conventional therapy (n=5).
• Interventions were administered over a specified period, with focus on maximal repetitions for TOT groups.
• Upper limb capacity, perceived performance, body functions, and structures were assessed using standardized measures.

Main Results:

• All participants tolerated individualized TOT without adverse events.
• Significant improvements over time were observed across all groups for the Box and Block Test (BBT), Action Research Arm Test, and Manual Ability Measure-36.
• Task-oriented training at 100% intensity demonstrated significant interaction effects (group*time) favoring greater improvements in BBT and static fatigue index compared to other groups.

Conclusions:

• Task-oriented training is a feasible and safe intervention for MS patients at individualized intensities.
• While all groups showed improvement, 100% intensity TOT appears superior for enhancing upper limb function and reducing fatigue.
• Results support the use of high-intensity, individualized TOT for optimizing functional recovery in MS.