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Task-oriented virtual reality and brain functional plasticity in progressive multiple sclerosis: A randomized controlled trial on upper limb rehabilitation.

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Related Experiment Video

Updated: Jan 20, 2026

Author Spotlight: Enhancing Upper Limb Rehabilitation in Stroke Patients Through Advanced Robotic and Neuromodulation Technologies
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Preserved brain functional plasticity after upper limb task-oriented rehabilitation in progressive multiple

G Boffa1, A Tacchino2, E Sbragia1

  • 1Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy.

European Journal of Neurology
|August 17, 2019
PubMed
Summary

Task-oriented upper limb rehabilitation significantly improved motor function and reduced fatigue in progressive multiple sclerosis patients. This approach is more effective than passive treatment, even in later stages of the disease.

Keywords:
functional MRIprogressive multiple sclerosisrehabilitationupper limbs

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Area of Science:

  • Neurorehabilitation
  • Neuroimaging
  • Progressive Multiple Sclerosis

Background:

  • Limited research exists on upper limb (UL) rehabilitation for progressive multiple sclerosis (PMS).
  • Investigating task-oriented UL rehabilitation in PMS is crucial for improving patient outcomes.
  • Understanding the neuroimaging correlates of motor improvements is essential.

Purpose of the Study:

  • To evaluate the efficacy of task-oriented upper limb rehabilitation in patients with progressive multiple sclerosis.
  • To explore the magnetic resonance imaging (MRI) correlates associated with changes in motor performance.
  • To compare active treatment with passive treatment in PMS patients.

Main Methods:

  • 26 PMS patients with mild UL impairment were randomized into active (n=13) or passive (n=13) treatment groups.
  • Patients underwent MRI scans (structural and functional) and motor assessments (Action Research Arm Test, Nine-Hole Peg Test, ABILHAND, MFIS) at baseline and post-training.
  • Motor finger performance was quantified using an engineered glove.

Main Results:

  • The active treatment group showed significant improvements in finger motor tasks and reduced Modified Fatigue Impact Scale (MFIS) scores compared to the passive group.
  • Active treatment led to increased functional connectivity in cerebellar and thalamic resting-state networks.
  • Motor improvements correlated with changes in thalamic and sensorimotor network connectivity.

Conclusions:

  • Task-oriented UL rehabilitation benefits PMS patients with mild UL dysfunction, outperforming passive mobilization.
  • Despite significant disability, PMS patients retain adaptive capacities, supporting rehabilitative interventions.
  • Rehabilitation is a viable strategy for managing late-stage progressive multiple sclerosis.