Intensity-dependent Clinical Effects of a Task-oriented Upper Limb Training Program in Multiple Sclerosis

Abstract

People with multiple sclerosis (MS) often suffer from substantial sensorimotor impairments in the upper limb. Task-oriented training might be a valuable rehabilitation approach but the influence of training dosage on therapy outcomes is unknown. The aim of this pilot study was to compare the clinical effects of a task-oriented upper limb training program at two different training intensities and usual occupational therapy. People with MS (n=20, EDSS range 4-8) with different levels of upper limb disability (mild, moderate, severe) were divided into three groups: task-oriented training at a higher intensity (n=7), a lower intensity (n=8) and usual occupational therapy (n=5). Participants attended one-hour training sessions, five days/week, during eight weeks. Primary outcome measures addressed the ICF activity level, secondary outcome measures addressed the ICF body functions and structures level. People with MS from all upper limb disability levels were able to perform high-intense one-hour sessions. We found several significant improvements over time on ICF activity level, but no clear intensity-dependent effect during task-oriented training in MS. However, intervention results on the Box and Block Test and a sustained handgrip strength test may suggest a superiority of task-oriented training at a higher intensity.