Intensity-dependent clinical effects of an individualized technologysupported task-oriented upper limb training program in Multiple Sclerosis: A pilot randomized controlled trial

Abstract

Background:Task-oriented training promotes functional recovery in Multiple Sclerosis (MS). Know-how to de-termine an individualized training intensity and intensity-dependent effects are, however, unknown. The ob-jective of the study was to investigate the feasibility and the clinical effects of a task-oriented upper limb trainingprogram at different individualized training intensities with conventional occupational therapy.Methods:People with MS (n= 20, EDSS range 4–8) were divided into three groups, receiving task-orientedtraining at 100% (n= 7) or 50% (n= 8) of their individual maximal number of repetitions, or conventionaloccupational therapy (n= 5). Effects were evaluated using different upper limb capacity and perceived per-formance measures on activity level, and measures on body functions and structures level.Results:Mixed model analyses revealed significant improvements (p< 0.05) over time on the Box and block test(BBT), Action Research Arm Test and the Manual Ability Measure-36. Significant interaction effects (group*-time) in favor of the task-oriented group training at the highest intensity were found for BBT and static fatigueindex during a maximal sustained handgrip strength test.Conclusion:All participants were able to perform the task-oriented training at their individualized intensitywithout any adverse effects. Several improvements over time were found for all intervention groups, howeverthe results suggest a superiority of task-oriented training at 100%.Clinical trial registration number on clinicaltrials.gov:=NCT02688231