title: Motor programme activating therapy influences adaptive brain functions in multiple sclerosis: clinical and MRI study.
abstract: There is still little scientific evidence for the efficacy of neurofacilitation approaches and their possible influence on brain plasticity and adaptability. In this study, the outcome of a new kind of neurofacilitation approach, motor programme activating therapy (MPAT), was evaluated on the basis of a set of clinical functions and with MRI. Eighteen patients were examined four times with standardized clinical tests and diffusion tensor imaging to monitor changes without therapy, immediately after therapy and 1 month after therapy. Moreover, the strength of effective connectivity was analysed before and after therapy. Patients underwent a 1-h session of MPAT twice a week for 2 months. The data were analysed by nonparametric tests of association and were subsequently statistically evaluated. The therapy led to significant improvement in clinical functions, significant increment of fractional anisotropy and significant decrement of mean diffusivity, and decrement of effective connectivity at supplementary motor areas was observed immediately after the therapy. Changes in clinical functions and diffusion tensor images persisted 1 month after completing the programme. No statistically significant changes in clinical functions and no differences in MRI-diffusion tensor images were observed without physiotherapy. Positive immediate and long-term effects of MPAT on clinical and brain functions, as well as brain microstructure, were confirmed.
authors.affiliation: aDepartment of Rehabilitation, Third Medical Faculty, Charles University in Prague bMR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine cDepartment of Neurology, Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Kamila
authors.initials: K
authors.lastname: Rasova
authors.forename: Marie
authors.initials: M
authors.lastname: Prochazkova
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Tintera
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ibrahim
authors.forename: Denisa
authors.initials: D
authors.lastname: Zimova
authors.forename: Ivana
authors.initials: I
authors.lastname: Stetkarova
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D026741:Physical Therapy Modalities