title: Effects of rehabilitation treatment of the upper limb in multiple sclerosis patients and predictive value of neurophysiological measures.
abstract: BACKGROUND
  Dysfunctions of the upper limbs occur in the 66% of multiple sclerosis (MS) patients. To date, no data, about the persistence of the effects of a rehabilitation treatment and no prognostic markers of functional improvement, have been established.
  
  
  OBJECTIVE
  The aim of this study was to define clinical data supporting the efficacy of a rehabilitation treatment in MS patients with upper limb impairment and to find prognostic factors for functional improvement.
  
  
  METHODS
  Pre-post comparison prospective study.
  
  
  METHODS
  Two tertiary Italian MS centres: Rome and Siena.
  
  
  METHODS
  Twenty-five consecutive MS patients were tested for eligibility.
  
  
  METHODS
  We multidimensionally evaluated 25 consecutive patients with MS-related upper limbs impairment through clinical objective, patient-oriented and neurophysiological measures pre and post a16-week rehabilitation treatment on upper limb sensorimotor function.
  
  
  RESULTS
  We found a significant improvement in the Nine Hole Peg Test (9-HPT) at either sides, both at an immediate post-training visit (T1) (left: P=0.018, right: P=0.004) and at a 12-week postintervention assessment visit (T2) (left: P=0.033, right: P=0.022). We also found a positive correlation between the 12-week post-training changes in the 9-HPT and the N14-P20 interpeak of the somatosensory evoked potentials, (rho=0.374, P=0.008).
  
  
  CONCLUSIONS
  Our study demonstrates that a rehabilitation treatment can lead to an improvement of the upper limb motor performance in MS patients which continues to persist even after 3 months of treatment-discontinuation suggesting a possible role of rehabilitation in neuroplasticity changes. Moreover, we found, in the latency of the N14-P20 interpeak, a possible prognostic marker for the effects of a upper limb rehabilitation treatment in MS patients.
  
  
  CONCLUSIONS
  The N14-P20 interpeak could be used as a prognostic marker of the effects of rehabilitation of the upper limb.
authors.affiliation: Institute of Neurology, Department of Geriatrics, Neurosciences and Orthopedics, Catholic University, Rome, Italy - viviana.nociti@rm.unicatt.it.|Don Carlo Gnocchi Foundation, Milan, Italy - viviana.nociti@rm.unicatt.it.
authors.forename: Viviana
authors.initials: V
authors.lastname: Nociti
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Prosperini
authors.affiliation: Neurology and Clinical Neurophysiology, Department of Neurological and Neurosensory Sciences, University Hospital of Siena, Siena, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Ulivelli
authors.affiliation: Institute of Neurology, Department of Geriatrics, Neurosciences and Orthopedics, Catholic University, Rome, Italy.
authors.forename: Francesco A
authors.initials: FA
authors.lastname: Losavio
authors.affiliation: Neurology and Clinical Neurophysiology, Department of Neurological and Neurosensory Sciences, University Hospital of Siena, Siena, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Bartalini
authors.affiliation: Neurology Unit, Ospedale Vito Fazzi, Lecce, Italy.
authors.forename: Marcella
authors.initials: M
authors.lastname: Caggiula
authors.affiliation: Neurology and Clinical Neurophysiology, Department of Neurological and Neurosensory Sciences, University Hospital of Siena, Siena, Italy.
authors.forename: David
authors.initials: D
authors.lastname: Cioncoloni
authors.affiliation: Institute of Neurology, Department of Geriatrics, Neurosciences and Orthopedics, Catholic University, Rome, Italy.|Don Carlo Gnocchi Foundation, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Caliandro
authors.affiliation: Institute of Neurology, Department of Geriatrics, Neurosciences and Orthopedics, Catholic University, Rome, Italy.
authors.forename: Ileana
authors.initials: I
authors.lastname: Minciotti
authors.affiliation: Institute of Neurology, Department of Geriatrics, Neurosciences and Orthopedics, Catholic University, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mirabella
authors.affiliation: Institute of Neurology, Department of Geriatrics, Neurosciences and Orthopedics, Catholic University, Rome, Italy.|Don Carlo Gnocchi Foundation, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
mesh_terms: D004185:Disability Evaluation; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000534:rehabilitation*; D011379:Prognosis; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*