A Three-Arm Parallel-Group Exploratory Trial documents balance improvement without much evidence of white matter integrity changes in people with multiple sclerosis following two months ambulatory neuroproprioceptive “facilitation and inhibition” physical therapy

0540731 - ÚI 2022 RIV IT eng J - Článek v odborném periodiku
Řasová, K. - Bučková, Barbora - Prokopiusová, T. - Procházková, M. - Angel, G. - Marková, M. - Hrušková, N. - Štětkářová, I. - Špaňhelová, Š. - Mareš, J. - Tintěra, J. - Zach, P. - Musil, V. - Hlinka, Jaroslav
A Three-Arm Parallel-Group Exploratory Trial documents balance improvement without much evidence of white matter integrity changes in people with multiple sclerosis following two months ambulatory neuroproprioceptive “facilitation and inhibition” physical therapy.
European Journal of Physical and Rehabilitation Medicine. Roč. 57, č. 6 (2021), s. 889-899. ISSN 1973-9087. E-ISSN 1973-9095
Grant CEP: GA ČR GA13-23940S
Grant ostatní: GA MŠk(CZ) LO1611
Institucionální podpora: RVO:67985807
Klíčová slova: adaptive plasticity * neural plasticity * multiple sclerosis * physical therapy * diffusion tensor imaging * functional recovery
Obor OECD: Neurosciences (including psychophysiology
Impakt faktor: 5.313, rok: 2021
Způsob publikování: Open access

BACKGROUND: Changes of white matter integrity in people with multiple sclerosis (MS) were documented following mainly motor/skill acquisitions physical therapy, while following neuroproprioceptive ”facilitation, inhibition” (neurofacilitation) only by two pilot studies. Neurofacilitation has potential to induce white matter changes due to possibility to interfere with the neuronal tactility threshold, but stronger evidence is missing. AIM: This study investigates whether neurofacilitation (three physical therapy types) induce white matter changes and if they relate to clinical improvement. DESIGN: The Three-Arm Parallel-Group Exploratory Trial (NCT04355663). SETTING: Each group underwent different kind of two months ambulatory therapy (Motor Program Activating Therapy, Vojta's reflex locomotion, and Functional Electric Stimulation in Posturally Corrected Position). POPULATION: MS people with moderate disability. METHODS: At baseline and after the program, participants underwent magnetic resonance diffusion tensor imaging (DTI) and clinical assessment. Fractional anisotropy maps obtained from DTI were further analyzed using tract-based spatial statistic exploring the mean values in the whole statistic skeleton. Moreover, additional exploratory analysis in 48 regions of white matter was done. RESULTS: 92 people were recruited. DTI data from 61 were analysed. The neurofacilitation (irrespective type of therapy) resulted in significant improvement on the Berg Balance Scale (p=0.0089), mainly driven by the Motor Program Activating Therapy. No statistically significant change in the whole statistic skeleton was observed (only a trend for decrement of fractional anisotropy after Vojta's reflex locomotion). Additional exploratory analysis confirmed significant decrement of fractional anisotropy in the right anterior corona radiata. CONCLUSIONS: Neurofacilitation improved balance without much evidence of white matter integrity changes in people with MS. CLINICAL REHABILITATION IMPACT: The study results point to the importance of neuroproprioceptive “facilitation and inhibition” physical therapy in management of balance in people with multiple sclerosis and the potential to induce white matter changes due to possibility to interfere with the neuronal tactility threshold.
Trvalý link: http://hdl.handle.net/11104/0318348