- •Task-oriented training (TOT) is an evidence-based rehabilitation method for multiple sclerosis (MS), however, underutilized.
- •TOT as a standalone approach can be effective for patients with MS.
- •TOT is as effective as conventional physical therapy for improving UL functions for patients with MS.
Patients with multiple sclerosis (MS) typically experience varying degrees of impairments and disabilities. Task-oriented training (TOT) has been used for those patients to improve their motor skills. This review aimed to evaluate the primary research on the effectiveness of TOT in improving upper limb functions in patients with MS. The systematic search was performed using PubMed, Cochrane library and Physical therapy Evidence Database (PEDro) databases up to 2022. Only randomized controlled trials that used TOT alone for UL functions of adult patients with MS were included. Two independent reviewers screened records, extracted data and assessed studies' quality by using PEDro scale. The meta-analysis was based on the standardized mean differences and the random effect. The search screened 9148 records; only five randomized controlled trials were eligible; four of them were of good quality. The trials included 147 patients with MS; 66% of them were females, their mean average age was 47 years. TOT duration ranged from 40 to 210 min with total period of 10 days to 8 weeks; it was applied alone without conventional physical therapy. Meta-analyses compared TOT alone versus control interventions revealed non-significant difference in the improvement of UL functions on Nine-Hole Peg Test, Action Reach Arm Test, Motor Activity Log-Amount Of Use scale, and Manual Ability Measurement. This review concluded that TOT alone can be effective for improving UL functions in patients with MS but meta-analyses showed non-significant differences when it was compared with conventional physical therapy.
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- Upper limb motor training based on task oriented exercises induces functional brain reorganization in patients with multiple sclerosis.Neuroscience. 2019; 410: 150-159https://doi.org/10.1016/j.neuroscience.2019.05.004
- Upper limb motor rehabilitation impacts white matter microstructure in multiple sclerosis.Neuroimage. 2014; 90: 107-116https://doi.org/10.1016/j.neuroimage.2013.12.025
- Does task-oriented practice improve upper extremity motor recovery after stroke? A Systematic Review.ISRN Stroke. 2014; 2014504910https://doi.org/10.1155/2014/504910
- What is the impact of robotic rehabilitation on balance and gait outcomes in people with multiple sclerosis? A systematic review of randomized control trials.Eur. J. Phys. Rehabil. Med. 2021; 57: 246-253https://doi.org/10.23736/S1973-9087.21.06692-2
- Recovery of upper limb function.in: Raine S Meadows L. Bobath Concept Theory and Clinical Practice in Neurological Rehabilitation. 1st ed. Wiley-Blackwell, London2009: 154-155
- Effect of task-oriented training on upper limb function in adults following stroke - a systematic review.in: Stokes E Paillex R World Confederation of Physical Therapy Congress. WCPT, Geneva, Switzerland2019 (10-13 May2019- Abstracts and presentations; PO-H17-SUN1)
- Study protocol: improving cognition in people with progressive multiple sclerosis: a multi-arm, randomized, blinded, sham-controlled trial of cognitive rehabilitation and aerobic exercise (COGEx).BMC Neurol. 2020; 20 (PMID: 32443981; PMCID: PMC7245035): 204https://doi.org/10.1186/s12883-020-01772-7
- Aquatic training in MS: neurotherapeutic impact upon quality of life.Ann. Clin. Transl. Neurol. 2015; 2 (Epub 2015 Jun 26. PMID: 26339680; PMCID: PMC4554447): 864-872https://doi.org/10.1002/acn3.220
- Effects of high-intensity robot assisted hand training on upper limb recovery and muscle activity in individuals with multiple sclerosis: a randomized, controlled, single blinded trial.Front. Neurol. 2018; 9: 905https://doi.org/10.3389/fneur.2018.00905
- Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations.BMC Neurol. 2017; 17 (PMID: 28915856; PMCID: PMC5602953): 185https://doi.org/10.1186/s12883-017-0960-9
- Selecting studies and collecting data: data extraction forms.Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration and John Wiley & Sons, England, UK2008: 164-167
- Special topics in statistics: missing data: missing standard deviations.in: Higgins J. Green S. Cochrane Handbook for Systematic Reviews of Interventions. 1st ed. The Cochrane Collaboration and John Wiley & Sons Ltd., England, UK2008: 485-488
- Natural history of multiple sclerosis symptoms.Int. J. MS Care. 2013; 15: 146-158
- Associations of upper limb disability measures on different levels of the International Classification of Functioning, Disability and Health in people with multiple sclerosis.Phys. Ther. 2015; 95: 65-75https://doi.org/10.2522/ptj.20130588
- Upper limb rehabilitation in people with multiple sclerosis: a systematic review.Neurorehabil. Neural. Repair. 2016; 30: 773-793https://doi.org/10.1177/1545968315624785
- Intensity-dependent clinical effects of an individualized technology-supported task-oriented upper limb training program in Multiple Sclerosis: a pilot randomized controlled trial.Mult. Scler. Relat. Disord. 2019; 34: 119-127https://doi.org/10.1016/j.msard.2019.06.014
- Do patients with multiple sclerosis benefit from semi-immersive virtual reality? A randomized clinical trial on cognitive and motor outcomes.Appl. Neuropsychol. Adult. 2020; : 1-7https://doi.org/10.1080/23279095.2019.1708364
- Profusely increased cortical grey, subcortical grey and white matter structural neuroplasticity with enduring realworld motor improvement following CI therapy for MS: results from a randomised controlled trial.Mult. Scler. 2016; 22: 7-87https://doi.org/10.1177/1352458516663068
- Phase II randomized controlled trial of constraint-induced movement therapy in multiple sclerosis. part 1: effects on real-world function.Neurorehabil. Neural. Repair. 2018; 32: 223-232https://doi.org/10.1177/1545968318761050
- Upper limb impairment is associated with use of assistive devices and unemployment in multiple sclerosis.Mult. Scler. Relat. Disord. 2017; 13: 87-92https://doi.org/10.1016/j.msard.2017.02.013
- Using research to guide practice: the physiotherapy evidence database (PEDro).Braz. J. Phys. Ther. 2020; 24: 384-391https://doi.org/10.1016/j.bjpt.2019.11.002
- Effect of video-based exergaming on arm and cognitive function in persons with multiple sclerosis: a randomized controlled trial.Mult. Scler. Relat. Disord. 2020; 40101966https://doi.org/10.1016/j.msard.2020.101966
- The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ. 2021; 372: n71https://doi.org/10.1136/bmj.n71
- Dual-task program training in patients with acquired brain injury.Parkinsonism Relat. Disord. 2010; 16: S53
- Quantification of upper limb dysfunction in the activities of the daily living in persons with multiple sclerosis.Mult. Scler. Relat. Disord. 2022; 63https://doi.org/10.1016/j.msard.2022.103917
- Functional and structural brain plasticity enhanced by motor and cognitive rehabilitation in multiple sclerosis.Neural. Plast. 2015; : 12
- Emerging evidence-based physical rehabilitation for multiple sclerosis - towards an inventory of current content across Europe.Health Qual. Life Outcomes. 2010; 8: 76https://doi.org/10.1186/1477-7525-8-76
- Respiratory muscle training for multiple sclerosis.Cochrane Database Syst. Rev. 2017; 12 (PMID: 29267988; PMCID: PMC6486138)CD009424https://doi.org/10.1002/14651858.CD009424.pub2
- Over-ground walking or robot-assisted gait training in people with multiple sclerosis: does the effect depend on baseline walking speed and disease related disabilities? A systematic review and meta-regression.BMC Neurol. 2019; 19: 93https://doi.org/10.1186/s12883-019-1321-7
- Feeding interventions for children with cerebral palsy: a review of the evidence.Phys. Occup. Ther. Pediatr. 2011; 31: 58-77
- Haptic vs sensorimotor training in the treatment of upper limb dysfunction in multiple sclerosis: a multi-center, randomised controlled trial.J. Neurol. Sci. 2020; 412https://doi.org/10.1016/j.jns.2020.116743
- Stroke Recovery and Rehabilitation.2nd ed. Demos Medical, New York, United States2015
- Treadmill training in multiple sclerosis: can body weight support or robot assistance provide added value? A systematic review.Mult. Scler. Int. 2012; 240274https://doi.org/10.1155/2012/240274
- A meta-analysis of constraint-induced movement therapy after stroke.J. Rehabil. Med. 2014; 46: 833-842https://doi.org/10.2340/16501977-1859
- Motor assessment of upper extremity function and its relation with fatigue, cognitive function and quality of life in multiple sclerosis patients.J. Neurol. Sci. 2006; 246: 117-122https://doi.org/10.1016/j.jns.2006.02.018
Published online: March 22, 2023
Accepted: March 18, 2023
Received in revised form: March 10, 2023
Received: December 25, 2022
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