Publications by authors named "Lousin Moumdjian"

16 Publications

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Rhythmic interlimb coordination of the lower limbs in multiple sclerosis during auditory pacing to three different frequencies.

Gait Posture 2021 May 5;86:334-340. Epub 2021 Apr 5.

REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; UMSC Pelt-Hasselt, Belgium. Electronic address:

Background: Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system with heterogeneous symptoms. Persons with MS (PwMS) show reduced walking capacity with changes in their gait pattern. It is unknown to which extent coordination deficits are present in PwMS, which can be measured by seated lower leg interlimb coordination tasks, and to which extent they are related to motor and cognitive function.

Research Question: How is the control of interlimb coordination of the lower limbs characterized in PwMS compared to healthy controls (HC) during a seated rhythmical coordination task and what is the relationship between interlimb coordination, motor or cognitive function?

Methods: Rhythmical interlimb coordination was assessed during a single session in 38 PwMS and 13 HC, using a seated rhythmical coordination task, comprising of antiphase flexion-extension of the lower limbs, to metronomes at 0.75 Hz, 1.00 Hz, 1.50 Hz. Outcomes were phase coordination index (PCI), movement amplitude and movement frequency. Correlations between interlimb coordination, motor, and cognitive function were examined.

Results: PwMS showed impaired walking capacity but preserved cognitive function. Mixed model analysis revealed a significant effect of group and metronome frequency for PCI, attenuated by the variability in generating knee (antiphase flexion-extension) movements. Movement amplitude was highest at metronome frequency 1.00 Hz. In PwMS significant correlations were found between PCI and cognitive function when performing the task at metronome frequencies 0.75 Hz and 1.50 Hz, as well as motor function at 1.50 Hz.

Significance: PwMS had a higher variability in interlimb coordination compared to HC. The most stable interlimb antiphase coordination mode was performed at 1.00 Hz. Significant correlations support the existence of a relationship between information processing speed, as well as walking impairment, with interlimb coordination. While cognitive and motor control are always needed for interlimb coordination movements, associations are strongest in the deviant higher and lower metronome rhythms.
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http://dx.doi.org/10.1016/j.gaitpost.2021.04.001DOI Listing
May 2021

Clinical manifestation and perceived symptoms of walking-related performance fatigability in persons with multiple sclerosis.

Int J Rehabil Res 2021 06;44(2):118-125

REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.

Fatigue and walking difficulties are common impairments and activity limitations in persons with multiple sclerosis (PwMS). Walking fatigability (WF) can be measured by a Distance Walked Index and is defined as a decline in walking distance of 10% or more during the six-minute walking test (6MWT). However, the clinical manifestation and perceived symptoms related to fatigability are still not well documented. Forty-nine PwMS [Expanded Disability Status Scale (EDSS) ≤6] and 28 healthy controls (HC) performed a 6MWT. The perceived severity of 11 common symptoms was rated on a visual analogue scale of 0-10 before, immediately after, and 10, 20 and 30 minutes after the 6MWT by means of the symptom inventory. Short motor impairment screening tests at baseline together with other descriptive measures were performed. Twenty pwMS were categorized in the WF group and were more disabled (EDSS: 4.16 ± 1.41) than the non-walking fatigability group (n = 29, EDSS: 2.62 ± 1.94). PwMS showed exacerbations of several perceived symptoms in MS, where most symptoms returned to baseline within 10 minutes after the walking test. The WF group showed significantly more muscle weakness and gait impairment, together with balance problems, and experienced an increase in spasticity, pain and dizziness after 6MWT. Our findings showed that perceived severity of symptoms are higher in pwMS presenting WF, and increase temporally after the 6MWT. Future research with quantitative measurement during and after walking is recommended.
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http://dx.doi.org/10.1097/MRR.0000000000000457DOI Listing
June 2021

Comparing 16 Different Dual-Tasking Paradigms in Individuals With Multiple Sclerosis and Healthy Controls: Working Memory Tasks Indicate Cognitive-Motor Interference.

Front Neurol 2020 28;11:918. Epub 2020 Aug 28.

Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, Hasselt University, Hasselt, Belgium.

Cognitive-motor interference (CMI) is measured by dual-tasking (DT), which involves motor and cognitive tasks. There is no consensus as to whether CMI is present in multiple sclerosis (MS). We investigated the effects of 16 DT conditions by measuring motor complexity, cognitive domain, and task difficulty. In total, 40 persons with MS (pwMSs) with Expanded Disease Status Scale (EDSS) 3.2 ± 1.7 and 31 age- and sex-matched healthy controls (HCs) completed 2 single walking, 8 single cognitive, and 2 complex walking tasks and 16 cognitive-motor DT. The main outcomes were mean values of gait velocity and the percentage change from single to DT (motor DT costs, mDTCs) and mean values of cognitive task accuracy and the percentage changes (cognitive DTC, cDTC). Two-way analyses of variance showed the main effect of cognitive task yielded an ratio of = 72.35, < 0.01, for mean gait velocity, and an ratio of = 17.12, < 0.001, for mDTC, indicating that the mean velocity was significantly lower and the mDTC significantly higher for DS_B (mean = 1.27, SD = 0.03, and mean = 13.52, SD = 1.28, respectively). The main effect of cognitive task yielded an ratio of = 84.32, < 0.001, with the lowest average accuracy for DS_B (mean = 43.95, SD = 3.33); no effect was found for cDTC. In pwMSs, the EDSS accounted for 28% ( = 13.65, = 0.001) of variance in a model predicting the highest mDTC. Overall, among different cognitive tasks added, the Digit Span backward was the most interfering cognitive task over gait velocity and accuracy. The effect was similar independently from the motor complexity and the group. PwMSs and HCs behaved in a similar manner at all motor complexity levels and during all cognitive task.
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http://dx.doi.org/10.3389/fneur.2020.00918DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485559PMC
August 2020

Rehabilitation should be prescribed acutely in motor relapses - Yes.

Mult Scler 2020 12 16;26(14):1822-1823. Epub 2020 Sep 16.

Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.

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http://dx.doi.org/10.1177/1352458520935723DOI Listing
December 2020

Detrended fluctuation analysis of gait dynamics when entraining to music and metronomes at different tempi in persons with multiple sclerosis.

Sci Rep 2020 07 31;10(1):12934. Epub 2020 Jul 31.

IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Gent, Belgium.

In persons with multiple sclerosis (PwMS), synchronizing walking to auditory stimuli such as to music and metronomes have been shown to be feasible, and positive clinical effects have been reported on step frequency and perception of fatigue. Yet, the dynamic interaction during the process of synchronization, such as the coupling of the steps to the beat intervals in music and metronomes, and at different tempi remain unknown. Understanding these interactions are clinically relevant, as it reflects the pattern of step intervals over time, known as gait dynamics. 28 PwMS and 29 healthy controls were instructed to walk to music and metronomes at 6 tempi (0-10% in increments of 2%). Detrended fluctuation analysis was applied to calculate the fractal statistical properties of the gait time-series to quantify gait dynamics by the outcome measure alpha. The results showed no group differences, but significantly higher alpha when walking to music compared to metronomes, and when walking to both stimuli at tempi + 8, + 10% compared to lower tempi. These observations suggest that the precision and adaptation gain differ during the coupling of the steps to beats in music compared to metronomes (continuous compared to discrete auditory structures) and at different tempi (different inter-beat-intervals).
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http://dx.doi.org/10.1038/s41598-020-69667-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395137PMC
July 2020

Measuring walking-related performance fatigability in clinical practice: a systematic review.

Eur J Phys Rehabil Med 2020 Feb 18;56(1):88-103. Epub 2019 Nov 18.

REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Hasselt, Belgium.

Introduction: Fatigability, a change in performance according to tasks and circumstances, can contribute to walking limitations in daily life. Walking-related fatigability (WF) has been assessed subjectively, but current knowledge on best objective measurement methods is limited. The aim of this study was to provide an overview of objective clinical measurement methods assessing WF in different populations.

Evidence Acquisition: Articles were searched in Pubmed and Web Of Science by two independent raters. Studies were included when meeting inclusion criteria of measuring WF objectively in a clinical setting, with no exclusion towards any population. Case studies and reviews were not included in the review (systematic review registration number: PROSPERO - CRD42017074121). In total, 28 articles were included. The study populations were older adults (N.=7), multiple sclerosis (N.=14), spinal muscle atrophy (N.=3), osteoarthritis (N.=3), interstitial lung diseases (N.=1), and myasthenia gravis (N.=1). Data about patient characteristics, walking task, WF formula and interpretation (cut-off values and/or psychometric properties) got extracted from included literature. Every included article got checked for quality and risk of bias.

Evidence Synthesis: WF was mostly measured during longer walking test such as six-minute walking test (6MWT) and 500 or 400-m walking test, by comparing the first and last minute or lap for spatiotemporal or kinematic changes in well-defined formulas. No gold standard is however available yet given different tasks or outcome measures across study populations.

Conclusions: Longer walking test were most often used, with a preference towards the 6MWT, thereby comparing the changes over the last and first part of the test. Psychometric properties need more documentation before inclusion as experimental outcome.
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http://dx.doi.org/10.23736/S1973-9087.19.05878-7DOI Listing
February 2020

Continuous 12 min walking to music, metronomes and in silence: Auditory-motor coupling and its effects on perceived fatigue, motivation and gait in persons with multiple sclerosis.

Mult Scler Relat Disord 2019 Oct 20;35:92-99. Epub 2019 Jul 20.

REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, BIOMED, Hasselt University, Hasselt, Belgium.

Background: In Persons with Multiple Sclerosis (PwMS), coupling walking to beats/pulses in short bursts is reported to be beneficial for cadence and perceived fatigue. However it is yet to be investigated if coupling and its effects can be sustained for longer durations, required for task-oriented training strategy in PwMS.

Aims: To investigate if PwMS compared to healthy controls (HC) sustain synchronization for 12 min when walking to music and metronome, and its effects on perceived physical and cognitive fatigue, motivation and gait compared to walking in silence.

Methods: Participants walked for 12 min in three conditions (music, metronome and silence). The tempo of the auditory conditions was individualized. Auditory-motor coupling and spatio-temporal gait parameters were measured during walking. The visual analogue scale was used for perceived fatigue, and the Likert scale for motivation.

Results: 27 PwMS and 28 HC participated. All participants synchronized to both stimuli, yet PwMS synchronized better to music. Overall, participants had lower cadence, speed and stride length when over time all conditions, with an exception of HC, with increasing cadence during the music condition. PwMS perceived less cognitive fatigue, no difference in perceived physical fatigue and a higher motivation walking to music compared to metronomes and silence.

Conclusion: 12 min of uninterrupted walking was possible in PwMS in all conditions, while better synchronization, low perception of cognitive fatigue and high motivation occurred with music compared to other conditions. Coupling walking to music could offer novel paradigms for motor task-oriented training in PwMS.
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http://dx.doi.org/10.1016/j.msard.2019.07.014DOI Listing
October 2019

A pilot study of the effects of running training on visuospatial memory in MS: A stronger functional embedding of the hippocampus in the default-mode network?

Mult Scler 2020 10 18;26(12):1594-1598. Epub 2019 Jul 18.

Department of Anatomy & Neurosciences, MS Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Background/objective: Endurance exercise can improve memory function in persons with multiple sclerosis (pwMS), but the effects on hippocampal functioning are currently unknown. We investigated the effects of a running intervention on memory and hippocampal functional connectivity in pwMS.

Methods/results: Memory and resting-state functional magnetic resonance imaging (fMRI) data were collected in a running intervention ( = 15) and waitlist group ( = 14). Visuospatial memory improvement was correlated to increased connectivity between the hippocampus and the default-mode network (DMN) in the intervention group only.

Conclusion: As a result of endurance exercise, improvements in visuospatial memory may be mediated by a stronger functional embedding of the hippocampus in the DMN.
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http://dx.doi.org/10.1177/1352458519863644DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7575292PMC
October 2020

Test-Retest Reliability of Cognitive-Motor Interference Assessments in Walking With Various Task Complexities in Persons With Multiple Sclerosis.

Neurorehabil Neural Repair 2019 08 26;33(8):623-634. Epub 2019 Jun 26.

1 REVAL Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium.

. Simultaneous execution of motor and cognitive tasks can result in worsened performance on one or both tasks, indicating cognitive-motor interference (CMI). A growing amount of research on CMI in persons with multiple sclerosis (pwMS) is observed. However, psychometric properties of dual-task outcomes have been scarcely reported. . To investigate the between-day test-retest reliability of the motor and cognitive dual-task costs (DTCs) during multiple CMI test conditions with various task complexities in pwMS and matched healthy controls (HCs). . A total of 34 pwMS (Expanded Disability Status Scale score 3.0 ± 0.8) and 31 HCs were tested and retested on 3 single cognitive, 4 single motor, and 12 cognitive-motor dual tasks. Cognitive tasks included serial subtraction by 7, titrated digit span backward, and auditory vigilance. Motor tasks were walking at self-selected speed, over obstacles, crisscross, and while carrying a water-filled cup. Outcome measures were cognitive and motor DTC, calculated as percentage change of dual-task performance compared with single-task performance. Intraclass correlations (ICCs) and Spearman correlation coefficients were calculated as appropriate. . For DTC of gait speed, ICCs ranged from 0.45 to 0.81 and Spearman correlations from 0.74 to 0.82. For DTC, ICCs ranged from -0.18 to 0.49 and Spearman correlations from -0.28 to 0.26. Reliability depended on the type of motor and cognitive task. . Reliability of the DTC was, overall, good, whereas that of the DTC was poor. The "walking" and "cup" dual-task conditions were the most reliable regardless of the integrated cognitive task.
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http://dx.doi.org/10.1177/1545968319856897DOI Listing
August 2019

Walking to Music and Metronome at Various Tempi in Persons With Multiple Sclerosis: A Basis for Rehabilitation.

Neurorehabil Neural Repair 2019 06 13;33(6):464-475. Epub 2019 May 13.

1 Hasselt University, REVAL Rehabilitation Research Center, Hasselt, Belgium.

. Mobility dysfunctions are prevalent in persons with multiple sclerosis (PwMS), thus novel rehabilitation mechanisms are needed toward functional training. The effect of auditory cueing is well-known in Parkinson's disease, yet the application of different types of auditory stimuli at different tempi has not been investigated yet. . Investigating if PwMS, compared with healthy controls (HC), can synchronize their gait to music and metronomes at different tempi during walking and the effects of the stimuli on perceived fatigue and gait. Additionally, exploring if cognitive impairment would be a factor on the results. . The experimental session consisted of 2 blocks, music and metronomes. Per block, participants walked 3 minutes per tempi, with instructions to synchronize their steps to the beat. The tempi were 0%, +2%, +4% +6%, +8%, +10% of preferred walking cadence (PWC). . A total of 28 PwMS and 29 HC participated. On average, participants were able to synchronize at all tempi to music and metronome. Higher synchronization was obtained for metronomes compared with music. The highest synchronization for music was found between +2% and +8% of PWC yet pwMS perceived less physical and cognitive fatigue walking to music compared with metronomes. Cognitive impaired PwMS (n = 9) were not able to synchronize at tempi higher than +6%. . Auditory-motor coupling and synchronization was feasible in HC and PwMS with motor and cognitive impairments. PwMS walked at higher tempi than their preferred walking cadence, and lower fatigue perception with music. Coupling walking to music could be a promising functional walking training strategy.
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http://dx.doi.org/10.1177/1545968319847962DOI Listing
June 2019

A model of different cognitive processes during spontaneous and intentional coupling to music in multiple sclerosis.

Ann N Y Acad Sci 2019 06 13;1445(1):27-38. Epub 2019 Mar 13.

IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium.

Evidence for using auditory-motor coupling in neurological rehabilitation to facilitate walking is increasing. However, the distinction between spontaneous and intended coupling and its underlying mechanisms is yet to be investigated. In this study, we include 30 persons with multiple sclerosis and 30 healthy controls (HCs) in an experiment with two sessions in which participants were asked to walk to music with various tempi, matching their preferred walking cadence (PWC) up to 10% above in incremental steps of 2%. In the first session, no instructions were given to synchronize. In the second, participants were instructed to synchronize steps to the beats. Spontaneous synchronization was possible at 0% and +2% of the PWC, and fewer persons with multiple sclerosis were able to do so compared with HCs. Instruction was needed to synchronize at above +2% tempo in all participants. In the instructed session, the +6% condition marked a cutoff for cognitively impaired persons, as they were no longer able to synchronize. Based on our findings, we constructed a model illustrating that spontaneous entrainment is limited, operating during spontaneous coupling at only 0% and +2% of the PWC, and that at a higher tempo, entrainment requires intentional synchronization, with an active cognitive control mechanism.
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http://dx.doi.org/10.1111/nyas.14023DOI Listing
June 2019

Walking endurance and perceived symptom severity after a single maximal exercise test in persons with mild disability because of multiple sclerosis.

Int J Rehabil Res 2018 Dec;41(4):316-322

Fit Up Physiotherapy Centre Kontich, Kontich, Belgium.

People with multiple sclerosis (PwMS) are less physically active compared with the general population. This might also be because of the perception of temporary worsening of symptoms during physical activity. Forty-two PwMS with a mild level of disability underwent a maximal exercise test on a bicycle ergometer. Fifteen minutes before and 15 and 75 min after the maximal exercise test, the 6-minute walking test was conducted and the rate of perceived exertion was recorded. Twice before and three times after the maximal exercise test, participants rated the symptom inventory, including symptom domains of general fatigue, muscle fatigue, balance, gait pattern, muscle weakness, spasticity, pain, sensory disturbance, dizziness, and visual impairment. The visual analogue scale was used to rate the perceived symptoms from 0 (no intensity) to 10 (maximal intensity). The 6-minute walking test distance increased significantly over time, whereas the rate of perceived exertion increased temporarily after the maximal exercise test. Immediately after the maximal exercise test, significant temporary increases were found in balance, gait pattern, muscle weakness, and visual impairment. General and muscle fatigue were elevated, compared with the baseline, till 15 and 75 min after the maximal exercise test, respectively. A short-term impact of a single maximal exercise test was considered as the temporary worsening of perceived symptoms, especially (muscle) fatigue and the gait pattern, in PwMS with a mild level of disability. However, a recovery was observed after 75 min. Walking endurance was not affected by the maximal exercise test.
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http://dx.doi.org/10.1097/MRR.0000000000000305DOI Listing
December 2018

Entrainment and Synchronization to Auditory Stimuli During Walking in Healthy and Neurological Populations: A Methodological Systematic Review.

Front Hum Neurosci 2018 26;12:263. Epub 2018 Jun 26.

Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Gent, Belgium.

Interdisciplinary work is needed for scientific progress, and with this review, our interest is in the scientific progress toward understanding the underlying mechanisms of auditory-motor coupling, and how this can be applied to gait rehabilitation. Specifically we look into the process of entrainment and synchronization; where entrainment is the process that governs the dynamic alignments of the auditory and motor domains based on error-prediction correction, whereas synchronization is the stable maintenance of timing during auditory-motor alignment. A systematic literature search in databases PubMed and Web of Science were searched up to 9th of August 2017. The selection criteria for the included studies were adult populations, with a minimum of five participants, investigating walking to an auditory stimulus, with an outcome measure of entrainment, and synchronization. The review was registered in PROSPERO as CRD42017080325. The objective of the review is to systematically describe the metrics which measure entrainment and synchronization to auditory stimuli during walking in healthy and neurological populations. Sixteen articles were included. Fifty percent of the included articles had healthy controls as participants ( = 167), 19% had neurological diseases such as Huntington's and Stroke ( = 76), and 31% included both healthy and neurological [Parkinson's disease (PD) and Stroke] participants ( = 101). In the included studies, six parameters were found to capture the interaction between the human movement and the auditory stimuli, these were: cadence, relative phase angle, resultant vector length, interval between the beat and the foot contact, period matching performance, and detrended fluctuation analysis. In this systematic review, several metrics have been identified, which measure the timing aspect of auditory-motor coupling and synchronization of auditory stimuli in healthy and neurological populations during walking. The application of these metrics may enhance the current state of the art and practice across the neurological gait rehabilitation. These metrics also have current shortcomings. Of particular pertinence is our recommendation to consider variability in data from a time-series rather than time-windowed viewpoint. We need it in view of the promising practical applications from which the studied populations may highly benefit in view of personalized medical care.
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http://dx.doi.org/10.3389/fnhum.2018.00263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028729PMC
June 2018

Effects of an individual 12-week community-located "start-to-run" program on physical capacity, walking, fatigue, cognitive function, brain volumes, and structures in persons with multiple sclerosis.

Mult Scler 2019 01 8;25(1):92-103. Epub 2017 Nov 8.

Fit Up, Physiotherapy Centre, Kontich, Belgium.

Background: Exercise therapy studies in persons with multiple sclerosis (pwMS) primarily focused on motor outcomes in mid disease stage, while cognitive function and neural correlates were only limitedly addressed.

Objectives: This pragmatic randomized controlled study investigated the effects of a remotely supervised community-located "start-to-run" program on physical and cognitive function, fatigue, quality of life, brain volume, and connectivity.

Method: In all, 42 pwMS were randomized to either experimental (EXP) or waiting list control (WLC) group. The EXP group received individualized training instructions during 12 weeks (3×/week), to be performed in their community aiming to participate in a running event. Measures were physical (VO, sit-to-stand test, Six-Minute Walk Test (6MWT), Multiple Sclerosis Walking Scale-12 (MSWS-12)) and cognitive function (Rao's Brief Repeatable Battery (BRB), Paced Auditory Serial Attention Test (PASAT)), fatigue (Fatigue Scale for Motor and Cognitive Function (FSMC)), quality of life (Multiple Sclerosis Impact Scale-29 (MSIS-29)), and imaging. Brain volumes and diffusion tensor imaging (DTI) were quantified using FSL-SIENA/FIRST and FSL-TBSS.

Results: In all, 35 pwMS completed the trial. Interaction effects in favor of the EXP group were found for VO, sit-to-stand test, MSWS-12, Spatial Recall Test, FSMC, MSIS-29, and pallidum volume. VO improved by 1.5 mL/kg/min, MSWS-12 by 4, FSMC by 11, and MSIS-29 by 14 points. The Spatial Recall Test improved by more than 10%.

Conclusion: Community-located run training improved aerobic capacity, functional mobility, visuospatial memory, fatigue, and quality of life and pallidum volume in pwMS.
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http://dx.doi.org/10.1177/1352458517740211DOI Listing
January 2019

Cognitive-motor dual-task interference: A systematic review of neural correlates.

Neurosci Biobehav Rev 2017 Apr 16;75:348-360. Epub 2017 Jan 16.

Department of Medical Sciences, Surgical and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Italy.

Cognitive-motor interference refers to dual-tasking (DT) interference (DTi) occurring when the simultaneous performance of a cognitive and a motor task leads to a percentage change in one or both tasks. Several theories exist to explain DTi in humans: the capacity-sharing, the bottleneck and the cross-talk theories. Numerous studies investigating whether a specific brain locus is associated with cognitive-motor DTi have been conducted, but not systematically reviewed. We aimed to review the evidences on brain activity associated with the cognitive-motor DT, in order to better understand the neurological basis of the CMi. Results were reported according to the technique used to assess brain activity. Twenty-three articles met the inclusion criteria. Out of them, nine studies used functional magnetic resonance imaging to show an additive, under-additive, over- additive, or a mixed activation pattern of the brain. Seven studies used near-infrared spectroscopy, and seven neurophysiological instruments. Yet a specific DT locus in the brain cannot be concluded from the overall current literature. Future studies are warranted to overcome the shortcomings identified.
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http://dx.doi.org/10.1016/j.neubiorev.2017.01.010DOI Listing
April 2017

Effectiveness of music-based interventions on motricity or cognitive functioning in neurological populations: a systematic review.

Eur J Phys Rehabil Med 2017 06 23;53(3):466-482. Epub 2016 Nov 23.

REVAL-BIOMED, University of Hasselt, Diepenbeek, Belgium.

Background: Motor and cognitive symptoms are frequent in persons with neurological disorders and often require extensive long-term rehabilitation. Recently, a variety of music-based interventions have been introduced into neurological rehabilitation as training tools.

Evidence Acquisition: This review aims to 1) describe and define music-based intervention modalities and content which are applied in experimental studies; and 2) describe the effects of these interventions on motor and/or cognitive symptoms in the neurological population. The databases PubMed and Web of Science were searched. Cited references of included articles where screened for potential inclusion. A systematic literature search up to 20th of June 2016 was conducted to include controlled trials and cohort studies that have used music-based interventions for ≥3 weeks in the neurological population (in- and outpatients) targeting motor and/or cognitive symptoms. No limitations to publication date was set. EVIDENCE SYNTHESISː Nineteen articles comprising thirteen randomized controlled trials (total participants Nexp=241, Nctrl=269), four controlled trials (Nexp=59, Nctrl=53) and two cohort studies (N.=27) were included. Fourteen studies were conducted in stroke, three in Parkinson's disease, and two in multiple sclerosis population. Modalities of music-based interventions were clustered into four groups: instrument-based, listening-based, rhythm-based, and multicomponent-based music interventions. Overall, studies consistently showed that music-based interventions had similar or larger effects than conventional rehabilitation on upper limb function (N.=16; fine motricity, hand and arm capacity, finger and hand tapping velocity/variability), mobility (N.=7; gait parameters), and cognition (N.=4; verbal memory and focused attention). CONCLUSIONSː Variety of modalities using music-based interventions has been identified and grouped into four clusters. Effects of interventions demonstrate an improvement in the domains assessed. Evidence is most available for improving motricity in stroke. More studies are warranted to investigate cognition as well as motor and cognition dysfunctions in combination. Instrument-based music interventions can improve fine motor dexterity and gross motor functions in stroke. Rhythm-based music interventions can improve gait parameters of velocity and cadence in stroke, Parkinson's disease and multiple sclerosis. Cognition in the domains of verbal memory and focused attention can improve after listening-based music interventions in stroke.
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http://dx.doi.org/10.23736/S1973-9087.16.04429-4DOI Listing
June 2017