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Erschienen in:

01.05.2020 | Original Article

Premorbid functional reserve modulates the effect of rehabilitation in multiple sclerosis

verfasst von: Letizia Castelli, Laura De Giglio, Shalom Haggiag, Arianna Traini, Francesca De Luca, Serena Ruggieri, Luca Prosperini

Erschienen in: Neurological Sciences | Ausgabe 5/2020

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Abstract

Background

Premorbid physically and intellectually enriching lifestyles have increasingly been recognized as able to mitigate the risk of disease-related disability in patients with multiple sclerosis (MS).

Objective

To explore if premorbid physical activity, cognitive reserve and trait personality act as proxies for functional reserve that contributes to rehabilitation outcome.

Methods

We recruited all patients previously enrolled in two pilot trials investigating the effect of home-based video game training in improving balance (Study 1) and attention (Study 2) for additional assessments with the Historical Leisure Activity Questionnaire (HLAQ; a proxy for premorbid physical activity), Cognitive Reserve Index Questionnaire (CRIQ), and Temperament and Character Inventory (TCI). Hierarchical logistic regression (HLR) analyses tested the association of HLAQ, CRIQ, and TCI with training effect on balance (static posturography) and on attention (Symbol Digit Modalities Test).

Results

We identified 94% (34/36) and 74% (26/35) of patients participating at the original Study 1 and Study 2, respectively. HLR analyses showed an exclusive “intra-modal” modulation of rehabilitation outcome by functional reserve, given that (1) larger training effect on balance was associated with higher HLAQ (OR = 2.03, p = 0.031); (2) larger training effect on attention was associated with higher CRIQ (OR = 1.27, p = 0.033). Furthermore, we found specific personality traits associated with (1) greater training effect on balance (self-directedness; OR = 1.40, p = 0.051) and lower training effect on attention (harm avoidance; OR = 0.66, p = 0.075).

Conclusion

We hypothesize that premorbid physical and intellectual activities not only act as a buffer for limiting the MS-related damage but also as functional reserve that can be retrieved by task-oriented training to promote recovery through rehabilitation.
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Metadaten
Titel
Premorbid functional reserve modulates the effect of rehabilitation in multiple sclerosis
verfasst von
Letizia Castelli
Laura De Giglio
Shalom Haggiag
Arianna Traini
Francesca De Luca
Serena Ruggieri
Luca Prosperini
Publikationsdatum
01.05.2020
Verlag
Springer International Publishing
Erschienen in
Neurological Sciences / Ausgabe 5/2020
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-019-04237-z

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