Clinical Trial: Occupational Therapy in Patients With Multiple Sclerosis
Study Status: Completed
Recruit Status: Completed
Study Type: Interventional
Official Title: Apraxia-specific Occupational Therapy in Patients With Multiple Sclerosis
Brief Summary:
Limb apraxia is defined as the inability to correctly perform skilled and/or learned limb movements, which cannot be explained by elementary motor and sensory deficits or cognitive problems. Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system and the leading cause of disability in young adults. Apraxia and impaired manual dexterity are common problems in patients with MS leading to impaired activities of daily living. However, a specific training program to improve apraxia as well as manual dexterity in MS is lacking.
In this study, the investigators want to evaluate the impact of a targeted occupational therapy program on apraxia and manual dexterity in patients with MS that have dexterity problems.
Patients routinely seen in the investigators MS consulting hour, fulfilling all inclusion and exclusion criteria and willing to participate in the study will be evaluated for Apraxia and manual dexterity. In case of Apraxia and/or impaired manual dexterity, patients will be randomized 1:1 using sealed envelopes to receive occupational home therapy (experimental group) or general physical exercises (control group) for 4 weeks.
At study entry and study end after 4 weeks, apraxia and manual dexterity will be tested in all patients.
Detailed Summary:
Background
Limb apraxia is defined as the inability to correctly perform skilled and/or learned limb movements, which cannot be explained by elementary motor and sensory deficits or cognitive problems. It impairs real object/tool use as well as pantomime and imitation of gestures affecting both sides of the body and can be a major source of disability independent of other neurological deficits. It significantly affects activities of daily living (ADL) and is associated with poorer outcome for independent living or return to work.
Apraxia is largely based on left parieto-frontal damage due to focal injury or more widespread neurodegeneration of cortical areas and/or their connections. However, apraxia has been described in damage of the right hemisphere, although less frequent and severe.
Apraxia is increasingly recognized as a clinical problem in restorative neurology and various approaches were described how to treat the disorder.
Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system and the leading cause of disability in young adults. It is characterized by focal demyelination as well as axonal damage. MS has been classically thought of as a typical white matter disorder. However, early pathology studies and recent magnetic resonance tomography (MRI) studies show demyelination in the cortex and deep gray matter nuclei. Grey matter damage starts early in the disease and substantially affects cognitive functioning.
Apraxia and impaired manual dexterity are common problems in MS leading to impaired activities of daily living. However, a specific training program to improve apraxia and manual dexterity in MS is lacking. In this study, we want t
Sponsor: University Hospital Inselspital, Berne
Current Primary Outcome: Change in apraxia score as measured by TULIA [ Time Frame: From day of randomisation to end of study, expected to be after 4 weeks ]
Original Primary Outcome: Same as current
Current Secondary Outcome:
- Change in manual dexterity [ Time Frame: From day of randomisation to end of study, expected to be after 4 weeks ]Measured by the coin rotation task and 9-hole-peg-test
- Change in activities of daily living [ Time Frame: From day of randomisation to end of study, expected to be after 4 weeks ]Measured by questionnaire
- Change in quality of life [ Time Frame: From day of randomisation to end of study, expected to be after 4 weeks ]Measured by questionnaire
- Change in fatigue [ Time Frame: From day of randomisation to end of study, expected to be after 4 weeks ]Measured by questionnaire
Original Secondary Outcome: Same as current
Information By: University Hospital Inselspital, Berne
Dates:
Date Received: January 4, 2012
Date Started: January 2012
Date Completion:
Last Updated: May 14, 2013
Last Verified: May 2013
