Multiple sclerosis and related disorders最新文献

{"title":"Genetic and environmental mediators of multiple sclerosis susceptibility but not early severity run in families","authors":"Cato E.A. Corsten ,&nbsp;Ana M. Marques ,&nbsp;Yifan van Hasselt ,&nbsp;Jeroen van Rooij ,&nbsp;Ide Smets ,&nbsp;Marvin M. van Luijn ,&nbsp;Rinze F. Neuteboom ,&nbsp;Beatrijs Wokke ,&nbsp;Joost Smolders","doi":"10.1016/j.msard.2026.107101","DOIUrl":"10.1016/j.msard.2026.107101","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) susceptibility and severity are mediated by different genetic and environmental risk factors. Familial aggregation in MS is partially explained by susceptibility determinants, yet impact on early disease course after clinically isolated syndrome (CIS) is uncertain. We investigated associations of reported familial MS with genetic and environmental risk factors, and with clinical presentation and disease course after CIS.</div></div><div><h3>Methods</h3><div>CIS participants were included in a prospective cohort within six months after symptom onset. Family history was assessed at baseline. We evaluated weighted genetic risk scores (wGRS) for MS susceptibility, 25-hydroxyvitamin D (25(OH)D) and body mass index (BMI), and determined HLA-DRB1*15:01 and MS severity SNP rs10191329 carriership. Anti-Epstein Barr virus Nuclear Antigen-1 (anti-EBNA1) IgG antibodies and 25(OH)D levels were measured. Disease course associations were estimated with Cox regression.</div></div><div><h3>Results</h3><div>Family members with MS were reported by 81/415 (19.5%) CIS participants. Familial MS was associated with higher MS susceptibility wGRS (7.54 (SD1.17) vs. 7.19 (SD1.22), p=0.04) and more frequent HLA-DRB1*15:01 carriership (first-degree 66.7%, other-degree 30.2%, no 38.4%, p=0.02). Anti-EBNA1 IgG and 25(OH)D levels did not differ, yet wGRS for lower 25(OH)D and higher adult BMI characterised MS participants with first-degree MS relatives. Baseline characteristics and disease severity measures were similar between participants with and without familial MS.</div></div><div><h3>Conclusion</h3><div>Our results confirm that familial MS is associated with enrichment of genetic risk for MS susceptibility, low 25(OH)D and high BMI, but not with early disease course after CIS. These data support that MS susceptibility and disease course are driven by different pathophysiological processes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107101"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional cycling ergometry with or without electrical stimulation in individuals with secondary progressive multiple sclerosis: A randomized controlled trial","authors":"Alexandra C. Simpson ,&nbsp;Jennifer Keller ,&nbsp;Thomas Shoemaker ,&nbsp;Julie Fiol ,&nbsp;Michael Comisac ,&nbsp;Daniel Becker ,&nbsp;Sandra D. Cassard ,&nbsp;Kathleen Zackowski ,&nbsp;Scott D. Newsome","doi":"10.1016/j.msard.2026.107095","DOIUrl":"10.1016/j.msard.2026.107095","url":null,"abstract":"<div><h3>Background</h3><div>People with secondary progressive multiple sclerosis (PwSPMS) experience symptoms impacting their ability to walk or exercise. Functional electrical stimulation (FES) cycling is a promising, safe therapeutic intervention for MS, but relatively little is known about its use in PwSPMS with moderate to severe disability.</div></div><div><h3>Objective</h3><div>To determine effects of active FES and passive cycling on walking speed and other disability measures in PwSPMS.</div></div><div><h3>Methods</h3><div>PwSPMS and Expanded Disability Status Scale (EDSS) 5.0–7.0 were randomized to a 12-week FES-assisted or passive (control) cycling intervention. The primary outcome was change in Timed 25-Foot Walk (T25FW [s]) pre-post intervention. Secondary outcomes assessed functional mobility (Timed Up and Go [TUG], 2-Minute Walk Test), strength, disability, cognition and quality of life.</div></div><div><h3>Results</h3><div>Fourteen participants completed the intervention (8 active FES; 6 passive). One active FES cyclist with an unrelated injury was excluded from analysis. Mean ±SD age was 54.1 ± 8.9 years and 85 % were female. Participants tolerated the intervention. No significant differences were observed between participants receiving FES compared to passive cycling in any measures. Within groups, FES cyclists trended towards but did not reach significant improvement in T25FW (10.2 to 8.4 s; <em>p</em> = 0.08), while passive cyclists significantly improved in TUG (12.4 to 11.6 s; <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Change in ambulatory function did not differ in participants receiving FES versus passive cycling. Within-group improvement occurred in isolated measures and no adverse events occurred, demonstrating feasibility and acceptability. Longer interventions may be necessary to demonstrate improvements beyond lack of decline, given greater baseline disability in this population.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107095"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access and barriers to diagnosis of multiple sclerosis in Iran - A clinician survey","authors":"Sanaz Khodadadi ,&nbsp;Sahar Nikkhah Bahrami ,&nbsp;Shima Jahani ,&nbsp;Mohammad Ali Sahraian ,&nbsp;Andrew J. Solomon","doi":"10.1016/j.msard.2026.107089","DOIUrl":"10.1016/j.msard.2026.107089","url":null,"abstract":"<div><h3>Background</h3><div>Timely diagnosis of multiple sclerosis (MS) is critical for optimal outcomes, but delays are common, particularly in resource-limited settings. This study investigates the barriers to MS diagnosis in Iran from the perspectives of neurologists.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using a questionnaire adapted from the MS International Federation (MSIF) Atlas of MS, 3rd Edition, and the 2024 Topical Survey, administered via an online platform to Iranian neurologists. Data collection occurred from April 1, 2024, to June 30, 2024.</div></div><div><h3>Results</h3><div>The survey received responses from 103 neurologists (34.1 % response rate), of whom 64 were general neurologists (GN) and 39 were MS specialists (NMS). Eighty percent reported at least one 'major barrier' to early MS diagnosis. These barriers included a lack of public (43.7 %) and healthcare provider (37.9 %) awareness of MS symptoms and patient reluctance to undergo testing due to social stigma (77.3 %). Access to paraclinical testing, including visual evoked potentials (VEP), optical coherence tomography (OCT), MOG-IgG, and AQP4-IgG testing, was variable. Most respondents (98.05 %) reported adherence to national guidelines, yet 4 % of NMS and 16 % of GN reported that they did not use the McDonald criteria.</div></div><div><h3>Conclusions</h3><div>Barriers to timely MS diagnosis in Iran are multifactorial, involving public awareness, healthcare professional education, and access to adequate resources. Addressing these issues through targeted education and improved infrastructure is essential.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107089"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning model predicts prognosis in SARS-CoV-2-infected autoimmune encephalitis patients","authors":"Xingjie Li ,&nbsp;Xueying Kong ,&nbsp;Aiqing Li ,&nbsp;Xue Gong ,&nbsp;Kundian Guo ,&nbsp;Xu Liu ,&nbsp;Yue Liu ,&nbsp;Tianyu Zhang ,&nbsp;Xiaolin Deng ,&nbsp;Jinmei Li ,&nbsp;Dong Zhou ,&nbsp;Zhen Hong","doi":"10.1016/j.msard.2026.107028","DOIUrl":"10.1016/j.msard.2026.107028","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the neurological prognosis of patients with autoimmune encephalitis (AE) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and construct risk prediction models for a worse prognosis.</div></div><div><h3>Methods</h3><div>This was a prospective, multicenter, observational cohort study. Patients with AE, with or without SARS-CoV-2, were followed up every 3 months. Multivariate logistic regression was used to identify factors influencing neurological prognosis. Prediction models were created using nine machine-learning strategies.</div></div><div><h3>Results</h3><div>SARS-CoV-2 infection was noted in 241 of 308 patients. Multivariate logistic regression showed inactivated immunizations plus recombinant or adenovirus vector vaccines protected against SARS-CoV-2 infection (odds ratio [OR] 0.05, 95% confidence interval [CI] 0.01–0.52, <em>p</em> = 0.01). Three months after infection, 12.4% of patients with stable AE had a worse neurological prognosis, 6.2% failed to recover their working conditions. Pre-infection modified Rankin Scale (mRS) = 1 (OR 4.06, 95% CI 1.11–14.91, <em>p</em> = 0.04) and mRS &gt; 1 (OR 13.4, 95% CI 3.31–54.02, <em>p</em> &lt; 0.01), immunotherapy during infection (OR 5.1, 95% CI 1.65–15.79, <em>p</em> = 0.01), and SARS-CoV-2-related drowsiness (OR 19.5, 95% CI 5.42–70.34, <em>p</em> &lt; 0.01) and gastrointestinal symptoms (OR 4.4, 95% CI 1.58–11.96, <em>p</em> &lt; 0.01) were identified as risk factors for worse prognosis. The ranger model(<span><span>https://xingjieli1999.shinyapps.io/clinical_prediction_app/</span><svg><path></path></svg></span>) using these four parameters showed a discrimination accuracy of 0.96 (95% CI 0.94–0.99).</div></div><div><h3>Conclusions</h3><div>Patients with AE could experience exacerbated neurological symptoms following SARS-CoV-2 infection. Machine-learning algorithms showed feasibility of predicting prognoses based on clinical information in patients with AE.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107028"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of PLISSIT model-based counseling on the sexual life of women with multiple sclerosis: A systematic review and meta-analysis","authors":"İlknur Özkan ,&nbsp;Seçil Taylan ,&nbsp;Cansu Polat Dünya","doi":"10.1016/j.msard.2026.107110","DOIUrl":"10.1016/j.msard.2026.107110","url":null,"abstract":"<div><h3>Background</h3><div>Women with Multiple Sclerosis (MS) face significant challenges in their sexual life, including physical limitations and emotional barriers. The PLISSIT model offers a structured framework for counselors to address these issues effectively. This study aimed to investigate the effects of counseling interventions based on the PLISSIT model on the sexual life of women with MS through randomized controlled trials.</div></div><div><h3>Methods</h3><div>This was a systematic review and meta-analysis study. Databases such as Google Scholar, OpenAIRE, Web of Science, Social Sciences Citation Index, Academic Search Ultimate, Complementary Index, Scopus, CINAHL Complete, MEDLINE, and PubMed were searched for English-language studies without year restrictions up to February 2024. The PRISMA guidelines were followed. Comprehensive Meta-Analysis 3 software was used for data analysis. Two researchers independently assessed the quality of the included studies using the Cochrane Collaboration tool.</div></div><div><h3>Results</h3><div>Three randomized controlled trials with a total of 232 participants were included in this study. Counseling based on the PLISSIT model was found to have a high and positive effect on the sexual life of women with MS (Hedges' <em>g</em> = 0.927, 95 % CI = -1.122 to 2.976, <em>p</em> = 0.375).</div></div><div><h3>Conclusions</h3><div>This meta-analysis suggests that sexual counseling based on the PLISSIT model may have a positive impact on the sexual life of women with MS, although statistically significant results were not obtained. Future research with larger sample sizes and more homogeneous study groups may provide clearer results.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107110"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Reproductive and Clinical Variables to Predict Postpartum Disability Outcomes in Multiple Sclerosis Using Machine Learning","authors":"Murat Emec ,&nbsp;Said Alizada ,&nbsp;Yasemin Simsek ,&nbsp;Ulvi Samadzade ,&nbsp;Mehmet Hilal Ozcanhan ,&nbsp;Serkan Ozakbas","doi":"10.1016/j.msard.2026.107107","DOIUrl":"10.1016/j.msard.2026.107107","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy represents a unique immunological state in women with multiple sclerosis (MS), and postpartum disease reactivation is a major concern. While pregnancy outcomes have been extensively described, the long-term effects of reproductive and obstetric variables on disability progression remain poorly elucidated.</div></div><div><h3>Objective</h3><div>To predict postpartum EDSS-based disability change based on pregnancy-related clinical and demographic variables in women with MS, using validated machine learning models.</div></div><div><h3>Methods</h3><div>This retrospective real-world study included 662 women contributing 909 pregnancies. Engineered features included pre- and post-pregnancy Expanded Disability Status Scale (EDSS) scores, disease duration, maternal age, postpartum relapse, and obstetric variables. Regression and classification models (Random Forest, XGBoost, Elastic Net, Support Vector Classifier) were trained on an 80/20 train–test split with five-fold cross-validation. Model performance was assessed using R², mean absolute error (MAE), accuracy, and F1 score.</div></div><div><h3>Results</h3><div>Classification models achieved superior generalization performance (test accuracy 85–88%, F1 0.84–0.87) compared to regression models (test R² 0.31–0.39, MAE 0.41–0.48). Postpartum relapse was the strongest predictor of disability change, followed by disease duration and age at pregnancy. Predictive performance was highest among women with multiple pregnancies, suggesting that cumulative reproductive history carries prognostic value. Obstetric variables such as delivery type and breastfeeding contributed secondary but clinically relevant effects.</div></div><div><h3>Conclusion</h3><div>Machine learning models integrating pregnancy-related variables can provide clinically informative predictions regarding postpartum EDSS-based disability change in women with MS. Postpartum relapse remains the dominant driver of disability change, while reproductive and obstetric factors provide additional prognostic information. These findings highlight the postpartum period as a critical therapeutic window and support incorporating reproductive variables into individualized prognostic frameworks for women with MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107107"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross sectional analyses indicated that body fat distribution was not associated with performance-based and self-reported outcomes among ambulatory people with multiple sclerosis","authors":"Ariel Kidwell-Chandler,&nbsp;Brenda Jeng,&nbsp;Robert W. Motl","doi":"10.1016/j.msard.2026.107084","DOIUrl":"10.1016/j.msard.2026.107084","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is cited as a relevant factor in multiple sclerosis (MS). To date, there is inconsistent evidence regarding the relationship between total body fat and frequently studied outcomes in MS. Body fat distribution, or the location of adipose tissue and depots within the body, may represent a biologically meaningful correlate of MS-related outcomes.</div></div><div><h3>Purpose</h3><div>This exploratory study assessed whether dual-energy X-ray absorptiometry (DXA)-based body fat distribution metrics were associated with performance-based and self-reported outcomes of MS.</div></div><div><h3>Methods</h3><div>Fifty-seven ambulatory adults with MS underwent DXA to quantify visceral and subcutaneous adipose tissue; android- and gynoid- % fat mass; and android/gynoid ratio. Outcomes included performance-based (Timed Up and Go, Timed 25-Foot Walk, Six-Minute Walk) and self-reported assessments (Hospital Anxiety and Depression Scale anxiety and depression [HADS-D] sub-scales), Multiple Sclerosis Impact Scale physical [MSIS Physical] and psychological domains, Fatigue Severity Scale, and the short form of the McGill Pain Questionnaire). Spearman correlation assessed bivariate and partial (controlling for sex and age) associations.</div></div><div><h3>Results</h3><div>Correlations between body fat distribution metrics and performance-based and self-reported outcomes were generally small and not statistically significant. Gynoid % fat mass correlated with depressive symptoms (HADS-D: <em>r_s</em> = –.28, <em>p</em> = .033) and physical health-related quality of life (MSIS Physical: <em>r_s</em> = –.31, <em>p</em> = .018), but partial correlations were not statistically significant.</div></div><div><h3>Conclusion</h3><div>Our results did not support an association between body fat distribution and frequently studied MS-related outcomes. This aligns with research suggesting a limited role of adiposity and MS-related outcomes.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107084"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of postpartum infection after cesarean section in women with multiple sclerosis: A population-based cohort study","authors":"Mette Louise Andersen ,&nbsp;Line Riis Jølving ,&nbsp;Maria Iachina ,&nbsp;Egon Stenager ,&nbsp;Torben Knudsen ,&nbsp;Bente Mertz Nørgård","doi":"10.1016/j.msard.2026.107076","DOIUrl":"10.1016/j.msard.2026.107076","url":null,"abstract":"<div><h3>Objective</h3><div>Cesarean section (CS) rates are increased in women with multiple sclerosis (MS). It is unknown whether CS in women with MS constitutes a risk of maternal postpartum infection compared to vaginal delivery.</div></div><div><h3>Methods</h3><div>We used the Danish national health registers to establish a cohort of all live births by women with MS in Denmark from 1995 to 2023. We estimated the risk of maternal postpartum infections according to the mode of delivery in women with MS using logistic regression models adjusted for confounders such as age, body mass index, and comorbidity.</div></div><div><h3>Results</h3><div>Overall, 872 women with MS gave birth to their child by CS, and 2542 women with MS had a vaginal birth. Within the postpartum period of 42 days, 21.0% with CS and 14.1% with vaginal birth had an infectious complication. The overall risk of infections among women with MS giving birth by CS, relative to those with vaginal delivery, was an adjusted odds ratio (aOR) of 1.54, 95% confidence interval (95% CI 1.18–2.01). The risk of mild to moderate infections (prescriptions of antibiotics) was aOR 1.60 (95% CI 1.24–2.08), and the risk of severe infections (hospital-diagnosed) was aOR 1.55 (95% CI 0.82–2.94).</div></div><div><h3>Conclusion</h3><div>Women with MS who give birth by CS have an increased risk of postpartum infection compared to women with MS who give birth vaginally. This is important to be aware of since infection can cause worsening of neurological symptoms or trigger a new relapse in patients with MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107076"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and concurrent validity of L test under dual-task conditions in people with multiple sclerosis","authors":"Meltem Uzun ,&nbsp;Hakan Polat ,&nbsp;Zekiye İpek Katirci Kirmaci ,&nbsp;Yasemin Ekmekyapar Firat ,&nbsp;Suat Erel","doi":"10.1016/j.msard.2026.107085","DOIUrl":"10.1016/j.msard.2026.107085","url":null,"abstract":"<div><div>Functional assessments of mobility are crucial for managing the symptoms of people with Multiple Sclerosis(pwMS). Impairment in dual-task skills, which is seen in pwMS, can have a negative effect on daily living activities. The purpose of this study was to determine validity and the intra-rater and inter-rater reliability of the L-test under dual-task conditions in pwMS. In total, 47 pwMS were included in the study. The L-test with single and dual task was administered along with the timed up and go (TUG) test, 25-foot walk (T25-FW) test by two rater. The tests were repeated seven to ten days later. According to the results of the study; the intra-rater and inter-rater reliabilities of the L-test under dual-task conditions were excellent (intraclass correlation coefficient intra-rater= 0.915, 0.922 and inter-rater= 0.96, 0.970), a significant positive relationship was found between the L test in dual-task conditions and the TUG (p &lt; 0.001, r = 0.673), the T25-FW (p = 0.024, r = 0.328), and the L test with single and the TUG and the T25-FW (p &lt; 0.001, r = 0.743, p= 0.002, r = 0.432) The L test under dual-task conditions is a reliable and valid tool for the assessment of cognitive ability on functional mobility in PwMS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107085"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a practical documentation of inpatient rehabilitation goals, therapy content and outcomes for improving mobility in people with multiple sclerosis in Austria: A multicentre single-arm pragmatic clinical trial","authors":"Andreas Wanitschek ,&nbsp;Barbara Seebacher ,&nbsp;Barbara Linert ,&nbsp;Andreas Mühlbacher ,&nbsp;Robert Hatschenberger ,&nbsp;Nicole Kranawetter ,&nbsp;Lisa Tischler ,&nbsp;Monika Scarpatetti ,&nbsp;Verena Walder ,&nbsp;Alexandra Holzinger ,&nbsp;Bernhard Haider ,&nbsp;Doris Hörtenhuber ,&nbsp;Eva Kronberger-Schaffer ,&nbsp;Viktoria Mangold ,&nbsp;Christian Brenneis ,&nbsp;Rainer Ehling","doi":"10.1016/j.msard.2026.107100","DOIUrl":"10.1016/j.msard.2026.107100","url":null,"abstract":"<div><h3>Background</h3><div>Improved understanding of effective therapeutic interventions (TI) is required to optimise mobility outcomes in people with multiple sclerosis (pwMS) undergoing multidisciplinary neurological rehabilitation (MNR). The primary objective was to explore clinically meaningful effects of active TI on mobility during inpatient MNR. Secondary objectives were to assess mobility-related goal attainment and to develop and evaluate a standardised TI documentation catalogue.</div></div><div><h3>Methods</h3><div>A TI catalogue and manual were developed and refined based on moderate interrater reliability from 12 video-recorded therapy sessions rated by eight clinicians. Usability was assessed by 47 physiotherapists using the System Usability Scale (SUS). Mobility outcomes included the 12-item Multiple Sclerosis Walking Scale (MSWS-12), 2-Minute Walk Test (2 MWT), Five Times Sit-to-Stand Test (5-TSTS), and Timed 25-Foot Walk. Effect sizes were calculated for individual and group-based TI. Goal attainment was measured using Goal Attainment Scaling.</div></div><div><h3>Results</h3><div>The TI catalogue showed good usability (mean SUS score 72.3). Significant improvements were observed across all mobility outcomes, with clinically meaningful changes for MSWS-12, 2MWT and 5-TSTS. Gait training variants, robot-assisted gait training, strength, task-oriented, dual-task, endurance, coordination, and balance training showed medium-to-large effect sizes. Goal achievers demonstrated significantly greater improvements in walking perception, speed, and distance than non-achievers, with no difference in sit-to-stand performance. Over 88% of 255 pwMS achieved or exceeded their therapy goals.</div></div><div><h3>Conclusions</h3><div>The TI catalogue is a reliable and practical tool for documenting TI in routine MNR. Several interventions, particularly stair gait training, strength training, and robot-assisted gait training, were associated with clinically meaningful mobility improvements in pwMS.</div></div><div><h3>Trial registration</h3><div>The study was prospectively registered with the German Clinical Trials Register (DRKS00025216 and DRKS00030391).</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"109 ","pages":"Article 107100"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}