Neurorehabilitation in Multiple Sclerosis: insights into fatigue and motor function

About this work This doctoral project aims to improve the overall knowledge on the effects of neurorehabilitation in People with Multiple Sclerosis (PwMS), by providing more insights on fatigue and the relationship between fatigue and motor functional aspects. The general introduction provides background information on the main topics of this doctoral project. In the first part, the specific disease characteristics of Multiple Sclerosis are described. In the second part, the current status of fatigue and motor impairment and a focus on the management are presented. Finally, the aims and outline thesis are reported. Four studies were conducted and reported in 4 different chapters. The first study provides information about the cardiac autonomic function during rest, postural changes and exercise and the relationship between autonomic modulation of heart rate and the perceived fatigue. The second study investigates the effect of an experimental rehabilitation protocol which combines aerobic training and task oriented exercises aimed to reduce fatigue and improve upper limb impairments and function. The third study provides information about preliminary effects of a high-intensity rehabilitative multimodal training protocol carried out on a treadmill aimed at improving mobility and balance. The fourth study shows the effectiveness of functional electrical stimulation on reducing falls, improving gait kinematics and promoting energy recovery. Lastly, general conclusions, including main findings and clinical implications, are provided at the end of the doctoral thesis.