New Technological-Based Approach to Intensive Physical Therapy in Patients with Multiple Sclerosis; Recommendations for Best Practice and Future Directions

Multiple sclerosis (MS) is a chronic and inflammatory disease of the brain and spinal cord characterized by focal demyelination and axon destruction. MS causes many symptoms such as motor, sensory, visual, and autonomic disorders, and also impairs physical and cognitive functions. Balance problems and limited gait cause fear of falling and decreased multitasking performance. Physiotherapy is one of the most important treatment options and is frequently used for managing symptoms in patients with MS. It is critical that rehabilitative interventions should comprehensively manage and control abovementioned symptoms in the patients with MS. New technological based approach has provided new possibilities for neuro-rehabilitation. Along with technological developments, the multiple symptoms of MS can be managed. Here, the clinical goal is to reach an important principle of neuro-rehabilitation and motor learning, the "concept of practice". The concept of practice is known as a critical principle in neuro-rehabilitation that should contain three main characteristics modified in MS, including "optimal intensity", "optimal repetition" and "functional". Technology-based rehabilitation, as a sensory-motor-cognitive network, provides multisensory feedback and allows therapist to control quantitatively and adjust the therapeutic parameters such as duration, intensity and frequency in a planned manner. It also allows to create an intensive and motivational context to transform the patients from a passive element to an active participant in compliance with the treatment regimen. Therefore, new technological approach provides various advantages in patients with MS with providing goal-specific training based on motor learning principles, and enabling objective evaluation of functional performance.