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Neurorehabilitation in Multiple Sclerosis Approaches


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Journal of
Clinical Medicine
Review
Neurorehabilitation in Multiple Sclerosis—A Review of Present Approaches and Future Considerations
Carmen Adella Sîrbu 1 Dragos, Cătălin Jianu 6
, Dana-Claudia Thompson 2,3, Florentina Cristina Plesa 1,4,*, Titus Mihai Vasile 1,5,*, , Marian Mitrica 4, Daniela Anghel 7,† and Constantin Stefani 8,9,†
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* Correspondence: plesacristina@yahoo.com (F.C.P.); mtvasile@yahoo.com (T.M.V.) † These authors contributed equally to this work as co-last authors.
Abstract: Multiple sclerosis is an increasingly prevalent disease, representing the leading cause of non-traumatic neurological disease in Europe and North America. The most common symptoms include gait deficits, balance and coordination impairments, fatigue, spasticity, dysphagia and an overactive bladder. Neurorehabilitation therapeutic approaches aim to alleviate symptoms and improve the quality of life through promoting positive immunological transformations and neuro- plasticity. The purpose of this study is to evaluate the current treatments for the most debilitating symptoms in multiple sclerosis, identify areas for future improvement, and provide a reference guide for practitioners in the field. It analyzes the most cited procedures currently in use for the management of a number of symptoms affecting the majority of patients with multiple sclerosis, from different training routines to cognitive rehabilitation and therapies using physical agents, such as electrostimulation, hydrotherapy, cryotherapy and electromagnetic fields. Furthermore, it inves- tigates the quality of evidence for the aforementioned therapies and the different tests applied in practice to assess their utility. Lastly, the study looks at potential future candidates for the treatment and evaluation of patients with multiple sclerosis and the supposed benefits they could bring in clinical settings.
Keywords: multiple sclerosis; rehabilitation; gait; balance; fatigue; spasticity; dysphagia; overactive bladder; neurorehabilitation
1. Introduction
Multiple sclerosis (MS) is an immunologically driven pathology affecting the central nervous system, characterized by chronic inflammation and progressive demyelinating lesions, with an unidentified etiology [1]. MS is currently affecting 2.8 million people worldwide, while in North America and Europe it is the leading cause of chronic non- traumatic neurological disease in young adults [2]. The prevalence is higher in women
Department of Neurology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital,
010242 Bucharest, Romania
Department of Rehabilitation Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania Alessandrescu-Rusescu National Institute for Mother and Child Health,
Fetal Medicine Excellence Research Center, 020395 Bucharest, Romania
Department of Preclinical Disciplines, Titu Maiorescu University, 031593 Bucharest, Romania
Clinical Neurosciences Department, University of Medicine and Pharmacy “Carol Davila”,
050474 Bucharest, Romania
Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Department of Neurology, Faculty of Medicine, “Victor Babes, ” University of Medicine and Pharmacy, 300041 Timis, oara, Romania Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University,
031593 Bucharest, Romania
Department of Family Medicine and Clinical Base, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania
Department No. 5, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
Citation: Sîrbu, C.A.; Thompson, D.-C.; Plesa, F.C.; Vasile, T.M.; Jianu, D.C.; Mitrica, M.; Anghel, D.; Stefani, C. Neurorehabilitation in Multiple Sclerosis—A Review of Present Approaches and Future Considerations. J. Clin. Med. 2022, 11, 7003. https://doi.org/10.3390/ jcm11237003
Academic Editors: Hideki Nakano, Akiyoshi Matsugi, Naoki Yoshida and Yohei Okada
Received: 6 November 2022 Accepted: 24 November 2022 Published: 27 November 2022
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations.
Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
J. Clin. Med. 2022, 11, 7003. https://doi.org/10.3390/jcm11237003 https://www.mdpi.com/journal/jcm

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