Majid Mardaniyan Ghahfarokhi
Ebrahim Banitalebi
Mohammad Faramarzi
Robert Motl

Physical disability and cognitive impairment are common manifestations of multiple sclerosis (MS). Neurofunctional training is a specific intervention performed in realistic environments that have many beneficial effects in multiple sclerosis patient with cognitive impairment. This RCT investigated the effects of ۶ months home based neurofunctional training (HBNFT) vs. home based resistance training (HBRT) on physical performance and cognitive function in MS patients with mild cognitive impairment.Ninety-six males/females with MS (age ۱۸-۵۰ years, Expanded Disability Status Scale (EDSS) score ≤ ۶. processing speed score ≤ ۴۱.۵ as a diagnosis of cognitive impairment) were randomly assigned into HBNFT, HBRT and usual care (Control) groups. After one mouth (three sessions per week) center-based, supervised training, the participants completed ۶ moths (three sessions per week) of training program. Exercises were provided to the subjects through videos, brochures and DVDs at clinic visits (monthly). Physical performance (static and dynamic balance, timed up-and-go (TUG), six-minute walk test; (۶MWT), ۱۰-meter walking test; (۱۰MWT), timed ۲۵ toot walking test; (T۲۵FWT), five times sit to stand test; (۵TSTS), six spot step test; (SSST), and hand grip) were measured monthly. As well as, cognitive function (processing speed, learning and memory) were measured pre and post of exercise program. At all the stages of data analysis in this RCT, intention-to-treat (ITT) analysis was performed. Two-way repeated measures ANOVA employed to determine the main changes.Result: Result showed that HBNFT was well tolerated by patients with multiple sclerosis and resulted in no adverse events, while, there were some reports of pain, muscle cramps, and extreme fatigue among HBRT participant. Also, HBNFT and HBRT significantly improved physical performance and cognitive function compared to control (P≤۰.۰۵). HBNFT significantly improved some physical and cognitive domain (static and dynamic balance, ۶MWT, processing speed and learning) compared to HBRT (P≤۰.۰۵).HBNFT was more safe and feasible than HBRT that Recommend as approach for improving physical and cognitive performance in persons with MS who had cognitive impairment.

home-based exercise training؛ Physical function؛ Cognition؛ Multiple Sclerosis