Interoception and Sense of Movement in the Patient With Multiple Sclerosis

Multiple sclerosis (MS) is a chronically progressive, disabling, autoimmune disease that affects the central nervous system causing a wide spectrum of sensory, motor, and neuropsychiatric signs and symptoms. In the great part of patients with MS, there is a cognitive deficit that can start already in the early stages of the disease. Disability related to the disease is usually investigated through the Expanded Disability Status Scale (EDSS), however, the scale does not evaluate some very disabling aspects of the disease such as diplopia, fatigue and the impact of cognitive disorders.

The posture and postural self-correction are dependent on the image that anyone have of his own body and on the perception of it in the space, both internal and external. In multiple sclerosis proprioception and interoception are often altered due to motor and cognitive impairment.

The investigators propose a rehabilitative protocol that combine postural rehabilitation with specific visual-spatial tasks, relaxation sessions with self-awareness improvement and cognitive rehabilitation.

Inclusion criteria

• BMI<30
• Diagnosis of multiple sclerosis for less than 10 years
• Course of relapsing remitting type
• Relapse-free for at least 30 days
• EDSS score <2,5
• FDA-approved disease-modifying therapy for at least 6 months
• MMSE>24
• Public health guidelines for participating in physical activity

Exclusion criteria

• Other concurrent neurological and psychiatric diseases (like schizophrenia, bipolar disorder I or II and substance abuse disorders)
• Oncological diseases
• Cardiovascular disease, pacemaker carrier
• Diabetes
• Rheumatological diseases
• Scoliosis >20° Cobb
• Previous surgery on the spine
• Pregnancy
• Other physiotherapy in progress