Daniela Ivaldi

Background: People with multiple sclerosis (PwMS) often experience motor impairments that require long-term rehabilitation. In recent years, digital technologies such as mobile applications and sensor-based systems, have been explored as tools to support motor rehabilitation in this population. However, their implementation in real-world settings critically depends on usability, which influences user engagement, adherence, and integration into clinical practice. Objective: To systematically review the usability, acceptability, and preliminary clinical impact of digital rehabilitation interventions targeting motor function in pwMS. Methods: A systematic literature search was conducted in PubMed, Scopus, Embase, and Web of Science up to June 2025, to identify studies that evaluated usability within the context of motor rehabilitation interventions delivered through digital platforms. Only studies involving pwMS were included. Results: Nine studies were included. Interventions employed Kinect-based exergaming, mobile applications, pressure-sensitive platforms, and wearable sensors. Usability was generally high, with System Usability Scale (SUS) scores >70 in several studies. Adherence ranged from moderate to high, particularly when interventions incorporated real-time feedback, personalization, and user-centered design. Preliminary improvements were observed in gait speed, balance, cognitive-motor function, and physical activity levels. Conclusion: Digital rehabilitation tools demonstrate promising usability and feasibility for motor rehabilitation in pwMS. Personalized, interactive systems designed with user-centered approaches may enhance engagement and support behavioural activation. Future large-scale trials with standardized outcomes are needed to establish clinical effectiveness and inform integration into routine care. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251125034 , PROSPERO CRD420251125034.

Background: Group-based dance interventions (GBDIs) have emerged as a promising approach to rehabilitation for neurological disorders. This pilot study evaluated the feasibility and preliminary effects of a GBDI on motor function, cognition, fatigue, and quality of life in individuals with Relapsing–Remitting Multiple Sclerosis (RRMS). Methods: The intervention consisted of two 60-min ballet sessions per week over 10 weeks, structured as 10 min of warm-up, 40 min of ballet exercises, and 10 min of stretching. Assessments were conducted at baseline (T0) and post-intervention (T1). Concerning motor measures, balance was assessed using the Mini-BESTest; gait performance was evaluated through the 6-min walk test (6MWT), four square step test (FSST), and figure-of-8 walk test (F8WT); upper limb motor functions were assessed using the box and block test (BBT) and 9-hole peg test (9HPT). Regarding cognitive functions, the Rey auditory verbal learning test (RAVLT), symbol digit modalities test (SDMT), and trail making test A and B (TMT-A/B) were administered, while fatigue and quality of life were assessed using the modified fatigue impact scale (MFIS) and the Short Form survey-36 (SF-36), respectively. Results: At T1, participants improved in Mini-BESTest (+17.5%), 6MWT (+7.3%), and BBT dominant hand (+6.9%). Performance also improved on the following cognitive tests: RAVLT Immediate Recall (+5.9%), RAVLT Delayed Recall (+20.3%), SDMT (+47.4%), TMT-A (−21.2%), and (TMT-B −24.5%). Conclusions: The very small sample size (n = 4) and the lack of a control group probably restrict the generalizability of the findings. Consequently, the results obtained by this pilot study should be considered exploratory and hypothesis-generating rather than definitive evidence of a robust benefit. Future studies should confirm these findings by enlarging the intervention cohorts and adopting a randomized controlled design. In this sense, a 10-week GBDI may provide a solid base for a safe and promising dance-based rehabilitation program that could lead to improvements in motor, cognition, and psychosocial spheres in people with RRMS.

Background: Stroke remains a leading cause of long-term disability globally, frequently resulting in persistent motor and cognitive impairments. Rehabilitation is critical for promoting recovery, and dance-based interventions have emerged as a promising complementary approach. Objective: This scoping review aimed to examine the recent literature on the application of dance in stroke rehabilitation, with a particular focus on its effects on motor function (including balance and gait), cognitive performance, and quality of life. Methods: A comprehensive literature search was conducted across four electronic databases, PubMed, Embase, Web of Science, and Scopus, between January and March 2025. Studies were eligible for inclusion if they involved adult participants with a history of stroke, implemented dance-based rehabilitation interventions, and reported outcomes related to motor function, cognition, or psychosocial well-being. The review process adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results: Of the 778 records initially identified, four studies met the inclusion criteria: two randomized controlled trials, one interventional study, and one feasibility study. Overall, dance-based interventions were associated with improvements in dynamic balance, gait coordination, and general mobility. Furthermore, the interventions demonstrated high levels of adherence and participant satisfaction. Conclusions: Dance-based rehabilitation may offer meaningful motor benefits for individuals recovering from stroke, particularly in improving balance, gait, and overall mobility. However, the heterogeneity of intervention protocols and the limited assessment of cognitive and psychosocial outcomes underscore significant gaps in the current literature. To establish the efficacy and underlying mechanisms of dance-based approaches, future research should prioritize high-quality randomized controlled trials employing standardized intervention designs and comprehensive outcome measures, including cognitive and quality-of-life domains.

Background/Objectives: Multiple sclerosis (MS) is a chronic neurodegenerative disorder mainly affecting young adults and can greatly impair quality of life (QoL). Among its often overlooked but significant symptoms are bowel dysfunctions (BD), such as constipation and fecal incontinence, which can impact physical, emotional, and social well-being, especially in younger patients. This study aims to investigate the impact of BD on the QoL in young adults diagnosed with relapsing-remitting MS (RRMS) and mild disability. Methods: This retrospective cross-sectional study examined the effect of BD on QoL in 110 young adults with RRMS and mild disability (EDSS ≤ 3.5). Bowel symptoms were assessed using the Wexner Incontinence and Constipation Scales, while QoL was measured with the MSQoL-54 questionnaire. Statistical analyses were performed to examine correlations between BD severity and QoL domains. Results: Our findings showed significant correlations between the severity of intestinal symptoms and different domains of QoL, like physical functioning, emotional well-being, and social functioning. Abdominal pain and liquid fecal incontinence were especially linked to lower mental and physical health scores. Subgroup analyses also indicated gender-specific vulnerabilities, with women showing distinct effects on social and emotional dimensions. Conclusion: BD represents an important burden on bowel dysfunctions for young people with MS, deeply impacting various dimensions of QoL. This underscores an urgent need for an integrated, multidisciplinary care model that tackles physical symptoms but also psychological and social challenges. A holistic clinical strategy is vital to improving the overall well-being of this population.

Introduction: The figure-of-eight walk test (F8WT) assesses gait on a curved path, reflecting everyday walking complexity. Despite recognized validity among elderly individuals, its application in neurological disorders remains inadequately explored. This scoping review summarizes evidence regarding F8WT use, validity, and clinical applicability among individuals with neurological disorders. Methods: A systematic literature search was conducted in the PubMed, Scopus, Embase, and Web of Science databases. After reading the full text of the selected studies and applying predefined inclusion criteria, seven studies, involving participants with multiple sclerosis (n = 3 studies), Parkinson’s disease (n = 2 studies), and stroke (n = 2 studies), were included based on pertinence and relevance to the topic. Results: F8WT demonstrated strong reliability and validity across various neurological populations and correlated significantly with established measures of gait, balance, and disease severity. Preliminary evidence supports its ability to discriminate individuals at increased fall risk and detect subtle motor performance changes. Discussion: The F8WT emerges as a valuable tool, capturing multifaceted gait impairments often missed by linear walking assessments. Sensitive to subtle functional changes, it is suitable for tracking disease progression and intervention efficacy. Conclusions: F8WT is reliable and clinically relevant, effectively identifying subtle, complex walking impairments in neurological disorders.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia. The accurate and continuous monitoring of these symptoms is essential for optimizing treatment strategies and improving patient outcomes. Traditionally, clinical assessments have relied on scales and methods that often lack the ability for continuous, real-time monitoring and can be subject to interpretation bias. Recent advancements in wearable technologies, such as smartphones, smartwatches, and activity trackers (ATs), present a promising alternative for more consistent and objective monitoring. This review aims to evaluate the use of smartphones and smart wrist devices, like smartwatches and activity trackers, in the management of PD, assessing their effectiveness in symptom evaluation and monitoring and physical performance improvement. Studies were identified by searching in PubMed, Scopus, Web of Science, and Cochrane Library. Only 13 studies of 1027 were included in our review. Smartphones, smartwatches, and activity trackers showed a growing potential in the assessment, monitoring, and improvement of motor symptoms in people with PD, compared to clinical scales and research-grade sensors. Their relatively low cost, accessibility, and usability support their integration into real-world clinical practice and exhibit validity to support PD management.