The Effects of a 12-week In-phase Bilateral Exercise Programme on the Corticospinal Plasticity in People With Progressive Multiple Sclerosis

This study investigates whether a structured exercise program using coordinated movements of both arms can improve brain and motor function in people with Progressive Multiple Sclerosis (MS). Progressive MS is associated with gradual worsening of neurological function, including difficulties with movement, strength, balance, and cognition. Because current medications have limited effects on disease progression, rehabilitation strategies that promote brain plasticity and functional recovery are increasingly important. In this study, five individuals with Progressive Multiple Sclerosis participated in a 12-week exercise program consisting of in-phase bilateral upper-limb movements performed three times per week. Brain activity related to movement was measured using transcranial magnetic stimulation (TMS), which assessed corticospinal excitability through active motor threshold measurements. Additional clinical tests evaluated walking speed, balance, hand dexterity, muscle strength, cognitive processing speed, fatigue, and quality of life. The study used a single-case experimental design with repeated measurements during baseline and intervention phases to determine whether the exercise program produced measurable neurophysiological and functional changes.