USask rehabilitation research helping MS patients maximize their goals
For Canadians diagnosed with neurodegenerative diseases like Multiple Sclerosis (MS), losing the ability to do the things they love is a real fear. And while breakthroughs in drug treatments have helped slow the progression of MS, there is still more to be done to ensure that people affected are able to keep living active and engaged lives.
By Erin Matthews, Research Profile and ImpactUSask researcher Dr. Sarah Donkers (PhD), an associate professor in the School of Rehabilitation Science, believes rehabilitation is a crucial component of MS care that gives people this opportunity, but it is often overlooked.
“MS has both an inflammatory component and a neurodegenerative component. And while there have been a lot of breakthrough therapies for that inflammatory component, there is still neurodegeneration and accumulating disability that occurs. Rehab is a critical component to halt or at least help slow that down,” said Donkers.
Donkers is part of a multidisciplinary research network known as MSCanRehab, specialists who are passionate about transforming care for people with MS through increased research into rehabilitation approaches and multidisciplinary initiatives and innovation in neurorecovery.
“Typically, as this neurodegeneration progresses, people are given mobility aids to help with their decline, which is important, but not comprehensive,” said Donkers. “We don’t have a system where we intervene early, try to maximize what you have, and focus on functional training across varying ability levels. There is growing evidence that this neurorecovery approach to rehabilitation can help give people the opportunity for improved skills, functional abilities, and overall brain health.”
Donkers and her team — co-led by Dr. Lara Pilutti (PhD) of the University of Ottawa — are looking to see how they can maximize the outcomes of rehabilitation for people with MS who are in the progressive stage of the disease. For the new study, the team is looking at the impacts of brain priming on training efforts and outcomes. They will be conducting a large-scale multi-site international research trial.
According to Donkers, “priming” the brain prior to rehabilitation training can enhance its ability to learn, and the team is using two different approaches to achieve this. In this study, MS participants will either receive transcranial direct current stimulation — a device which provides the brain with electrical currents that stimulate neurons — or perform aerobic exercise. One group will receive both priming methods at the same time.
Electrical stimulation and aerobic activity have been shown to “jump start” neurons in the brain, which helps people learn and retain information better. This can help people with MS get the most out of rehabilitation training sessions and the effort put into their training. The type of training paired with the priming matters as well, and the team uses a goal-directed skills based functional training program that is tailored to each participant.
The team’s research project was one of three funded by International Progressive MS Alliance and was selected from 73 world-wide applications to test innovative treatments focused on the well-being of people living with progressive MS.
“Research funding is competitive but receiving this opportunity was next-level excitement,” said Donkers. “Beyond the findings, this study will help us better support neuro recovery, learn more about people’s functional goals and priorities, and ultimately will help us figure out how to build a better health care system where access to functional training and multidisciplinary rehabilitation can be routine care accessible for all people with MS.”