Successful long-term management of spasticity in patients with multiple sclerosis using a software application (APP): A pilot study

Abstract Background Spasticity is a very common syndrome in patients with multiple sclerosis (pwMS), but available treatments lead to sufficient symptom control only in one third. Objective To investigate the impact of an individualized training program on improving spasticity in a prospective pilot trial in pwMS suffering from moderate spasticity (defined as ≥ 4 on a normative rating scale; NRS). Methods PwMS were familiarized with predefined exercises targeting spasticity while undergoing inpatient rehabilitation (IR). After IR, 20 pwMS were 1:1 randomized either to a newly designed APP-based home therapy program providing suitable exercises on a daily basis or to a paper-based home therapy program for 3 months. At month 3, all patients received the APP-based home program for another 3 months. Degree of spasticity was rated on the NRS. Results Undergoing inpatient rehabilitation for a mean of 32 days led to a significant reduction in spasticity in pwMS (p = 0.00). Further self-training with the APP-based home program for 3 months led to 1.2 lower mean NRS as compared to training with the conventional paper-based program (p = 0.09). Spasticity was found to be on low levels again in both groups after 6 months. Conclusion In pwMS, an individually tailored anti-spasticity program delivered by a software APP is a feasible tool for increasing long-term adherence to self-training thereby positively impacting spasticity in pwMS.