Upper Extremity Motor Imagery Functional Skills and Quality of Life in Patients With Multiple Sclerosis

Plain-language summary

Multiple sclerosis (MS) is a chronic inflammatory and autoimmune disease of the central nervous system (CNS) characterised by axonal loss and demyelination. MS is characterized by myelin, oligodendrocyte and axon damage. MS progresses in a wide spectrum, with motor, sensory, autonomic and cognitive disorders depending on the area affected. Upper extremity dysfunction is common in patients with MS (pwMS), too. 75% of pwMS have impaired ability to perform activities of daily living (ADL) and quality of life (QoL). Motor imagery (MI) refers to the mental simulation of an action without physical intervention. MS is also characterised by motor and cognitive symptoms. Cognitive impairment, seen in approximately 40-70% of patients, is mainly related to problems in attention, information processing speed, memory, cognitive and visual structure. MI refers to the mental simulation of an action without physical intervention, which can be classified as explicit or implicit. MI skill is linked to motor planning and execution skills. MI is related to the subconscious activation of motor systems that play a role not only in producing movement, but also in imagining actions, learning through observation, recognising tools, and also understanding other people's behaviour.The speed and quality of upper extremity functional skills in pwMS may be related to MI ability. Health-related quality of life (HRQoL) is an individual's assessment of how a health problem and its treatment affect their ability to perform daily activities and roles. Research studies have shown that pwMS report lower QoL scores than healthy controls. Losses in upper extremity functional skills may affect the activities of daily living and work life in pwMS, leading to a decrease in their QoL. When evaluating MI ability in these patients, the patient's functional skills and cognitive status should also be taken into consideration. It is thought that upper extremity MI skills may be negatively affected by impairments with the cognitive syptoms in pwMS. The aim of this study is to investigate the relationship between upper extremity MI ability, upper extremity functional skills and QoL in pwMS.

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