{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:18:43Z","timestamp":1778087923987,"version":"3.51.4"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Chronic pain affects approximately 63% of people with multiple sclerosis (pwMS), contributing to fatigue, depression, anxiety, poor sleep, reduced quality of life, and cognitive decline. Within the biopsychosocial model, music therapy has emerged as a promising intervention to address these complex symptoms. This study aims to examine the effects of heart rate\u2010synchronized music therapy combined with motor imagery practice on pain, autonomic and cognitive functions, and psychosocial outcomes in patients with pwMS. We hypothesize that the combined intervention will lead to greater improvements than music therapy alone or routine care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A double\u2010blind, randomized, and three\u2010arm parallel trial will be conducted with 45 patients with pwMS experiencing chronic pain. Participants will be randomly assigned to one of three groups: (1) heart rate\u2010synchronized music therapy combined with motor imagery, (2) heart rate\u2010synchronized music therapy alone, or (3) a control group receiving routine care. Interventions will be delivered twice weekly for 8\u00a0weeks, with each session lasting 20\u201330\u00a0min. The experimental groups will receive music therapy via videoconferencing. Assessments will be conducted at baseline, post\u2010intervention (week 8), and follow\u2010up (week 12). The primary outcome is pain intensity. Secondary outcomes include neuropathic pain, central sensitization, heart rate variability, anxiety, depression, fatigue, sleep quality, quality of life, and cognitive function. Sample size was calculated using G*Power; HRV data will be analyzed with Kubios software. Statistical analyses will be performed using SPSS and GraphPad Prism 10.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following randomization, baseline data will be collected. Blinded assessors will evaluate all outcomes at follow\u2010up points. An independent researcher will perform statistical analyses to assess changes across time and between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study may provide evidence supporting a novel, non\u2010pharmacological, and telehealth\u2010compatible intervention for chronic pain in pwMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NCT06800144, 24th January 2025<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70186","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:24:24Z","timestamp":1772983464000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Telerehabilitation\u2010Based Music Therapy and Motor Imagery on Pain, Autonomic Function, and Psychosocial Outcomes in People With Multiple Sclerosis: A Randomized Controlled Trial Protocol"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3355-4117","authenticated-orcid":false,"given":"Hilal","family":"Karakas","sequence":"first","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation Faculty of Health Sciences, Istanbul Bilgi University  Istanbul Turkey"},{"name":"Department of Physiotherapy and Rehabilitation Graduate School of Health Sciences, Dokuz Eylul University  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9935-0673","authenticated-orcid":false,"given":"Ozge","family":"Ertekin","sequence":"additional","affiliation":[{"name":"Faculty of Physical Therapy and Rehabilitation Dokuz Eylul University  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4065-9534","authenticated-orcid":false,"given":"Ipek","family":"Yavas","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation Graduate School of Health Sciences, Dokuz Eylul University  Izmir Turkey"},{"name":"Department of Physiotherapy Vocational School of Health Services Izmir University of Economics  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8186-8703","authenticated-orcid":false,"given":"Rabia Gokcen","family":"Gozubatik\u2010Celik","sequence":"additional","affiliation":[{"name":"Department of Neurology, Bak\u0131rk\u00f6y Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Neurological Disorders University of Health Sciences  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-604X","authenticated-orcid":false,"given":"Hasan","family":"Kazdagli","sequence":"additional","affiliation":[{"name":"Vocational School of Health Services Izmir University of Economics  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5699-9077","authenticated-orcid":false,"given":"Barbara","family":"Seebacher","sequence":"additional","affiliation":[{"name":"Clinical Department of Neurology Medical University of Innsbruck  Innsbruck Austria"},{"name":"Department of Rehabilitation Science Clinic for Rehabilitation Muenster  Muenster Austria"},{"name":"Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research  Muenster Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8776-0664","authenticated-orcid":false,"given":"Turhan","family":"Kahraman","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation Faculty of Health Sciences Izmir Katip Celebi University  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_14_2_1","first-page":"107","article-title":"Pittsburgh Uyku Kalitesi Indeksinin Gecerligi ve Guvenirligi","volume":"7","author":"Agargun M. 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