{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:06:07Z","timestamp":1771257967675,"version":"3.50.1"},"reference-count":111,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T00:00:00Z","timestamp":1549324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["NSF-CHS 1565328, NSF-PFI 1719031"],"award-info":[{"award-number":["NSF-CHS 1565328, NSF-PFI 1719031"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MTI"],"abstract":"<jats:p>Multiple sclerosis (MS) is a disease that affects the central nervous system, which consists of the brain and spinal cord. Although this condition cannot be cured, proper treatment of persons with MS (PwMS) can help control and manage the relapses of several symptoms. In this survey article, we focus on the different technologies used for the assessment and rehabilitation of motor impairments for PwMS. We discuss sensor-based and robot-based solutions for monitoring, assessment and rehabilitation. Among MS symptoms, fatigue is one of the most disabling features, since PwMS may need to put significantly more intense effort toward achieving simple everyday tasks. While fatigue is a common symptom across several neurological chronic diseases, it remains poorly understood for various reasons, including subjectivity and variability among individuals. To this end, we also investigate recent methods for fatigue detection and monitoring. The result of this survey will provide both clinicians and researchers with valuable information on assessment and rehabilitation technologies for PwMS, as well as providing insights regarding fatigue and its effect on performance in daily activities for PwMS.<\/jats:p>","DOI":"10.3390\/mti3010006","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T03:03:05Z","timestamp":1549422185000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["A Survey of Assistive Technologies for Assessment and Rehabilitation of Motor Impairments in Multiple Sclerosis"],"prefix":"10.3390","volume":"3","author":[{"given":"Akilesh","family":"Rajavenkatanarayanan","sequence":"first","affiliation":[{"name":"The Heracleia Human Centered Computing Laboratory, Department of Computer Science and Engineering, The University of Texas Arlington, Arlington, TX 76019, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varun","family":"Kanal","sequence":"additional","affiliation":[{"name":"The Heracleia Human Centered Computing Laboratory, Department of Computer Science and Engineering, The University of Texas Arlington, Arlington, TX 76019, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-0494","authenticated-orcid":false,"given":"Konstantinos","family":"Tsiakas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Yale University, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Calderon","sequence":"additional","affiliation":[{"name":"The Heracleia Human Centered Computing Laboratory, Department of Computer Science and Engineering, The University of Texas Arlington, Arlington, TX 76019, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michalis","family":"Papakostas","sequence":"additional","affiliation":[{"name":"The Heracleia Human Centered Computing Laboratory, Department of Computer Science and Engineering, The University of Texas Arlington, Arlington, TX 76019, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maher","family":"Abujelala","sequence":"additional","affiliation":[{"name":"The Heracleia Human Centered Computing Laboratory, Department of Computer Science and Engineering, The University of Texas Arlington, Arlington, TX 76019, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marnim","family":"Galib","sequence":"additional","affiliation":[{"name":"The Heracleia Human Centered Computing Laboratory, Department of Computer Science and Engineering, The University of Texas Arlington, Arlington, TX 76019, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8044-6536","authenticated-orcid":false,"given":"James C.","family":"Ford","sequence":"additional","affiliation":[{"name":"Brain Research Network, Department of Psychiatry Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Wylie","sequence":"additional","affiliation":[{"name":"Neuroimaging Center and Neuropsychology and Neuroscience Research, The Kessler Foundation, W. Orange, NJ 07052, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fillia","family":"Makedon","sequence":"additional","affiliation":[{"name":"The Heracleia Human Centered Computing Laboratory, Department of Computer Science and Engineering, The University of Texas Arlington, Arlington, TX 76019, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,5]]},"reference":[{"key":"ref_1","unstructured":"National MS Society (2018, December 12). Definition of MS. Available online: https:\/\/www.nationalmssociety.org\/What-is-MS\/Definition-of-MS."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple Sclerosis","volume":"378","author":"Reich","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1212\/WNL.0000000000000560","article-title":"Defining the clinical course of multiple sclerosis: The 2013 revisions","volume":"83","author":"Lublin","year":"2014","journal-title":"Neurology"},{"key":"ref_4","unstructured":"National MS Society (2018, December 12). Types of MS. Available online: https:\/\/www.nationalmssociety.org\/What-is-MS\/Types-of-MS."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1002\/ana.22366","article-title":"Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria","volume":"69","author":"Polman","year":"2011","journal-title":"Ann. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1093\/brain\/122.5.871","article-title":"Development of a multiple sclerosis functional composite as a clinical trial outcome measure","volume":"122","author":"Cutter","year":"1999","journal-title":"Brain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jns.2013.02.007","article-title":"Movement disorders in multiple sclerosis and other demyelinating diseases","volume":"328","author":"Mehanna","year":"2013","journal-title":"J. Neurol. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1177\/1352458512437418","article-title":"Multiple sclerosis and progressive resistance training: A systematic review","volume":"18","author":"Vissing","year":"2012","journal-title":"Mult. Scler. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1212\/WNL.0000000000002469","article-title":"Multiple sclerosis prevalence in the United States commercially insured population","volume":"86","author":"Dilokthornsakul","year":"2016","journal-title":"Neurology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.gaitpost.2011.11.027","article-title":"Quantifying gait abnormalities in persons with multiple sclerosis with minimal disability","volume":"36","author":"Sosnoff","year":"2012","journal-title":"Gait Post."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1111\/j.1749-6632.1965.tb20235.x","article-title":"Problems of experimental trials of therapy in multiple sclerosis: Report by the panel on the evaluation of experimental trials of therapy in multiple sclerosis","volume":"122","author":"Schumacher","year":"1965","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1002\/ana.410130302","article-title":"New diagnostic criteria for multiple sclerosis: Guidelines for research protocols","volume":"13","author":"Poser","year":"1983","journal-title":"Ann. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/ana.1032","article-title":"Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis","volume":"50","author":"McDonald","year":"2001","journal-title":"Ann. Neurol."},{"key":"ref_14","unstructured":"Catherine Lovering, A.S.L. (2018, December 12). Why It Pays to Start MS Treatment Early. Available online: https:\/\/www.healthline.com\/health\/multiple-sclerosis\/recently-diagnosed-why-start-ms-treatment-early."},{"key":"ref_15","unstructured":"National MS Society (2018, December 12). Assessment and Interventions in MS. Available online: https:\/\/www.nationalmssociety.org\/For-Professionals\/Clinical-Care\/Managing-MS\/Rehabilitation\/Rehabilitation-Paradigm\/Assessment-and-Intervention."},{"key":"ref_16","first-page":"1063","article-title":"Relationship between two measures of upper extremity strength: Manual muscle test compared to hand-held myometry","volume":"73","author":"Schwartz","year":"1992","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_17","unstructured":"Prohealthcare.com (2018, December 12). Manual Muscle Testing Grading and Procedures. Available online: https:\/\/www.prohealthcareproducts.com\/blog\/manual-muscle-testing-grading-and-procedures\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.3109\/09638288.2013.854841","article-title":"Prevalence of joint contractures and muscle weakness in people with multiple sclerosis","volume":"36","author":"Hoang","year":"2014","journal-title":"Disab. Rehabil."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1002\/pri.358","article-title":"Clinical relevance using timed walk tests and \u2018timed up and go\u2019 testing in persons with Multiple Sclerosis","volume":"12","author":"Nilsagard","year":"2007","journal-title":"Physiother. Res. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1177\/026921559601000306","article-title":"Assessing mobility in multiple sclerosis using the Rivermead Mobility Index and gait speed","volume":"10","author":"Vaney","year":"1996","journal-title":"Clin. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The Timed \u201cUp & Go\u201d: A Test of Basic Functional Mobility for Frail Elderly Persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1177\/135245859900500409","article-title":"The Multiple Sclerosis Functional Composite measure (MSFC): An integrated approach to MS clinical outcome assessment","volume":"5","author":"Fischer","year":"1999","journal-title":"Mult. Scler. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.gaitpost.2008.07.011","article-title":"Gait analysis in multiple sclerosis: Characterization of temporal\u2014Spatial parameters using GAITRite functional ambulation system","volume":"29","author":"Givon","year":"2009","journal-title":"Gait Post."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.gaitpost.2011.11.026","article-title":"Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed","volume":"35","author":"Spain","year":"2012","journal-title":"Gait Post."},{"key":"ref_25","first-page":"536","article-title":"Gait characteristics in multiple sclerosis: Progressive changes and effects of exercise on parameters","volume":"67","author":"Gehlsen","year":"1986","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gong, J., Goldman, M.D., and Lach, J. (2016, January 25\u201327). Deepmotion: A deep convolutional neural network on inertial body sensors for gait assessment in multiple sclerosis*. Proceedings of the 2016 IEEE Wireless Health (WH), Bethesda, MD, USA.","DOI":"10.1109\/WH.2016.7764572"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0171346","article-title":"Monitoring gait in multiple sclerosis with novel wearable motion sensors","volume":"12","author":"Moon","year":"2017","journal-title":"PLoS ONE"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1177\/135245850000600411","article-title":"The significant change for the Timed 25-Foot Walk in the Multiple Sclerosis Functional Composite","volume":"6","author":"Kaufman","year":"2000","journal-title":"Mult. Scler. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1177\/135245859900500510","article-title":"Gait abnormalities in minimally impaired multiple sclerosis patients","volume":"5","author":"Benedetti","year":"1999","journal-title":"Mult. Scler. J."},{"key":"ref_30","unstructured":"Health Care Journey (2018, December 12). Loss of hand Dexterity and Coordination. Available online: http:\/\/www.healthcarejourney.com\/loss-of-hand-dexterity-and-coordination.html."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1177\/1352458517690824","article-title":"The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis","volume":"23","author":"Feys","year":"2017","journal-title":"Mult. Scler. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1136\/jnnp.68.6.756","article-title":"Evaluation of three different ways of assessing tremor in multiple sclerosis","volume":"68","author":"Alusi","year":"2000","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jns.2006.02.018","article-title":"Motor assessment of upper extremity function and its relation with fatigue, cognitive function and quality of life in multiple sclerosis patients","volume":"246","author":"Baskurt","year":"2006","journal-title":"J. Neurol. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/NPT.0b013e318235da08","article-title":"The 9-hole PEG test of upper extremity function: average values, test-retest reliability, and factors contributing to performance in people with Parkinson disease","volume":"35","author":"Earhart","year":"2011","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1197\/j.jht.2005.04.003","article-title":"Measuring dexterity in children using the Nine-hole Peg Test","volume":"18","author":"Poole","year":"2005","journal-title":"J. Hand Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"386","DOI":"10.5014\/ajot.39.6.386","article-title":"Adult norms for the Box and Block Test of manual dexterity","volume":"39","author":"Mathiowetz","year":"1985","journal-title":"Am. J. Occup. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1177\/1545968308331146","article-title":"Test-Retest Reproducibility and Smallest Real Difference of 5 Hand Function Tests in Patients with Stroke","volume":"23","author":"Chen","year":"2009","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.jht.2011.05.001","article-title":"Assessing Dexterity Function: A Comparison of Two Alternatives for the NIH Toolbox","volume":"24","author":"Wang","year":"2011","journal-title":"J. Hand Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"570","DOI":"10.5014\/ajot.57.5.570","article-title":"Adult norms for a commercially available Nine Hole Peg Test for finger dexterity","volume":"57","author":"Grice","year":"2003","journal-title":"Am. J. Occup. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.jht.2008.11.004","article-title":"A Narrative Review of Dexterity Assessments","volume":"22","author":"Yancosek","year":"2009","journal-title":"J. Hand Ther."},{"key":"ref_41","unstructured":"National MS Society (2018, December 12). Nine Hole Peg Test. Available online: https:\/\/www.nationalmssociety.org\/For-Professionals\/Researchers\/Resources-for-Researchers\/Clinical-Study-Measures\/9-Hole-Peg-Test-(9-HPT)."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1191\/0269215505cr832oa","article-title":"Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: A multicentre study","volume":"19","author":"Platz","year":"2005","journal-title":"Clin.Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Guralnik, J.M., Fried, L.P., Simonsick, E.M., Lafferty, M.E., and Kasper, J.D. (1995). The Women\u2019s Health and Aging Study: Health and Social Characteristics of Older Women With Disability, DIANE Publishing.","DOI":"10.1037\/e306362003-001"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"108","DOI":"10.5014\/ajot.57.1.108","article-title":"Test-retest reliability of the Purdue Pegboard for persons with multiple sclerosis","volume":"57","author":"Gallus","year":"2003","journal-title":"Am. J. Occup. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1177\/193229681000400403","article-title":"Assessing Postural Control and Postural Control Strategy in Diabetes Patients Using Innovative and Wearable Technology","volume":"4","author":"Najafi","year":"2010","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7224\/1537-2073-11.1.1","article-title":"Assessment of Postural Balance in Multiple Sclerosis","volume":"11","author":"Fjeldstad","year":"2009","journal-title":"Int. J. MS Care"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1743-0003-2-19","article-title":"Gait variability: Methods, modeling and meaning","volume":"2","author":"Hausdorff","year":"2005","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_48","unstructured":"Natioanl MS Society (2018, December 12). Walking Difficulties. Available online: https:\/\/www.nationalmssociety.org\/Symptoms-Diagnosis\/MS-Symptoms\/Walking-Gait-Balance-Coordination."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000485958","article-title":"Assessment of Postural Sway in Individuals with Multiple Sclerosis Using a Novel Wearable Inertial Sensor","volume":"2","author":"Sun","year":"2018","journal-title":"Digit. Biomark."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"4984","DOI":"10.1038\/s41598-018-22676-0","article-title":"Profiling walking dysfunction in multiple sclerosis: Characterisation, classification and progression over time","volume":"8","author":"Filli","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_51","unstructured":"MTx (2018, December 12). Xsens Technologies B.V.. Available online: https:\/\/www.xsens.com\/technologytech\/mtx\/."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1109\/JBHI.2015.2435057","article-title":"Assessment and Classification of Early-Stage Multiple Sclerosis With Inertial Sensors: Comparison Against Clinical Measures of Disease State","volume":"19","author":"Greene","year":"2015","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"ref_53","unstructured":"(2018, December 12). BioStamp. Available online: https:\/\/www.mc10inc.com\/our-products\/biostamprc."},{"key":"ref_54","unstructured":"(2018, December 12). GT3X. Available online: https:\/\/www.actigraphcorp.com\/support\/activity-monitors\/gt3x\/."},{"key":"ref_55","unstructured":"Lopez Martinez, D., and Picard, R. (2016, January 22\u201326). Wearable technologies for multiple sclerosis: The future role of wearable stress measurement in improving quality of life. Proceedings of the Second International Conference on Smart Portable, Wearable, Implantable and Disability-Oriented Devices and Systems (SPWID\u201916), Valencia, Spain."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.3390\/s140203362","article-title":"Gait Analysis Methods: An Overview of Wearable and Non-Wearable Systems, Highlighting Clinical Applications","volume":"14","year":"2014","journal-title":"Sensors"},{"key":"ref_57","unstructured":"(2018, December 12). GAITRite. Available online: https:\/\/www.gaitrite.com\/."},{"key":"ref_58","unstructured":"(2018, December 12). M3D Force Plate. Available online: http:\/\/www.tecgihan.co.jp\/en\/products\/m3d_forceplate\/."},{"key":"ref_59","unstructured":"(2018, December 12). Zebris FDM-T System. Available online: https:\/\/www.zebris.de\/en\/medical\/products-solutions\/gait-analysis-fdm-t\/."},{"key":"ref_60","unstructured":"(2018, December 12). FootScan. Available online: https:\/\/www.rsscan.com\/es\/footscan\/."},{"key":"ref_61","unstructured":"(2018, December 12). MatScan. Available online: https:\/\/www.tekscan.com\/products-solutions\/systems\/matscan."},{"key":"ref_62","unstructured":"(2018, December 12). Kistler Force Plate. Available online: https:\/\/www.kistler.com\/en\/applications\/sensor-technology\/biomechanics-and-force-plate\/."},{"key":"ref_63","unstructured":"(2018, December 12). OR6-7 Force Platform. Available online: http:\/\/www.amti.uk.com\/products\/or6-7-force-platform.php."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1177\/1545968311425908","article-title":"The Promise of mHealth: Daily Activity Monitoring and Outcome Assessments by Wearable Sensors","volume":"25","author":"Dobkin","year":"2011","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_65","unstructured":"DynaPort (2018, December 12). McRoberts B.V.. Available online: https:\/\/www.rsscan.com\/es\/footscan\/."},{"key":"ref_66","unstructured":"(2018, December 12). IDDEA LifeGait. Available online: http:\/\/www.minisun.com\/LifeGait.htm."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.gaitpost.2018.01.033","article-title":"Walking speed measurement with an Ambient Measurement System (AMS) in patients with multiple sclerosis and walking impairment","volume":"61","author":"Bethoux","year":"2018","journal-title":"Gait Post."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.clinbiomech.2017.11.010","article-title":"Validation of the Arm Profile Score in assessing upper limb functional impairments in people with multiple sclerosis","volume":"51","author":"Corona","year":"2018","journal-title":"Clin. Biomech."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00415-006-0431-5","article-title":"High concurrent presence of disability in multiple sclerosis","volume":"254","author":"Johansson","year":"2007","journal-title":"J. Neurol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1177\/0308022617726259","article-title":"Objective identification of upper limb tremor in multiple sclerosis using a wrist-worn motion sensor: Establishing validity and reliability","volume":"80","author":"Teufl","year":"2017","journal-title":"Br. J. Occup. Ther."},{"key":"ref_71","first-page":"271","article-title":"Clinical rating scale for tremor","volume":"2","author":"Fahn","year":"1993","journal-title":"Parkinson\u2019s Dis. Mov. Disord."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/00004356-198112000-00001","article-title":"A performance test for assessment of upper limb function in physical rehabilitation treatment and research","volume":"4","author":"Lyle","year":"1981","journal-title":"Int. J. Rehabil. Res."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/1743-0003-11-67","article-title":"Quantitative assessment of upper limb motor function in Multiple Sclerosis using an instrumented Action Research Arm Test","volume":"11","author":"Carpinella","year":"2014","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"046011","DOI":"10.1088\/1741-2560\/12\/4\/046011","article-title":"Hilbert-Huang transform based instrumental assessment of intention tremor in multiple sclerosis","volume":"12","author":"Carpinella","year":"2015","journal-title":"J. Neural Eng."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1109\/3516.951363","article-title":"Upper limb motion analysis using haptic interface","volume":"6","author":"Bardorfer","year":"2001","journal-title":"IEEE\/ASME Trans. Mechatron."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1038\/s41598-018-20343-y","article-title":"Evaluating upper limb impairments in multiple sclerosis by exposure to different mechanical environments","volume":"8","author":"Pellegrino","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_77","unstructured":"World Health Organization (2011). World Report on Disability, World Health Organization."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1046\/j.1525-1403.2003.03017.x","article-title":"Robotic Orthosis Lokomat: A Rehabilitation and Research Tool","volume":"6","author":"Jezernik","year":"2003","journal-title":"Neuromodulation Technol. Neural Interface"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/1352458507082358","article-title":"Robot-assisted gait training in multiple sclerosis: A pilot randomized trial","volume":"14","author":"Beer","year":"2008","journal-title":"Mult. Scler. J."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"555","DOI":"10.3233\/NRE-130990","article-title":"Does robot-assisted gait training ameliorate gait abnormalities in multiple sclerosis? A pilot randomized-control trial","volume":"33","author":"Straudi","year":"2013","journal-title":"NeuroRehabilitation"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1743-0003-7-15","article-title":"Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children","volume":"7","author":"Schuler","year":"2010","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Horst, R.W. (2009, January 3\u20136). A bio-robotic leg orthosis for rehabilitation and mobility enhancement. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Minneapolis, MN, USA.","DOI":"10.1109\/IEMBS.2009.5333581"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1177\/1352458516663033","article-title":"Does robot-assisted gait training improve ambulation in highly disabled multiple sclerosis people? A pilot randomized control trial","volume":"23","author":"Pompa","year":"2017","journal-title":"Mult. Scler. J."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1161\/01.STR.0000254607.48765.cb","article-title":"Effects of Locomotion Training with Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke","volume":"38","author":"Husemann","year":"2007","journal-title":"Stroke"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.neuroimage.2013.12.025","article-title":"Upper limb motor rehabilitation impacts white matter microstructure in multiple sclerosis","volume":"90","author":"Bonzano","year":"2014","journal-title":"NeuroImage"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"522","DOI":"10.12968\/ijtr.2018.25.10.522","article-title":"Effects and feasibility of virtual reality system vs traditional physical therapy training in multiple sclerosis patients","volume":"25","author":"Streicher","year":"2018","journal-title":"Int. J. Ther. Rehabil."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"966","DOI":"10.2340\/16501977-0401","article-title":"Robot-Based Rehabilitation of the Upper Limbs in Multiple Sclerosis: Feasibility and Preliminary Results","volume":"41","author":"Carpinella","year":"2009","journal-title":"J. Rehabil. Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1109\/TNSRE.2012.2187462","article-title":"Robot Training of Upper Limb in Multiple Sclerosis: Comparing Protocols With or WithoutManipulative Task Components","volume":"20","author":"Carpinella","year":"2012","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1109\/TNSRE.2015.2413906","article-title":"Using Functional Electrical Stimulation Mediated by Iterative Learning Control and Robotics to Improve Arm Movement for People With Multiple Sclerosis","volume":"24","author":"Sampson","year":"2016","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12984-015-0043-3","article-title":"Robot-supported upper limb training in a virtual learning environment: A pilot randomized controlled trial in persons with MS","volume":"12","author":"Feys","year":"2015","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1177\/1352458508090223","article-title":"Constraint-Induced Movement therapy can improve hemiparetic progressive multiple sclerosis. Preliminary findings","volume":"14","author":"Mark","year":"2008","journal-title":"Mult. Scler. J."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2165\/00023210-200317040-00002","article-title":"Fatigue in Multiple Sclerosis","volume":"17","author":"Krupp","year":"2003","journal-title":"CNS Drugs"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1477-7525-12-24","article-title":"Can the Fatigue Severity Scale 7-item version be used across different patient populations as a generic fatigue measure\u2014A comparative study using a Rasch model approach","volume":"12","author":"Johansson","year":"2014","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1093\/sleep\/33.8.1061","article-title":"Fatigue in Multiple Sclerosis: Mechanisms, Evaluation, and Treatment","volume":"33","author":"Braley","year":"2010","journal-title":"Sleep"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1007\/s00415-014-7415-7","article-title":"Objective assessment of motor fatigue in multiple sclerosis: The Fatigue index Kliniken Schmieder (FKS)","volume":"261","author":"Sehle","year":"2014","journal-title":"J. Neurol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1001\/archneur.1988.00520280085020","article-title":"Fatigue in multiple sclerosis","volume":"45","author":"Krupp","year":"1988","journal-title":"Arch. Neurol."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Barrios, L., Oldrati, P., Santini, S., and Lutterotti, A. (2018). Recognizing Digital Biomarkers for Fatigue Assessment in Patients with Multiple Sclerosis. Proceedings of the 12th EAI International Conference on Pervasive Computing Technologies for Healthcare, EAI. PervasiveHealth 2018.","DOI":"10.4108\/eai.20-4-2018.2276340"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1088\/0967-3334\/33\/12\/2033","article-title":"A wireless body measurement system to study fatigue in multiple sclerosis","volume":"33","author":"Yu","year":"2012","journal-title":"Physiol. Meas."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1080\/0963828031000062651","article-title":"A survey of the effects of fatigue on driving in people with multiple sclerosis","volume":"25","author":"Chipchase","year":"2003","journal-title":"Disab. Rehabil."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Nayak, B.P., Kar, S., Routray, A., and Padhi, A.K. (2012, January 27\u201329). A biomedical approach to retrieve information on driver\u2019s fatigue by integrating EEG, ECG and blood biomarkers during simulated driving session. Proceedings of the 4th International Conference on Intelligent Human Computer Interaction (IHCI), Kharagpur, India.","DOI":"10.1109\/IHCI.2012.6481812"},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Tsiakas, K., Papakostas, M., Ford, J.C., and Makedon, F. (2018, January 20\u201321). Towards a Task-driven Framework for Multimodal Fatigue Analysis During Physical and Cognitive Tasks. Proceedings of the 5th International Workshop on Sensor-based Activity Recognition and Interaction, Berlin, Germany.","DOI":"10.1145\/3266157.3266222"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1177\/1352458509360040","article-title":"Fatigue, mood and quality of life improve in MS patients after progressive resistance training","volume":"16","author":"Dalgas","year":"2010","journal-title":"Mult. Scler. J."},{"key":"ref_103","unstructured":"National MS Society (2018, December 12). Multiple Sclerosis\u2013Rehabilitaion. Available online: https:\/\/www.nationalmssociety.org\/Treating-MS\/Rehabilitation."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Octavia, J.R., Feys, P., and Coninx, K. (2015). Development of activity-related muscle fatigue during robot-mediated upper limb rehabilitation training in persons with multiple sclerosis: A pilot trial. Mult. Scler. Int., 2015.","DOI":"10.1155\/2015\/650431"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0133729","article-title":"Investigation of Fatigability during Repetitive Robot-Mediated Arm Training in People with Multiple Sclerosis","volume":"10","author":"Severijns","year":"2015","journal-title":"PLoS ONE"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/BF00236054","article-title":"Electromyogram mean power frequency in non-fatigued trapezius muscle","volume":"61","author":"Kadefors","year":"1990","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s11517-009-0485-5","article-title":"Scapular muscle activation and co-activation following a fatigue task","volume":"47","author":"Szucs","year":"2009","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1682\/JRRD.2010.03.0035","article-title":"Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis","volume":"48","author":"Wier","year":"2011","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1177\/1352458515620933","article-title":"The effects of robot-assisted gait training in progressive multiple sclerosis: A randomized controlled trial","volume":"22","author":"Straudi","year":"2016","journal-title":"Mult. Scler. J."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Holt, R., Makower, S., Jackson, A., Culmer, P., Levesley, M., Richardson, R., Cozens, A., Williams, M.M., and Bhakta, B. (2007, January 13\u201315). User involvement in developing Rehabilitation Robotic devices: An essential requirement. Proceedings of the IEEE 10th International Conference on Rehabilitation Robotics, Noordwijk, The Netherlands.","DOI":"10.1109\/ICORR.2007.4428427"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"122","DOI":"10.3389\/fneur.2016.00122","article-title":"Fatigue in multiple sclerosis: Misconceptions and future research directions","volume":"7","author":"Rudroff","year":"2016","journal-title":"Front. Neurol."}],"container-title":["Multimodal Technologies and Interaction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-4088\/3\/1\/6\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:31:12Z","timestamp":1760185872000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-4088\/3\/1\/6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,5]]},"references-count":111,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,3]]}},"alternative-id":["mti3010006"],"URL":"https:\/\/doi.org\/10.3390\/mti3010006","relation":{},"ISSN":["2414-4088"],"issn-type":[{"value":"2414-4088","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,5]]}}}