{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T03:08:00Z","timestamp":1788664080698,"version":"build-2803163510"},"reference-count":93,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background and Purpose: Progressive multiple sclerosis impairs cognitive and motor functions and reduces quality of life. Complex goal-directed movements are challenging due to cognitive deficits, whereas in-phase bilateral exercises require less attentional demand and cognitive effort. This type of exercise may therefore improve both cognitive and motor functions. Previous studies in people with progressive multiple sclerosis suggested a strong association between cognitive and upper limb functions; however, the effects of in-phase bilateral exercises remain unclear. Objectives: To evaluate the effects of in-phase bilateral upper limb exercise on cognitive processing, motor functions, and quality of life in people with progressive multiple sclerosis. Methods: Twenty participants (11 females, mean age = 55.8 years) were randomized (1:1) to an experimental or active control group for a 12-week intervention. The experimental group performed in-phase bilateral upper limb exercises while the active control group performed conventional exercises. ANOVA was conducted to determine the effect of intervention on information processing speed, motor function, fatigue, and quality of life. Results: Post hoc analyses revealed that the experimental group demonstrated significantly greater improvements than the active control group in information processing speed (t(18) = 8.6, p &lt; 0.05), as well as across all exploratory secondary outcome measures (all p &lt; 0.05). Conclusions: This pilot randomized controlled trial suggests that in-phase bilateral exercises, which demand less cognitive effort than other forms of bilateral coordination, are associated with improvements in information processing speed, motor functions, fatigue, and quality of life in people with progressive multiple sclerosis.<\/jats:p>","DOI":"10.3390\/brainsci16020191","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T15:24:19Z","timestamp":1770305059000},"page":"191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["In-Phase Bilateral Upper Limb Exercises Improve Cognitive and Motor Functions in Progressive Multiple Sclerosis: A Pilot Randomized Controlled Trial"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7595-4349","authenticated-orcid":false,"given":"Dimitris","family":"Sokratous","sequence":"first","affiliation":[{"name":"Physiotherapy Unit, Neurology Clinics, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus"},{"name":"Department of Rehabilitation Sciences, Faculty of Health Sciences, Cyprus University of Technology, Limassol 3036, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1547-1839","authenticated-orcid":false,"given":"Charalambos Costa","family":"Charalambous","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Duke University, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2937-384X","authenticated-orcid":false,"given":"Marios","family":"Pantzaris","sequence":"additional","affiliation":[{"name":"Neuroimmunology Department, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-1237","authenticated-orcid":false,"given":"Kyriaki","family":"Michailidou","sequence":"additional","affiliation":[{"name":"Biostatistics Department, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikos","family":"Konstantinou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Faculty of Health Sciences, Cyprus University of Technology, Limassol 3036, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1212\/WNL.46.4.907","article-title":"Defining the Clinical Course of Multiple Sclerosis: Results of an International Survey","volume":"46","author":"Lublin","year":"1996","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e00875","DOI":"10.1002\/brb3.875","article-title":"Progressive Multiple Sclerosis, Cognitive Function, and Quality of Life","volume":"8","author":"Schreiber","year":"2018","journal-title":"Brain Behav."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/S1474-4422(20)30277-5","article-title":"Cognitive Impairment in Multiple Sclerosis: Clinical Management, MRI, and Therapeutic Avenues","volume":"19","author":"Benedict","year":"2020","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/s41582-020-0355-1","article-title":"Treatment and Management of Cognitive Dysfunction in Patients with Multiple Sclerosis","volume":"16","author":"DeLuca","year":"2020","journal-title":"Nat. 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