{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:51:21Z","timestamp":1785246681613,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"WOMS (wetenschappelijk onderzoek in Multiple Sclerosis)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Upper limb intention tremor in persons with multiple sclerosis (pwMS) affects the ability to perform activities of daily life and is difficult to treat. The study investigated the effect of peripheral upper limb cooling on tremor severity and functional performance in MS patients with intention tremor. In experiment 1, 17 patients underwent two 15 min cooling conditions for the forearm (cold pack and cryomanchet) and one control condition. In experiment 2, 22 patients underwent whole arm cooling for 15 min using multiple cold packs. In both experiments, patients were tested at four time points (pre- and post-0, -25 and -50 min cooling) on unilateral tasks of the Test Evaluant les Membres sup\u00e9rieurs des Personnes Ag\u00e9es (TEMPA), Fahn\u2019s tremor rating scale (FTRS), Nine Hole Peg Test (NHPT). In experiment 1, the mean FTRS ranged from 13.2 to 14.1 across conditions. A two-way ANOVA showed mainly time effects, showing that cooling the forearm significantly reduced the FTRS, the performance on the NHPT, and three out of four items of the TEMPA, mostly independent of the cooling modality. In experiment 2, the mean FTRS was 13.1. A repeated measures ANOVA showed that cooling the whole arm reduced the FTRS and time needed to execute two out of four items of the TEMPA. These effects occurred immediately after cooling lasting at least 25 min. Cooling the whole upper limb led to a clinically noticeable effect on tremor severity and improved functional performance, which was pronounced during the first half-hour after cooling.<\/jats:p>","DOI":"10.3390\/jcm12134549","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:54:23Z","timestamp":1688950463000},"page":"4549","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Peripheral Cooling on Upper Limb Tremor Severity and Functional Capacity in Persons with MS"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-5495","authenticated-orcid":false,"given":"Peter","family":"Feys","sequence":"first","affiliation":[{"name":"REVAL Rehabilitation Research Center, Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"University MS Centre Hasselt-Pelt, 3500 Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijke","family":"Duportail","sequence":"additional","affiliation":[{"name":"National MS Center Melsbroek, 1820 Steenokkerzeel, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3566-2269","authenticated-orcid":false,"given":"Daphne","family":"Kos","sequence":"additional","affiliation":[{"name":"National MS Center Melsbroek, 1820 Steenokkerzeel, Belgium"},{"name":"Faculty of Kinesiology and Rehabilitation Sciences FABER, Katholieke Universiteit Leuven, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Ilsbroukx","sequence":"additional","affiliation":[{"name":"National MS Center Melsbroek, 1820 Steenokkerzeel, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6147-4769","authenticated-orcid":false,"given":"Ilse","family":"Lamers","sequence":"additional","affiliation":[{"name":"REVAL Rehabilitation Research Center, Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"University MS Centre Hasselt-Pelt, 3500 Hasselt, Belgium"},{"name":"Rehabilitation and MS Center Noorderhart, 3900 Pelt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Van Asch","sequence":"additional","affiliation":[{"name":"Fitness and Physiotherapy Center, 2550 Kontich, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7066-8127","authenticated-orcid":false,"given":"Werner","family":"Helsen","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Rehabilitation Sciences FABER, Katholieke Universiteit Leuven, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4973-5190","authenticated-orcid":false,"given":"Lousin","family":"Moumdjian","sequence":"additional","affiliation":[{"name":"REVAL Rehabilitation Research Center, Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"University MS Centre Hasselt-Pelt, 3500 Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1093\/brain\/124.4.720","article-title":"A study of tremor in multiple sclerosis","volume":"124","author":"Alusi","year":"2001","journal-title":"Brain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s00415-006-0296-7","article-title":"Tremor in multiple sclerosis","volume":"254","author":"Koch","year":"2007","journal-title":"J. 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