{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:53:01Z","timestamp":1787028781384,"version":"build-2736575974"},"reference-count":64,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>(1) Background: Multiple sclerosis (MS), a chronic progressive neurological disorder which affects the central nervous system (CNS), can result in disorders of all the functions controlled by the CNS: motor, sensory, cognitive and emotional. Physical therapy (PT), conducted through proprioceptive neuromuscular facilitation (PNF) techniques, can be customized to the individual patient\u2019s needs and has the potential to improve the patient\u2019s evolution. This study aims to establish if PT based on PNF techniques has a beneficial role in MS treatment. (2) Methods: We performed a prospective study on 40 patients who were diagnosed with MS and previously treated only with MS drug treatment (DT). These patients have participated in a PT program throughout one year. At the beginning and at the end of our study, after one year, we have assessed the following parameters: timed walk for 25 feet (Timed 25-Foot Walk test- T25FW test), dexterity of the upper limbs (9-Hole Peg Test\u20149HPT), disability level (Expanded Disability Status Scale\u2014EDSS) and cognitive function (Paced Auditory Serial Addition Test\u2014PASAT. (3) Results: In subjects in the early stages of MS, lower limb mobility improved significantly, T25FW decreasing from 6.46 to 5.80 (p &lt; 0.001) and upper limb ability increased significantly in the dominant hand, 9HPT decreasing from 17.73 to 16.97 (p = 0.006) and not significantly in the non-dominant hand, 9HPT decreasing from 17.73 to 17.50 (p = 0.255). Furthermore, among these subjects, cognitive performance improved; their PASAT increased from 52.14 to 54.14 (p = 0.036), while the level of disability of these subjects improved only slightly, the EDSS scale evolving from 3.08 to 2.91 (p = 0.650). (4) Conclusions: In patients with early forms of MS, combining DT with a PT program based on PNF techniques results in: regaining muscle strength in the lower limbs, improving coordination while walking, correcting dexterity in the upper limbs and increasing the ability to concentrate.<\/jats:p>","DOI":"10.3390\/life13071501","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T01:32:18Z","timestamp":1688434338000},"page":"1501","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Early Initiation Advantages of Physical Therapy in Multiple Sclerosis\u2014A Pilot Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9095-2595","authenticated-orcid":false,"given":"Florin Mihai","family":"Marcu","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilarie","family":"Brihan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0740-3702","authenticated-orcid":false,"given":"Anamaria","family":"Ciubara","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-8795","authenticated-orcid":false,"given":"Vasile Valeriu","family":"Lupu","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0380-3381","authenticated-orcid":false,"given":"Nicoleta","family":"Negrut","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0793-2877","authenticated-orcid":false,"given":"Anamaria","family":"Jurcau","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8147-3632","authenticated-orcid":false,"given":"Ancuta","family":"Lupu","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan Lucian","family":"Burlea","sequence":"additional","affiliation":[{"name":"Public Health and Management Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Dragan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6713-4244","authenticated-orcid":false,"given":"Lacramioara Ionela","family":"Butnariu","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina Elena","family":"Ignat","sequence":"additional","affiliation":[{"name":"\u201cAl. I. Cuza\u201d University, 700506 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8037-6002","authenticated-orcid":false,"given":"Alexandru Bogdan","family":"Ciubara","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"724718","DOI":"10.3389\/fphar.2021.724718","article-title":"Progress in the Application of Drugs for the Treatment of Multiple Sclerosis","volume":"12","author":"Wei","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1038\/nri3871","article-title":"Immunopathology of Multiple Sclerosis","volume":"15","author":"Dendrou","year":"2015","journal-title":"Nat. Rev. Immunol."},{"key":"ref_3","first-page":"527","article-title":"Progressive Multiple Sclerosis: From Pathogenic Mechanisms to Treatment","volume":"140","author":"Correale","year":"2017","journal-title":"Brain"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/ene.13819","article-title":"Multiple Sclerosis\u2014A Review","volume":"26","author":"Dobson","year":"2019","journal-title":"Eur. J. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/1756286419836571","article-title":"Risks and Risk Management in Modern Multiple Sclerosis Immunotherapeutic Treatment","volume":"12","author":"Klotz","year":"2019","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"409","DOI":"10.2174\/157015911796557911","article-title":"Multiple Sclerosis: Pathogenesis and Treatment","volume":"9","author":"Loma","year":"2011","journal-title":"Curr. Neuropharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1212\/WNL.0000000000000560","article-title":"Defining the clinical course of multiple sclerosis","volume":"83","author":"Lublin","year":"2014","journal-title":"Neurology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000360528","article-title":"Multiple Sclerosis: Current Knowledge and Future Outlook","volume":"72","author":"Kamm","year":"2014","journal-title":"Eur. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Halabchi, F., Alizadeh, Z., Sahraian, M.A., and Abolhasani, M. (2017). Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol., 17.","DOI":"10.1186\/s12883-017-0960-9"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Learmonth, Y.C., and Motl, R.W. (2021). Exercise Training for Multiple Sclerosis: A Narrative Review of History, Benefits, Safety, Guidelines, and Promotion. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182413245"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1016\/j.apmr.2013.07.011","article-title":"Objectively Quantified Physical Activity in Persons with Multiple Sclerosis","volume":"94","author":"Klaren","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/1756285615576663","article-title":"Exercise in the management of persons with multiple sclerosis","volume":"8","author":"Giesser","year":"2015","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"138","DOI":"10.7224\/1537-2073.2012-037","article-title":"Aerobic Exercise in People with Multiple Sclerosis Its Feasibility and Secondary Benefits","volume":"15","author":"Swank","year":"2013","journal-title":"Int. J. MS Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.annrmp.2007.04.004","article-title":"Physical training and multiple sclerosis","volume":"50","author":"Gallien","year":"2007","journal-title":"Ann. Readapt. Med. Phys."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1177\/1352458520915629","article-title":"Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course","volume":"26","author":"Kalb","year":"2020","journal-title":"Mult. Scler. J."},{"key":"ref_16","unstructured":"Rohrig, M. (2018). A Resource for Healthcare Professionals. Physical Therapy in Multiple Sclerosis, National Multiple Sclerosis Society."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2478\/v10078-012-0011-y","article-title":"Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function","volume":"31","author":"Hindle","year":"2012","journal-title":"J. Hum. Kinet."},{"key":"ref_18","unstructured":"Practical applications for the upper limb (2020). Neuroproprioceptive Facilitation Techniques, Presa Universitar\u0103 Clujean\u0103."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"929","DOI":"10.2165\/00007256-200636110-00002","article-title":"Proprioceptive neuromuscular facilitation stretching: Mechanisms and clinical implications","volume":"36","author":"Sharman","year":"2006","journal-title":"Sport. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1001\/archneur.57.9.1319","article-title":"Clinical significance of the multiple sclerosis functional composite: Relationship to patient-reported quality of life","volume":"57","author":"Miller","year":"2000","journal-title":"Arch. Neurol."},{"key":"ref_21","unstructured":"Fischer, J.S., Jak, A.J., Kniker, J.E., and Rudick, R.A. (2001). Multiple Sclerosis Functional Composite (MSFC) Administration and Scoring Manual, National Multiple Sclerosis Society."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.msard.2017.06.003","article-title":"The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions","volume":"16","author":"Edwards","year":"2017","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"35","DOI":"10.2217\/nmt-2017-0040","article-title":"Exercise therapy in multiple sclerosis and its effects on function and the brain","volume":"7","author":"Dalgas","year":"2017","journal-title":"Neurodegener. Dis. Manag."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1177\/1352458516687404","article-title":"Wellness and multiple sclerosis: The National MS Society establishes a Wellness Research Working Group and research priorities","volume":"24","author":"Motl","year":"2018","journal-title":"Mult. Scler. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.3389\/fneur.2019.00188","article-title":"Impact of the McDonald Criteria 2017 on Early Diagnosis of Relapsing-Remitting Multiple Sclerosis","volume":"10","author":"Schwenkenbecher","year":"2019","journal-title":"Front. Neurol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1111\/j.1365-2753.2007.00903.x","article-title":"Combined bias suppression in single-arm therapy studies","volume":"14","author":"Hamre","year":"2008","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_27","unstructured":"(2023, January 15). Available online: https:\/\/clinicspeak.com\/timed-25ft-walk\/."},{"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":"704","DOI":"10.1177\/1352458517690823","article-title":"Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis","volume":"23","author":"Motl","year":"2017","journal-title":"Mult. Scler. J."},{"key":"ref_30","unstructured":"(2023, January 15). Available online: https:\/\/www.nationalmssociety.org\/For-Professionals\/Researchers\/Resources-for-MS-Researchers\/Research-Tools\/Clinical-Study-Measures\/9-Hole-Peg-Test-(9-HPT)."},{"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","unstructured":"(2023, January 15). Available online: https:\/\/www.nationalmssociety.org\/For-Professionals\/Researchers\/Resources-for-MS-Researchers\/Research-Tools\/Clinical-Study-Measures\/Paced-Auditory-Serial-Addition-Test-(PASAT)."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e043699","DOI":"10.1136\/bmjopen-2020-043699","article-title":"Study protocol: Randomised controlled trial evaluating exercise therapy as a supplemental treatment strategy in early multiple sclerosis: The Early Multiple Sclerosis Exercise Study (EMSES)","volume":"11","author":"Riemenschneider","year":"2021","journal-title":"BMJ Open"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"199","DOI":"10.23736\/S1973-9087.18.04778-0","article-title":"The effects of 10-week core stability training on balance in women with multiple sclerosis according to Expanded Disability Status Scale: A single-blinded randomized controlled trial","volume":"55","author":"Amiri","year":"2019","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s40263-017-0412-5","article-title":"Outcome measures in clinical trials for multiple sclerosis","volume":"31","author":"Uitdehaag","year":"2017","journal-title":"CNS Drugs"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Lovric, M. (2010). International Encyclopedia of Statistical Science, Springer.","DOI":"10.1007\/978-3-642-04898-2"},{"key":"ref_37","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":"2020","journal-title":"Sleep"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Flensner, G., Landtblom, A.M., S\u00f6derhamn, O., and Ek, A.C. (2013). Work capacity and health-related quality of life among individuals with multiple sclerosis reduced by fatigue: A cross-sectional study. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-224"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1177\/1352458511401120","article-title":"The effect of exercise therapy on fatigue in multiple sclerosis","volume":"17","author":"Andreasen","year":"2011","journal-title":"Mult. Scler. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"811","DOI":"10.2340\/16501977-1047","article-title":"Effects of physiotherapy interventions on balance in multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials","volume":"44","author":"Paltamaa","year":"2012","journal-title":"J. Rehabil. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1728","DOI":"10.1002\/pri.1728","article-title":"Balance exercise facilitates everyday life for people with multiple sclerosis: A qualitative study","volume":"23","author":"Carling","year":"2018","journal-title":"Physiother. Res. Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s00421-019-04295-3","article-title":"Comfortable walking speed and energy cost of locomotion in patients with multiple sclerosis","volume":"120","author":"Stella","year":"2020","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"74","DOI":"10.7224\/1537-2073.2020-128","article-title":"Oxygen Cost of Walking in People With Multiple Sclerosis and Its Association With Fatigue: A Systematic Review and Meta-analysis","volume":"24","author":"Rooney","year":"2022","journal-title":"Int. J. MS Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1186\/s13063-020-04887-x","article-title":"Feasibility and initial efficacy of a high-intensity interval training program using adaptive equipment in persons with multiple sclerosis who have walking disability: Study protocol for a single-group, feasibility trial","volume":"21","author":"Hubbard","year":"2020","journal-title":"Trials"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1177\/1049732318796831","article-title":"The Mindful Body: A Phenomenology of the Body with Multiple Sclerosis","volume":"28","author":"Teunissen","year":"2018","journal-title":"Qual. Health Res."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Plow, M., Finlayson, M., Motl, R.W., and Bethoux, F. (2012). Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: Rationale and research protocol. BMC Neurol., 12.","DOI":"10.1186\/1471-2377-12-122"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.apmr.2008.09.558","article-title":"Exercise and quality of life among people with multiple sclerosis: Looking beyond physical functioning to mental health and participation in life","volume":"90","author":"Turner","year":"2009","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s10072-022-06456-3","article-title":"Change in upper limb function in people with multiple sclerosis treated with nabiximols: A quantitative kinematic pilot study","volume":"44","author":"Pau","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1177\/1352458514567553","article-title":"Unilateral and bilateral upper limb dysfunction at body functions, activity and participation levels in people with multiple sclerosis","volume":"21","author":"Bertoni","year":"2015","journal-title":"Mult Scler"},{"key":"ref_50","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":"Oxford","year":"2003","journal-title":"Am. J. Occup. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1080\/09638288.2016.1213900","article-title":"Physical Activity and Cognitive Function in Adults with Multiple Sclerosis: An Integrative Review","volume":"39","author":"Morrison","year":"2017","journal-title":"Disabil. Rehabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"408","DOI":"10.12775\/JEHS.2020.10.08.049","article-title":"Multiple sclerosis\u2014An overview of the most commonly used methods of physiotherapy","volume":"10","author":"Korabiusz","year":"2020","journal-title":"J. Educ. Health Sport"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/13548506.2010.521569","article-title":"Effects of change in fatigue and depression on physical activity over time in relapsing remitting multiple sclerosis","volume":"16","author":"Motl","year":"2011","journal-title":"Psychol. Health Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.msard.2011.08.003","article-title":"Fatigue, depression, and physical activity in relapsing-remitting multiple sclerosis: Results from a prospective, 18-month study","volume":"1","author":"Motl","year":"2012","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1136\/jnnp.2004.054635","article-title":"Depression in multiple sclerosis: A review","volume":"76","author":"Siegert","year":"2005","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1046\/j.1468-1331.2002.00450.x","article-title":"Health-related quality of life and its relationship to cognitive and emotional functioning in multiple sclerosis patients","volume":"9","author":"Morales","year":"2002","journal-title":"Eur. J. Neurol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1007\/s11136-021-02927-w","article-title":"Does depression in multiple sclerosis mediate effects of cognitive functioning on quality of life?","volume":"31","author":"Crouch","year":"2021","journal-title":"Qual. Life Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/JES.0b013e3181f44fab","article-title":"Physical Activity and Irreversible Disability in Multiple Sclerosis","volume":"38","author":"Motl","year":"2010","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/1756285611430719","article-title":"Exercise and disease progression in multiple sclerosis: Can exercise slow down the progression of multiple sclerosis?","volume":"5","author":"Dalgas","year":"2012","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.2522\/ptj.20090345","article-title":"Physical Activity Behavior of People With Multiple Sclerosis: Understanding How They Can Become More Physically Active","volume":"90","author":"Beckerman","year":"2010","journal-title":"Phys. Ther."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1002\/nur.20274","article-title":"Symptoms and physical activity behavior in individuals with multiple sclerosis","volume":"31","author":"Motl","year":"2008","journal-title":"Res. Nurs. Health"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1177\/1352458518777377","article-title":"Is there an overlooked \u201cwindow of opportunity\u201d in MS exercise therapy? Perspectives for early MS rehabilitation","volume":"24","author":"Riemenschneider","year":"2018","journal-title":"Mult. Scler. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s11910-019-1002-3","article-title":"Exercise as Medicine in Multiple Sclerosis-Time for a Paradigm Shift: Preventive, Symptomatic, and Disease-Modifying Aspects and Perspectives","volume":"19","author":"Dalgas","year":"2019","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1093\/qjmed\/hcx070","article-title":"Cognitive dysfunction in early multiple sclerosis: A review","volume":"111","author":"McNicholas","year":"2018","journal-title":"QJM: Int. J. 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