Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.
Physical Therapy Department, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan.
Phys Ther. 2021 Oct 1;101(10). doi: 10.1093/ptj/pzab175.
Neurorehabilitation that involves learning new motor skills is one of the promising clinical methods for motor recovery in people with multiple sclerosis (PwMS); therefore, factors that influence the acquisition of motor skills in PwMS need to be investigated. Sleep disturbances are common in PwMS; however, no study has investigated the effect of sleep and sleep-related biomarkers on skill acquisition in PwMS. This study aimed to examine the effect of sleep and sleep-related biomarkers on motor acquisition in PwMS.
Forty participants with MS and 40 controls were recruited in this study. To assess motor acquisition, each participant was asked to perform a novel game through a virtual reality (VR) system 5 times (blocks). The main outcome measures for each block were the required time to complete the VR game and the recorded errors. The difference in scores between Block 5 and Block 1 for both outcomes were considered to represent motor skill acquisition. Sleep was assessed by self-report using the Pittsburgh Sleep Quality Index (PSQI) and objectively using sleep monitor technology. Serotonin level was assessed using means of enzyme-linked immunosorbent assay using plasma samples.
There were significant positive correlations in both groups between motor skill acquisition and PSQI score. In PwMS, significant negative correlation between motor skill acquisition and sleep efficiency and significant positive correlation between motor skill acquisition and sleep latency were also observed. Interestingly, a significant negative correlation was observed between motor skill acquisition and the plasma serotonin level in both groups. Most of these correlations remained significant after controlling for disease severity, fatigue, baseline performance, and cognitive status.
Sleep quality may influence motor skill acquisition in PwMS. Circulatory serotonin level might explain this relationship.
Physical therapists are encouraged to be aware of sleep quality and sleep assessment. Sleep management strategies should be considered when treating PwMS.
涉及学习新运动技能的神经康复是多发性硬化症（MS）患者运动功能恢复的有前途的临床方法之一；因此，需要研究影响 MS 患者运动技能获得的因素。睡眠障碍在 MS 患者中很常见；然而，尚无研究调查睡眠和与睡眠相关的生物标志物对 MS 患者技能获得的影响。本研究旨在探讨睡眠和与睡眠相关的生物标志物对 MS 患者运动获得的影响。
本研究招募了 40 名 MS 患者和 40 名对照者。为了评估运动获得，要求每位参与者通过虚拟现实（VR）系统进行 5 次（块）新游戏。每个块的主要结果测量是完成 VR 游戏所需的时间和记录的错误。两个结果中第 5 块和第 1 块之间的分数差异被认为代表运动技能获得。使用匹兹堡睡眠质量指数（PSQI）和睡眠监测技术进行自我报告和客观评估来评估睡眠。使用酶联免疫吸附测定法（ELISA）使用血浆样本评估 5-羟色胺水平。
在两组中，运动技能获得与 PSQI 评分之间均存在显著正相关。在 MS 患者中，还观察到运动技能获得与睡眠效率呈显著负相关，与睡眠潜伏期呈显著正相关。有趣的是，在两组中，运动技能获得与血浆 5-羟色胺水平呈显著负相关。在控制疾病严重程度、疲劳、基线表现和认知状态后，大多数这些相关性仍然显著。
睡眠质量可能会影响 MS 患者的运动技能获得。循环 5-羟色胺水平可能解释了这种关系。
鼓励物理治疗师关注睡眠质量和睡眠评估。在治疗 MS 患者时，应考虑睡眠管理策略。
