Teaching Courses/Nurse Programme

We are organising three teaching courses in the margins of the RIMS Annual Conference. .

• Teaching course I:  Motor and Cognitive Fatigability in Persons with MS 
• Teaching course II: Music and Rhythm Based Rehabilitation in MS
• Teaching course III: Gait Analysis for Impactful Outcomes in MS with Wearable and High-resolution Instruments
• Teaching course IV: Health Behaviour Change through Healthcare Providers
• Nurse programme: Mindfulness for Caregivers

Please note:

• The Teaching courses will take place on Thursday 27 June.

• It is not obligatory to purchase an Annual Conference Registration to be able to register for a Teaching Course. Please follow the flow on the Registration module here.
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Teaching course I: Motor and Cognitive Fatigability in Persons with MS 

Fatigue in MS can be distinguished between the subjective of fatigue and fatigability, a decrease in performance over time. Further, people may experience motor and cognitive fatigability, either separately or in combination, especially in dual task conditions. Assessing fatigue and fatigability is challenging, but important to provide tailormade (rehabilitation) interventions.

In this teaching course, after introducing a mechanistic framework, we provide examples of potential methods to assess motor and cognitive fatigability to use in clinical practice and research. For motor fatigability, we will present methods at ICF body function and activity. Muscle fatigue indexes will be presented and the interpretations based on neurophysiological measures. For walking fatigability, different methods based on walking distance and changes in the gait pattern will be presented. Methods for cognitive fatigability as well as a patient-reported tool on fatigability will be presented.

The target group for this session includes all health care professionals and researchers interested in fatigability in MS.

Overview of presentations followed by a short workshop.

Course Coordinator: Peter Feys (UHasselt, Belgium) & Daphne Kos (KU Leuven, Belgium)

Programme:

• Introduction and Classifications
   
• Mechanisms Underlying Motor Fatigability in Persons with MS and Assessment of Muscular Function - Inge Zijdewindt  (University Medical Center Groningen, NL) & Ulrik Dalgas (Aarhus University, DK)

The first part of the talk will focus on techniques which can be used to investigate central and peripheral mechanisms which affect fatigability. Furthermore, the association and factors modulating the association between perceived fatigability and performance fatigability will be discussed. The second part of the talk will focus on studies that have evaluated muscle function of the lower extremity during different types of muscle contraction. A brief summary of the existing studies will be provided while trying to outline if peripheral or central mechanisms explain the abnormal fatigability observed in persons with MS as compared to healthy controls.
 

• Assessments of Walking Fatigability: Distance - and Quality - based Metrics - Peter Feys and Felipe Santinelli (Hasselt University, BE) & Zuhal Abasiyanik (Hasselt University & Izmir University, TR)

Walking fatigability has been described, in people with multiple sclerosis, as a decrease in distance walked during prolonged walking protocols such as the 6-minute walking test. Recent evidence also shows that walking fatigability might manifest in the gait quality, such as a drop in foot towards the end of the 6MWT. The presentation will first present definitions of walking fatigability (i.e., decrease in distance walked and decrease in gait quality) and its prevalence. The possible manners of assessment of walking fatigability in people with multiple sclerosis using wearable sensors and/or lab-based measures will be discussed.
 

• Cognitive Fatigability in MS: from lab testing to real life context - Daphne Kos  (KU Leuven & National MS Center Melsbroek, BE) & Mieke D’Hooge (Hasselt University & National MS Center Melsbroek, BE)

Cognitive fatigability is the decline in (perceived) performance when doing an activity that requires cognitive processes. There is no golden standard to measure cognitive fatigability, but potential options that are used in research and practice will be presented. The relevance of cognitive fatigability towards daily life context will be discussed. Participants will be able to practice and experience during the session.
 

• Break
   
• Workshop 'Cognitive Fatigability & Patient-Reported questionnaire - Daphne Kos &Mieke D’Hooge

                  OR Workshop ' Motor & Walking Fatigability' - Felipe Santinelli & Zuhal Abasiyanik
 

• Closing and Q&A

Teaching course II: Music and Rhythm Based Rehabilitation in MS

In this teaching course, we will outline the theoretical basis of the use of music-based rehabilitation in gait and coordination training in MS, followed by demonstrations and hands-on practical sessions on individual and group based techniques.

Course Coordinator: Lousin Moumdjian (UHasselt, Belgium)

Programme:

• 13:00-13:30   Theoratical Constructs of Audio-Motor Coupling, and Application in People with MS with Different Subtypes - Lousin Moumdjian
• 13:30-13:50   The Application of Rhythmic Cued Motor Imagery in People with MS - Barbara Seebacher
• 13:50-14:00   Break
• 14:00-15:00   Practical Sessions on Application of Theory in Hands-on Practice of Music-Based Rehabilitation Techniques in Individual and Group Settings - Nickeline Schmidt Larsen

Teaching course III: Stride Forward: Gait Analysis for Impactful Outcomes in MS with Wearables and High-Resolution Instruments

A teaching course on gait analysis during RIMS that provides a comprehensive platform for healthcare professionals, researchers, and students to explore into the complexities of gait disturbances caused by multiple sclerosis. The teaching course will highlight the latest research focused on the main outcomes of gait parameters and technological advancements such as the use of sensors, wearables and a brief overview of the GRAIL (The Ultimate Gait-Lab Solution) as high-tech movement analysis lab. The impact of rehabilitation on gait outcomes will be discussed.

Course Coordinator: Massimiliano Pau (University of Cagliari, Italy)

Programme:

• 13:00-13:15 Gait Metrics for Clinical Use in MS - Alon Kalron (Tel Aviv University, IL)
• 13:15-13:30 Technological Advancements in Gait Analyis, the Use of Sensor and Wearables: What are we looking for? - Massimiliano Pau (University of Cagliari, IT)
• 13:30-13:45 The Intersection of Instrumental Tools and Clinical Assessments in MS Rehabilitation: the Impact of Rehabilitation Interventions on Gait - a Gait Analysis Overview - Cintia Ramari (Hasselt University, BE)
• 13:45-15:00 Hands-on Gait Analysis Demonstration

This hands-on session is designed to offer participants a deep dive into the application of theoretical knowledge in a practical setting, fostering a collaborative learning environment.
 

1. Participants will be introduced to the gait analysis softwares and equipment:
       - BTS G-Sensor and a new IMU-based system for gait (7 sensors)
       - APDM sensors and kinematic analysis  
    
2. A demo session will be provided at the GRAIL Lab (MOTEK)  
    
3. A real-time analysis of walking patterns will be conducted in groups  
    
4. A short interpretation of the main parameters of Gait and the importance of providing a clinical report for the patients and clinicians

Teaching course IV: Health Behaviour Change through Healthcare Providers

There is increasing research supporting the benefits of health behaviour change in people living with multiple sclerosis (MS), and we know that people with MS have unmet needs when it comes to information about health behaviours. Based on formative research interviewing people with MS and healthcare providers, the MS healthcare provider is one of the best avenues for health behaviour change. That formative research has yielded conceptual models for health behaviour change and health behaviour counselling. We've recently learned that social determinants of health play a central role in health behaviours and the effectiveness of health promotion. This session will overview the formative research, conceptual models, and the role of social determinants of health and health behaviour change promotion within healthcare settings. The session will focus on learning best practice health behaviour promotion from worldwide clinicians attending the RIMS conference.

Course Coordinator: Yvonne C Learmonth (Murdoch University, USA) & Robert Motl 

Programme:

• 10:00-10:10 Introduction - Yvonne C Learmonth & Robert Motl
• 10:10-10:45 Health Behaviour in MS and Formative Research on Health Behaviour Promotion through Healthcare Providers - Yvonne C Learmonth
• 10:45-11:20 Conceptual Frameworks and Models for Implementing Health Behaviour, case study examples of exercise promotion through healthcare providers - Robert Motl
• 11:20-11:55 Health Behaviours in the Context of Social Determinants of Health - Claudia Marck
• 11:55-12:00 Closing

Nurse programme : The Effects of Mindfulness (MFN): Benefits on PwMS and on Nursing Staff

Course Coordinator: Corinne Oosterlinck (National MS Center Melsbroek, BE)

MFN was defined by Jon Kabat-Zin as 'paying your attention to one's inner and other experiences in a non-judgemental manner from moment to moment (Kabat-Zinn, 2003) MFN has been shown to have effects on quality of life and psychological well being of PwMS. In addition, it has been shown to be effective in decreasing stress, emotional exhaustion, depression and burnout among nurses. The concept of MFN in nursing can be applied to enhance nurses well-being and promote holistic health (White, 2014). This nursing course will provide an overview of the effect of Mindfulness both for PwMS as well as for nursing, and provide a session with practical exercises.  

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