Motor Learning in People with Multiple Sclerosis: A Systematic Review and Meta-analysis.

Abstract

To systematically review and quantitatively synthesize the existing evidence of motor learning in persons with multiple sclerosis (PwMS). PubMed, Cumulative Index to Nursing and Allied Health Literature, and Web of Science were searched using the following terms: multiple sclerosis, task learning, motor learning, skill learning, performance learning. Studies had to include PwMS with a main outcome being motor learning, be published in peer-reviewed journals, and be written in English. The search yielded 68 results, and the inclusion criteria were met by 17 studies. Basic descriptors of each study, study protocol, and motor learning measures were extracted. The Grading of Recommendations Assessment, Development, and Evaluation approach revealed the quality of evidence was low with a high risk of bias. Meta-analysis was conducted to determine the difference in implicit and explicit learning in PwMS and controls without multiple sclerosis. Studies scored on average 15.9 of 18 for quality assessment. PwMS were able to learn functional mobility and upper limb manipulation motor skills as indicated by short-term acquisition, transfer, and retention. Implicit learning conditions from the meta-analysis showed that PwMS were able to learn at a similar rate to controls without multiple sclerosis (P<.001), yet explicit learning conditions did not display a significant rate of learning (P=.133). While this review indicated that PwMS are capable of motor learning, several knowledge gaps still exist. Future research should focus on using higher-quality evidence to understand motor learning in PwMS and translate the findings to rehabilitation and activities of daily living.