Patients will receive six autologous stem cell injections through spinal taps every 2 months over a year.

MSC-NPs represent a neural subpopulation of MSCs from bone marrow with reduced pluripotency and minimized risk of ectopic differentiation, thus are likely to be more suitable for CNS delivery. Importantly, characterization of MSC-NPs demonstrated their immunoregulatory and trophic properties, and MSC-NPs derived from MS and non-MS patients alike were therapeutically viable.

Intrathecal MSC-NP injection

Patients will receive six placebo injections through spinal taps every 2 months over a year.

Intrathecal saline injection

Tisch Multiple Sclerosis Research Center of New York

10 weeks of home-based exercise performed with the telerehabilitation system. Partipicants will perform two sessions per week (30-45 minutes). The content of the exercise program and the specific exercises will be planned by specialized physiotherapists.

Advanced telerehabilitation with a program made by specialized physiotherapists and delivered through the WizeCare system.

Telerehabilitation

10 weeks of home-based exercise with paper-based instructions. Partipicants will perform two sessions per week (30-45 minutes). The content of the exercise program and the specific exercises will be planned by specialized physiotherapists.Paper-based exercise instructions

Paper-based exercise instructions made by specialized physiotherapists.

Paper-based exercise

Lars Hvid

Lars Hvid, Phd

Susan Coote

Alon Kalron

Massimiliano Pau

Telehealth visits will be performed using institutionally-approved, secure, web-based teleconferencing. The standard neurology visits will occur every 6 months with their established neurology clinician via telehealth. The comprehensive care will be offered via telehealth or within the patient's local community. The comprehensive care visits will be adapted for the individual participants' needs and symptoms, consistent with standard clinical care.

Intervention includes clinical care delivered via telehealth

Multiple Sclerosis Clinical Care Delivery via telehealth

Standard neurology visits will be conducted in-clinic visits every 6 months with their established neurology clinician. The comprehensive MS care visits will be conducted in-clinic. The comprehensive care visits will be adapted for the individual participants' needs and symptoms, consistent with standard clinical care.

Intervention includes clinical care delivered via standard in clinic visits

Multiple Sclerosis Clinical Care Delivery via standard in clinic visits

MS Participant Group 1 will receive the HOBSCOTCH-MS intervention consisting of 1:1 sessions delivered once per week including:

* 1 pre-HOBSCOTCH
* Session (on webcam)
* 1 educational session (on webcam)
* 6 telephone sessions
* 1 wrap-up session (webcam or telephone)

HOBSCOTCH is a home-based self-management program to treat cognitive symptoms and improve quality of life, while minimizing the barriers of access to care. The program is based on Problem Solving Therapy (PST) and teaches problem solving strategies and compensatory mechanisms to help manage cognitive dysfunction and enhance quality of life. HOBSCOTCH-MS is an adaptation of the HOBSCOTCH program specifically for people who have multiple sclerosis. It incorporates education about these conditions and cognition into the education module.

Home Based Self- management and Cognitive Training Changes lives in Multiple Sclerosis (HOBSCOTCH-MS)

MS Participant Group 2 will be on a 3-month wait list after which they will receive HOBSCOTCH-MS consisting of 1:1 sessions delivered once per week including:

* 1 pre-HOBSCOTCH
* Session (on webcam)
* 1 educational session (on webcam)
* 6 telephone sessions
* 1 wrap-up session (webcam or telephone)

Caregiver Group 1 will receive an adapted version of HOBSCOTCH-MS by attending the introductory session and session 1 of the HOBSCOTCH-MS (virtual) program with their MS participant as well as guidance and instructions on utilizing quick relaxation. Caregiver Group 1 will also attend session 8 of the program with the MS patient to focus on program wrap-up and maintenance planning.

Caregiver Group 2 will be on a 3 month wait list with their MS participant after which time they will receive an adapted version of HOBSCOTCH-MS by attending the introductory session and session 1 of the HOBSCOTCH-MS (virtual) program with their MS patient as well as guidance and instructions on utilizing quick relaxation. Caregiver Group 1 will also attend session 8 of the program with the MS patient to focus on program wrap-up and maintenance planning.

Meredith E Olenec

Sarah J. Kaden, BA

Elaine T. Kirikapoulos, MD, MPH, MSc

This group will do online rehabilitation three times a week. Every two weeks, an assessment will be made to determine whether to increase the intensity of the exercise

Adverse events are observed during online rehabilitation with computer vision technology in patients with MS.

Telerehab

This group will only have access to basic recommendations for physical activity.

This is a prospective, interventional study involving 30 subjects who have been diagnosed with multiple sclerosis and being treated with Ocrelizumab for at least one year.

The cognitive and fatigue assessments administered in this study are not currently part of the standard clinical care for multiple sclerosis patients on Ocrelizumab. By prospectively assigning participants to undergo these additional assessments, this aspect of the study is considered investigational, and findings may contribute to clinical decision-making regarding the incorporation of cognitive and fatigue assessments into routine management of multiple sclerosis conditions.

Multiple Sclerosis patients who have been on Ocrelizumab will undergo cognitive and fatigue assessments

Lynn Huber, MBA

Sara Omar, MSc

Anza Memon, M.D, FAAN

Kyrstina Mariouw, PhD

Participants in this condition will receive a 4-month home-based, remotely supported aerobic and resistance exercise program based on the Guidelines for Exercise in Multiple Sclerosis (GEMS).

Remotely-coached/guided, home-based program delivered using telerehabilitation focusing on aerobic fitness and muscle strength as a mode of training.

Guidelines for Exercise in Multiple Sclerosis (GEMS)

Participants in this condition will receive a 4-month home-based, remotely supported stretching program emphasizing flexibility and range of motion as important components of fitness based on Stretching for People with MS: An Illustrated Manual from the National MS Society.

Remotely-coached/guided, home-based program delivered using telerehabilitation focusing on stretching and range of motion as the mode of training.

FLEX Stretching and Toning Program

Robert W Motl, PhD

Edson Flores, MPH

Mapping of coordination, balance and gait pattern disorders caused by stroke. After diagnosis, introducing a neurorehabilitation exercise program that improves postural instability by supplementing virtual therapy with conventional balance and coordination exercises.

Investigating the effectiveness of neurorehabilitation treatments through therapy.

Changes in neurological status after intervention.

The Tecnobody ProKin stabilometer and posturometer is currently one of the most effective tools for objectively measuring static and dynamic balance. It can effectively measure the trunk control and sense of balance of patients in several ways: on stable or unstable surfaces, and while standing on one or two legs. With the help of various programs, the device determines the oscillations of the center of mass (CoP) of the patient's body, and is able to accurately determine the patient's proprioceptive perception. Furthermore, ProKin is able to examine the joint movements of the trunk and lower limbs together or even separately. Thanks to these quantified data, we have the opportunity to map the postural instability and balance disorders caused by different patient groups, and thus we will be able to provide a more accurate treatment for our patients.

With 3D motion analysis stride length, stride width and the number of steps in 10 meters were measured.

Stroke posturo/3D group

Mapping of coordination, balance and gait patterns disorders caused by Parkinson's disease.

After diagnosis, introducing a neurorehabilitation exercise program that improves postural instability by supplementing virtual therapy with conventional balance and coordination exercises.

Investigating the effectiveness of neurorehabilitation treatments through therapy.

Changes in neurological status after intervention.

Parkinson posturo/3D group

Mapping of coordination, balance and gait patterns disorders caused by multiple sclerosis.

After diagnosis, introducing a neurorehabilitation exercise program that improves postural instability by supplementing virtual therapy with conventional balance and coordination exercises.

Investigating the effectiveness of neurorehabilitation treatments through therapy.

Changes in neurological status after intervention.

Multiple sclerosis posturo/3D group

Somogy Megyei Kaposi Mór Teaching Hospital

A behavioral intervention that involves an internet website and one-on-one video coaching calls for increasing physical activity in people with MS.

The current behavioral intervention consists of two primary components; an internet website and one-on-one video chats with a behavioral coach. The internet website involves content delivered through interactive video courses.The interactive video courses are based on elements of social cognitive theory. Each course consists of an introduction, the primary content, and a take home message.The interactive courses include embedded, supplementary options such as videos on content and worksheets related to the topic.A pedometer is provided for tracking steps, and these steps will be entered into the website so progress can be monitored. The chats support adherence to the intervention,discussion of website material,supportive accountability,and reporting of adverse events/injuries. The chats are conducted face-to-face through an online videoconferencing platform. There are a total of 12 chats over 16 weeks. Chats occur on weeks 1-8, 10-11, 13 and16.

Behavioural intervention for physical activity for multiple sclerosis (BIPAMS)

Participants will have 16-weeks of no intervention or interaction.

An MS-specific fatigue management program, delivered as a stand-alone, fully automated intervention via an internet-browser.

Online Program for Fatigue

Fatigue Program B will use a web-based interface with similar design and functionality as Fatigue Program A.

척추강내 MSC-NP 주사, 척추강내 식염수 주사

원격 재활, 종이 기반 운동

원격진료를 통한 다발성 경화증 임상 진료 제공, 기존 병원 방문을 통한 다발성 경화증 임상 진료 제공

가정 기반 자기 관리 및 인지 훈련은 다발성 경화증 환자의 삶을 변화시킵니다(HOBSCOTCH-MS)

텔레리햅

오크렐리주맙을 복용한 다발성 경화증 환자는 인지 및 피로 평가를 받게 됩니다.

다발성 경화증 운동 지침(GEMS), FLEX 스트레칭 및 토닝 프로그램

뇌졸중 자세/3D 그룹, 파킨슨병 자세/3D 그룹, 다발성 경화증 자세/3D 그룹

다발성 경화증 환자의 신체 활동을 위한 행동 중재(BIPAMS)

피로 해소를 위한 온라인 프로그램