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Motor learning in people with multiple sclerosis: a systematic review and meta-analysis
Tablerion JM, Wood TA, Hsieh KL, Bishnoi A, Sun R, Hernandez M, An R, Sosnoff JJ
Archives of Physical Medicine and Rehabilitation 2020 Mar;101(3):512-523
systematic review

OBJECTIVE: To systematically review and quantitatively synthesize the existing evidence of motor learning in persons with multiple sclerosis (PwMS). DATA SOURCES: 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. STUDY SELECTION: 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. DATA EXTRACTION: 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. DATA SYNTHESIS: 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 < 0.001), yet explicit learning conditions did not display a significant rate of learning (p = 0.133). CONCLUSIONS: 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.

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