Andreas Wallin

Everyday living means being in complex environments and performing complex activities which usu¬ally consist of and require a combination of motor and cognitive skills. Having a neurological disease such as multiple sclerosis (MS) compromises motor-cognitive performance and corresponding brain activity. This leads to difficulties in balance and gait with or without the concurrent performance of cognitive tasks. New findings suggest that highly challenging, cognitively demanding physical exer¬cises could induce neuroplasticity. To further understand the underlying mechanisms we will study brain activity during complex walking in people with MS. The findings will give answers about the brain activity leading to motor-cognitive difficulties in MS and how it can be best targeted in rehabili¬tation. We will then perform a randomized controlled trial (RCT) in people with MS, determining the effects of a highly challenging balance training program on physical and cognitive functioning. This research project will, by use of a multi-disciplinary and multi-methodological approach, translate basic knowledge in neuroscience to applied research and clinical interventions. The overall purpose is to improve balance, gait, and motor-cognitive performance in people with MS and so reduce their fall risk, increase physical activity level, participation in everyday activities, rise self-management and health-related quality of life (HRQL). Improved functioning will reduce the burden on the indi¬vidual with MS and on the healthcare system/society. The goal of the research project is to explore motor-cognitive performance in people with MS as well as to investigate the behavioural effects in this group of highly challenging balance training in a full-scale RCT. In the project’s phase 1, a pio¬neering experimental set-up with a novel neuroimaging technique i.e., functional near-infrared spec¬troscopy (fNIRS) together with advanced gait analysis (APDM) will be used to assess complex walking in people with MS, in comparison with the outcomes of healthy controls. Then, in the project’s Phase 2 (not included in this proposal), an RCT of a progressive, highly challenging, balance training in¬tervention in people with MS will be performed. The specific aims of this application are to: 1. Investigate the effects of MS on motor-cognitive performance using measures of real-time brain activity (fNIRS) and advanced gait analysis of complex walking in comparison with healthy people 2. Link motor-cognitive performance to its underlying brain function obtained by fNIRS