Research Problem
In the clinical follow‑up of multiple sclerosis (MS), one of the most relevant objectives is to achieve a state of No Evidence of Disease Activity (NEDA). However, recent longitudinal studies have shown that this criterion does not always adequately predict long‑term disease stability. This discrepancy may be due to the limited sensitivity of the EDSS scale and conventional clinical assessments to detect subtle disability progression
Given this situation, the need has emerged to incorporate portable biomechanical technology into routine clinical practice, with the aim of identifying mild but meaningful changes in parameters related to motor function, balance, and strength.
Project Objective
To assess whether MS patients who maintain a NEDA status nonetheless exhibit signs of subclinical disability progression, as measured through biomechanical instruments, over a 4‑year follow‑up period. Additionally, the project will analyze the relationship between these functional changes and serum biomarkers of neurological damage or central nervous system integrity, such as sNfL, GFAP, and mRNA.
Study Design
Four‑year longitudinal follow‑up study. Baseline measurements have already been completed in a cohort of 96 participants with MS and 36 controls (June 2023 – February 2024; EXP_77443). The follow‑up sessions and parameters include:
Hospital visits (every 6 months): health information, blood samples, magnetic resonance imaging (annual).
Biomechanical Assessment 1 (Hospital, annual): balance and gait using a smartphone, strength using portable dynamometry and 2D analysis, HRV, PROMs, and cognitive processing speed.
Biomechanical Assessment 2 (Laboratory, years 2 and 4): balance using force platforms, strength using isokinetic dynamometry, and muscle function assessed through EMG.
Potential Impact
This study has high short‑ and medium‑term translational value. By employing portable, easy‑to‑use technologies with increasing validation, it aims to improve the clinical monitoring of people with MS, facilitating the early detection of disability progression. The results could contribute to optimizing treatment and the overall clinical management of the disease.
