Overview

Overview

Our main focus is to gather evidence regarding the efficacy of rehabilitation and symptomatic treatments to improve gait and balance in individuals with multiple sclerosis and other central nervous system disorders. We are involved in various projects, including the following:

  1. Clinical trials of physical therapy, exercise (including technology-enhanced exercise), assistive devices and orthotics, medications for spasticity, and other symptomatic medications that improve walking;
  2. Clinical trials of non-conventional interventions such as neuro-music therapy.
  3. Analysis of data from large clinical registries.
  4. Validation studies of measurement tools to assess neurologic performance, focusing on walking and balance.
Contact Information

Francois Bethoux, MD
bethouf@ccf.org

Funding

RPC 554 – CC Catalyst grant, Pilot study of Powered Exoskeleton Use for Gait Rehabilitation in Individuals with Multiple Sclerosis, Bethoux (PI), 5/30/19-5/30/20.

Consortium of MS Centers pilot grant, A pilot single-blind randomized controlled trial to evaluate the safety and feasibility of interactive rhythmic auditory stimulation for gait training in persons with Multiple Sclerosis, Bethoux (PI), 1/1/2020 – 12/31/2020.

NIH 1UH3NS100543-01, Deep cerebellar electrical stimulation for post-stroke motor recovery, Machado (PI), 09/30/2016 – 06/30/2021.

NEA 1856105-38-19, A Randomized Controlled Trial Utilizing the Arts to Improve Health, Resilience, and Well-Being in Individuals with Chronic Health Conditions in Underserved Neighborhoods, Gallagher (PI), 07/1/2019 - 06/30/2020.

Dept. of Defense SCIRP SC170311, Improving Spinal Cord Injury Rehabilitation Interventions by Retraining the Brain, Plow (PI), 9/1/2018- 8/31/2022.

PCORI MS-1610-36999, Comparative Effectiveness of an Exercise Intervention Delivered via Telerehabilitation and Conventional Mode of Delivery, Backus (PI), 2/1/18-1/31/22.

National Multiple Sclerosis Society pilot grant, Fall risk reduction in multiple sclerosis: exercise intervention vs. attention control Modification, Sosnoff (PI), 10/2016 – 09/2017.

Consortium of MS Centers pilot grant, Monitoring exertion-induced changes in gait parameters in patients with relapsing-remitting MS, Bethoux (PI), 01/2016 – 07/2017.

Biogen, Validation of the MSPT Walking and Balance Tests, Bethoux (PI), 2015 – 2017.

Adamas Pharmaceuticals Protocol # ADS-AMT-MS201, Safety and Efficacy of ADS-5102 (amantadine HCl) Extended Release Capsules in Patients with Multiple Sclerosis and Walking Impairment, 2015-2016.

Consortium of MS Centers pilot grant, Physical therapy enhanced with a virtual environment: impact on ambulation, mood, and cognition, Bethoux (PI), 12/2014 – 3/31/2016.

National Multiple Sclerosis Society RG 4665-A-1, Evaluating the effects of physical activity and fatigue management strategies, Plow (PI), 02/2014 – 09/2015.

Kelvin & Eleanor Smith Foundation, Effects of a home based walking program using rhythmic auditory stimulation on walking and cortical activation in patients with MS, Bethoux (PI), 10/2013 – 09//2015.

Publications

Publications

Long-term follow-up to a randomized controlled trial comparing peroneal nerve functional electrical stimulation to an ankle foot orthosis for patients with chronic stroke. Bethoux F, Rogers HL, Nolan KJ, Abrams GM, Annaswamy T, Brandstater M, Browne B, Burnfield JM, Feng W, Freed MJ, Geis C, Greenberg J, Gudesblatt M, Ikramuddin F, Jayaraman A, Kautz SA, Lutsep HL, Madhavan S, Meilahn J, Pease WS, Rao N, Seetharama S, Sethi P, Turk MA, Wallis RA, Kufta C. Neurorehabil Neural Repair 2015;29(10):911-22. PMID: 25653225.

Correlates of the timed 25 foot walk in a multiple sclerosis outpatient rehabilitation clinic. Bethoux F, Plow M. Int J Rehabil Res 2016;39(2):134-9. PMID: 26926380.

Validating Neuro-QoL short forms and targeted scales with persons who have multiple sclerosis.Miller DM, Bethoux F, Victorson D, Nowinski CJ, Buono S, Lai J-S, Wortman K, Burns JL, Moy C, Cella D. Mult Scler J 2016 ;22(6):830-41. PMID: 26238464.

A cross-sectional study of the impact of spasticity on daily activities in multiple sclerosis.Bethoux F, Marrie RA. Patient 2016;9(6):537-46. PMID: 27154536.

Early outcomes after intrathecal baclofen therapy in ambulatory patients with multiple sclerosis. Lee BS, Jones J, Lang M, Achey R, Dai L, Lobel DA, Nagel SJ, Machado AG, Bethoux F. J Neurosurg 2017;Epub ahead of print 01 Dec 2017:1-7. PMID: 29192855.

Safety, tolerability, and sensorimotor effects of extended-release dalfampridine in adults with cerebral palsy: a pilot study.Bethoux F, Fatemi A, Fowler E, Marciniak C, Mayadev A, Waksman J, Zackowski K, Suarez G, Blight AR, Rabinowicz AL, Carrazana E. Clin Ther 2017;39(2):337-46. PMID: 28131322.

Effects of Physical Therapy Training in an Immersive Virtual Reality System or Traditional Physical Therapy Training in MS Patients: a Case Series.Streicher MC, Alberts JL, Sutliff MH, Bethoux F. Int J Ther Rehabil 2018;25(10):522-8.

Occlusion of the Ascenda Catheter in a Patient with Pump Twiddler’s Sydrome: A Case Report. Shao J, Frizon L, Machado AG, McKee K, Bethoux F, Nagel SJ. Anesth Pain Med 2018;8(2):e65312. PMID: 30027067.

Case Series: Intrathecal Baclofen Therapy in Stiff Person Syndrome.Abbatemarco JR, Willis MA, Wilson RG, Nagel SJ, Machado AG, Bethoux FA. Neuromodulation 2018;21:655-9. PMID: 29532593.

Is the impact of fatigue related to walking capacity and perceived ability in persons with multiple sclerosis?Dalgas U, Langeskov-Christensen M, Skjerbaek A, Jensen E, Baert I, Romberg A, Santoyo Medina C, Gebara B, Maertens de Noordhout B, Knuts K, Béthoux F, Maamâgi H, Rasova K, Severijns D, Bibby BM, Kalron A, Norman B, Van Geel F, Wens I, Feys P. A multicenter study. J Neurol Sci 2018; 387:179-86. PMID: 29571860.

Impact of Music Therapy on Hospitalized Patients Post-Elective Orthopaedic Surgery. Gallagher LM, Gardner V, Bates D, Mason S, Nemecek J, Baker DiFiore J, Bena J, Li M, Bethoux F. Orthopaedic Nursing 2018;37:124-33. PMID: 29570546.

Walking Speed Measurement by an Ambient Measurement System (AMS) Correlates with Standard Gait Assessments in Multiple Sclerosis. Bethoux F, Varsanik JS, Chevalier TW, Halpern EF, Stough D, Kimmel ZA. Gait Posture 2018;61:393-97. PMID: 29454289.

Early outcomes after intrathecal baclofen therapy in ambulatory patients with multiple sclerosis.Lee BS, Jones J, Lang M, Achey R, Dai L, Lobel DA, Nagel SJ, Machado AG, Bethoux F. J Neurosurg 2018;129(4):1056-62. doi: 10.3171/2017.5.JNS162925. PMID: 29192855.

Defining the spectrum of spasticity-associated involuntary movements. Abboud H, Macaron G, Yu XX, Knusel K, Fernandez HH, Bethoux F. Parkinsonism Relat Disord. 2019;65:79-85.

Rationale and design of the STEP for MS Trial: Comparative effectiveness of Supervised versus Telerehabilitation Exercise Programs for Multiple Sclerosis. Motl RW, Backus D, Neil WN, Cutter G, Palmer L, McBurney R, Schmidt H, Bethoux F, Hebert J, Ng A, McCully K, Plummer P. Contemp Clin Trials 2019;81:110-22. PMID: 31022481.

A randomized controlled trial of telephone-delivered physical activity and fatigue self-management interventions in adults with multiple sclerosis. Plow M, Finlayson M, Liu J, Motl R, Bethoux F, Sattar A. Arch Phys Med Rehabil 2019 Jun. pii: S0003-9993(19)30397-1. PMID: 31229528.

Members & Collaborations

Members & Collaborations

Cleveland Clinic

External Relationships and Collaborations

  • Deborah Backus, PhD – Shepherd Center, Atlanta, GA
  • Robert W. Motl, PhD – University of Alabama in Birmingham, Birmingham, AL
  • Matthew Plow, PhD – Case Western Reserve University, Cleveland, OH