Hossein NAJAFPOUR, Azam RIAZAT
Journal of Multiple Sclerosis Research - 2026;6(1):46-49
Clinically meaningful functional improvement in advanced secondary progressive multiple sclerosis (SPMS) is uncommon. A 34-year-old man with very early-onset multiple sclerosis, currently classified as SPMS, completed a device-free, non-pharmacological SONAPS program (19 sessions over approximately 120-150 days). At baseline, the patient was fully wheelchair-dependent and exhibited severe multidomain impairment. Composite disability assessed using the Composite Disability and Functional Status Scale improved from 38/50 to 15/50. Improvements were observed across physical, functional, and psychological domains and were accompanied by gains in muscle strength (upper limbs: 3 ->4; lower limbs: 0 ->2, Medical Research Council Scale). Functional improvements were corroborated by video-documented observations and supported by descriptive graphical representations. No adverse events were reported. This hypothesis-generating observation suggests that multidomain functional improvement may be achievable in advanced SPMS. However, controlled and blinded studies are required to confirm these findings.
