From music to wearables, the new frontiers of MS rehabilitation at RiMS

Rome. Innovation, inclusion and a multidisciplinary approach were the themes at the centre of the 2025 edition of RiMS, the congress that took place from 24 to 26 September in Barcelona The aim of the conference is to promote rehabilitation as an integral part of the treatment plan for multiple sclerosis. Improving the quality of life of those with the disease through research, training, and clinical practice, the guidelines the experts discussed.

"It was a very interesting conference, divided into two educational sessions and three scientific sessions," emphasized Giampaolo Brichetto, president of RiMS, director of the Liguria Rehabilitation Service, and of the NeuroBrite Neurorehabilitation Research Center of Fism - AISM Research Foundation.

"The two educational sessions," Brichetto explains, "focused on how organizational and rehabilitation models must evolve to address complex disabilities, such as multiple sclerosis (MS) or diseases like neuromyelitis optica, seeking to further integrate the role of the clinical case coordinator. This," Brichetto adds, "is to ensure that, when developing a rehabilitation plan, we start from the specific needs of individuals, in terms of involvement in daily life and work activities." In this context, the results of the "Living Well with Progressive MS" study, tested in Italy, were presented at RiMS. Belgium and the United Kingdom. In a small case study with 12 people, "we used the rehabilitation plan coordinator to try to understand whether this approach could better meet the needs of the people," explains Brichetto. "From this, it emerged that, from an organizational standpoint, treatment pathways must be optimized, also considering cost reduction."

Another educational session focused on the use of music and rhythm in the rehabilitation of people with multiple sclerosis or related conditions, continues the RiMS president. There is evidence in the literature that these types of techniques, which we call 'tricks,' are additional modalities in the rehabilitation process that optimize walking speed, length, and cadence of steps, making them more regular. It's important to understand how to integrate these techniques into rehabilitation programs. These aren't activities aimed at the patient's well-being, like tango therapy, for example, Brichetto explains, but rather rehabilitation programs that use rhythm and music in addition to improving gait characteristics. Numerous studies demonstrate their effectiveness.

The focus of the scientific sessions was on technologies and how they can be used in clinical and research settings. "In the clinical setting," says Brichetto, "it's increasingly clear that monitoring with wearable devices has become essential at all levels. In particular, it's emerging that it's possible to predict the trajectory of diseases over time, and this is especially important for chronic diseases, as it allows us to anticipate possible progression and therefore therapeutic choices. A key point that emerged from this session is how the use of wearable devices is still not widespread. Clinicians and researchers still lack optimal knowledge of these types of technologies, and therefore, patients aren't offered their use as frequently as they should be. Patients, however, have the burden of having to remember to use the device, recharge it, or use it at night to monitor their sleep. From this perspective, it's therefore necessary to raise awareness of the potential of these types of technologies." Finally, a third reason why wearable devices are not widely used is related to research, explains the RiMS president. "There are so many devices that provide non-standard data, and therefore comparing them is complicated. Standardization work is needed to make the data consistent."

Another important point addressed during RiMS 2025 was the topic of aging in multiple sclerosis and the role of rehabilitation in old age. "Since both the quality and life expectancy of people with multiple sclerosis and related diseases have improved," Brichetto explains, "we asked ourselves how to clinically address the journey of a person who, in addition to a chronic, neurological disease and disability, also has comorbidities related to aging. Until a few years ago, this was still a rare occurrence because life expectancy was lower, and therefore people didn't age as much with the disease. On this topic, we need to understand exactly how a chronic disease evolves in older people. There is still little data on this subject, and therefore multicenter studies are needed."

A final session of RiMS was dedicated to psychological well-being and its importance in achieving more effective treatments. "We know," says Brichetto, "that a good mood can increase the effectiveness of treatments because people tend to be more adherent and engaged in the process. With less adherence, however, the treatment plan fails. Therefore," says Brichetto, "targeting the mechanisms that improve a person's mood is crucial. This can be achieved both with pharmacological interventions and with psychological support, which must go hand in hand with rehabilitation treatments. During the conference, there was an interesting presentation that hypothesized how to support people during rehabilitation treatment, trying to provide physiotherapists themselves with tools to do so."

RIMS: from a European network to an international platform, welcoming patients

The RiMS 2025 congress also marked a turning point for the European Network for Rehabilitation in Multiple Sclerosis, which announced its transition to an international platform, with a growing number of participants from every continent. "This was a strategic shift," says Brichetto. "In recent years, RiMS has seen an increase in professionals and physicians from the USA, Canada, Australia, and South America, and so the Network has decided to reposition itself as an international network. This offers the opportunity to further exchange knowledge and reach countries where rehabilitation is less widespread or less accessible."

"It was a strategic shift," says Brichetto. "In recent years, RiMS has seen an increase in operators and doctors from the USA, Canada, Australia, and South America, and so the Network has decided to reposition itself as an international network. This offers the opportunity to further exchange knowledge and reach countries where rehabilitation is less widespread or more difficult to access."

Another new development at RiMS 2025 was the creation of the first Patient Advisory Committee, a permanent body composed of people with multiple sclerosis who will work alongside the Executive Board to guide strategies and priorities. The committee includes representatives from EMSP, MSIF, AISM, and the Danish Multiple Sclerosis Society, and will be open to contributions from other international organizations in the future. For the first time, RiMS's scientific governance structure integrates the direct voice of those living with the disease. "This innovation is designed to help the management team develop a future strategy, but also to decide what content to address at the annual conferences, taking into account the perspective of people with MS. It is increasingly clear how necessary integration between clinicians, researchers, and the general public is to decide the future of research and rehabilitation."

Looking to the future

With this in mind, the 2026 edition of RiMS is already underway. "The congress will be held from June 11th to 13th in Prague," Brichetto concludes. "In February, we will have a meeting with the patient advisory committee to define the program and what aspects will need to be taken into consideration."

RiMS (Rehabilitation in Multiple Sclerosis) is the leading scientific network in Europe and worldwide for multiple sclerosis rehabilitation. It brings together clinical centers, universities, researchers, and patient organizations with the aim of promoting research, training, and clinical practice in rehabilitation. In Italy, RiMS is supported by AISM and its research foundation, Fism, strategic partners in promoting a comprehensive, person-centered approach.