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Complementary and Alternative Therapies (CAM01) Multiple Sclerosis Imbalance: Visual Rehabilitation Marcia Baptista Dias1 Alice Estevo Dias2 1Rehabilitation, Brazilian Association of Multiple Sclerosis, Sao Paulo, Brazil; 2Scientific Research, Brazilian Association of Multiple Sclerosis, Sao Paulo, Brazil Background: Imbalance is among the most debilitating symptoms in Multiple Sclerosis (MS), causing falls and reflecting, to a large extent, the dysfunctional integration of visual sensory signals. Objectives: This preliminary study aimed to show the effects of visual rehabilitation on balance in a small group of people with MS. Methods: Three people with MS presented signs and symptoms of body imbalance. All were evaluated before and after visual rehabilitation by specialized optometrist, from ocular motility, cover test and stereoscopy, as well as chromatic and pupil analysis. Rehabilitation consisted of 7 sessions involving balance exercises associated with vision. Results: In the initial evaluations, participants presented the same pattern of body imbalance. After visual rehabilitation, improvements in body posture, static and dynamic balance, and overall physical performance were observed in all participants. Conclusions: The data obtained revealed that visual function contributes positively to the postural control system and suggests that visual rehabilitation may be an advantageous option for the treatment of imbalance in MS, since it involves ocular exercises capable of producing physical and mental stimuli that, as they improve vision, make it possible to decrease the rates of falls and consequent impairment of functional capacity. Disclosure: Nothing to disclose. Keywords: Complementary/alternative therapies in MS (CAM02) Acupuncture and Electromagnetotherapy for Chronic PAIN Relief in Multiple Sclerosis 1 | P a g e Alice Estevo Dias1 Teresa Cristina Vieira2 1Scientific Research, Brazilian Association of Multiple Sclerosis, Sao Paulo, Brazil; 2Rehabilitation, Brazilian Association of Multiple Sclerosis, Sao Paulo, Brazil Background: Chronic pain is common in people with multiple sclerosis (PwMS) with approximately 42% to 90% experiencing pain at some stage of the disease course. Pharmacological treatment in MS-related pain are usually unsatisfactory and often have severe side effects, and therefore, a need for alternative methods of pain relief is critical. Objectives: To evaluate the effectiveness and analgesic efficiency of acupuncture associated with electromagnetotherapy for chronic pain relief in a PwMS group. Methods: A total of 12 patients with multiple sclerosis were included in this prospective study, being 10 women and 2 men, aged between 40 and 74. Mean Expanded Disability Status Scale (EDSS) score was 4.8; 42% of patients were classified as having relapsing-remitting multiple sclerosis, 33% as secondary-progressive, and 25% primary-progressive. All complained of pain (10= back, 2= legs/feet), used pharmacological treatment, underwent 15 acupuncture sessions and electromagnetic therapeutic equipment applications (Kenkobio®), and answered a structured pain questionnaire. Results: The primary end point was reduction in pain intensity or elimination, whilst the secondary end point improved symptoms and quality of life. This preliminary study revealed that MS-related pain can have a significant impact on health, activity, and participation. of people, drastically reducing the quality of life. Conclusions: Although our overall results suggest that these non-pharmacological interventions had beneficial effects on chronic pain and were not harmful, studies with robust methodology are needed to assess safety and possible long-term effects, justifying the use of these interventions on chronic pain in MS. Disclosure: Nothing to disclose. Keywords: Complementary/alternative therapies in MS (CAM03) The Effects of Reflexology in People with Multiple Sclerosis Alice Estevo Dias1 Evanda Soares Oliveira2 1Scientific Research, Brazilian Association of Multiple Sclerosis, Sao Paulo, Brazil; 2Rehabilitation, Brazilian Association of Multiple Sclerosis, Sao Paulo, Brazil Background: Multiple sclerosis (MS) is associated with a wide variety of different physical and psychological symptoms that have a profound effect on quality of life. Complementary and 2 | P a g e alternative medicine (CAM) is a current treatment which seems is effective in relieving symptoms of patients with MS. Objectives: To show the opinion of a group of people with MS about the effects of reflexology. Methods: This study involved 12 people with MS and healthy feet without injury, damage, thrombosis, inflation, lesion, or fractures, 7 (58%) women and 5 (42%) men, aged 25 to 72 years and mean Expanded Disability Status Scale (EDSS) score 4.5. In the group was performed reflexology interventions within 10 weeks, once a week for 45 min. Data were collected through a structured questionnaire, immediately after. Results: All expressed satisfaction with the interventions, among them, 7 (58%) reported reflexology benefits in both psychological symptoms and pain, and 5 (42%) in exclusively psychological. Conclusions: The results showed that, according to the participant´s opinion, reflexology in relieving anxiety, stress, depression and pain was effective. Therefore, this method, as an efficient technique, can be recommended for people with MS. However, sufficient scientific evidence should support its effectiveness and safety. Disclosure: Nothing to disclose. Keywords: Complementary/alternative therapies in MS (CAM04) The Effects of Cbd:THC Tincture Oil Reducing Symptoms and Overall Symptom Management Medication Dosages, in Persons with Multiple Sclerosis Aryn Sieber1 Kristine Werner2 Karen Carera3 Ben Thrower4 Jacqueline Rosenthal4 1CannaCauses Foundation, Los Angeles, CA; 2Smyrna, GA; 3Brookhaven, GA; 4Andrew C. Carlos MS Institute, Shepherd Center, Atlanta, GA Background: It is now becoming more common for persons with multiple sclerosis (pwMS) to use cannabis to try to alleviate their MS symptoms. A survey of pwMS published in 2017 found that 47% of respondents considered using cannabis to treat their MS symptoms, 26% used cannabis for their MS symptoms, 20% have spoken with their physician about using cannabis, and 16% currently use cannabis (Cofield et al.). Many reviews (Zhornitsky and Potvin, 2012; Jawahar et al., 2013; Koppel et al., 2014; Whiting et al., 2015) agree cannabis might have a positive effect on pain in MS. In addition to the legal status, limited research evidence remains a barrier to understanding the role cannabis can play in pwMS alleviate symptoms. The amount of scientific research in this area is increasing; however, case reports and anecdotes exceed studies; 3 | P a g e thus, data regarding cannabis use to treat pain, spasticity, neuropathy and sleep quality in pwMS remains limited. Objectives: The purpose of this study is to investigate if medicinal cannabis CBD:THC oil tinctures 1.) improve symptoms and 2.) reduce overall symptom management medication dosages in pwMS. We hypothesize that pwMS will experience improvements in these measures while using CBD:THC tinctures. Methods: Participants took CBD:THC tincture oil daily. Self-reported symptom and medication assessments rating a scale from 1 to 10 were completed at baseline prior to starting a tincture, and again after an average duration of 3 to 4 months. Results: 61 pwMS aged 25 and older are included in the study. There were significant reductions (p < 0.0001) in the following symptom management scores: pain (from a mean [SD] of 7.4 [2.0] to 3.9 [1.9], n = 45), spasticity (from a mean [SD] of 7.2 [1.9] to 3.3 [1.9], n = 31), neuropathy (from a mean [SD] of 7.7 [2.0] to 4.5 [2.6], n = 25), and sleep (from a mean [SD] of 7.5 [1.9] to 3.0 [2.1], n =34). Gabapentin intake was significantly reduced from a mean [SD] of 1581.3 [1284.6] mg to 625 [739.9] mg (n = 12; p = 0.036). There were no significant reductions in Baclofen, tizanidine, or benzodiazepine intake. Conclusions: Although medicinal cannabis CBD:THC tincture oil shows promise in overall symptom reduction and symptom management medication dosage reduction in pwMS, researchers need to conduct additional studies, including clinical research studies, for pwMS using medicinal cannabis CBD:THC tincture oil. A larger sample size will allow inferential statistics to be performed. This study will further contribute to the evidence related to the efficacy of this intervention. Disclosure: Aryn Sieber: CannaCauses Foundation (consulting fee). Kristine Werner, Karen Carera, Ben Thrower, Jacqueline Rosenthal: Nothing to disclose. Keywords: Complementary/alternative therapies in MS (CAM05) Challenges and Opportunities in Progressive Multiple Sclerosis Trials: Lessons from Lipoic Acid Carin S Waslo1,2 M. Mateo Paz Soldan3,4 Mark S. Freedman5 Pavle Repovic6 Andrew J Solomon7 John R Rinker8 Mitchell T Wallin9 Jodie K Haselkorn10 Rebecca I Spain11 1Neurology, VA Portland Health Care System, Portland, OR; 2Neurology, Oregon Health & Science University, Portland, OR; 3Neurology, University of Utah, Salt Lake City, UT; 4Neurology, VA Salt Lake City HCS, Salt Lake City, UT; 5University of Ottawa and the Ottawa Hospital Research Institute, Ottawa, ON, Canada; 6Multiple Sclerosis Center, Swedish 4 | P a g e Neuroscience Institute, Seattle, WA; 7Neurological Sciences, University of Vermont College of Medicine, Burlington, VT; 8Neurology, University of Alabama at Birmingham, Birmingham, AL; 9Washington, DC VAMC, MS Center of Excellence, Washington,
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