#036: Rehabilitation in MS (RIMS) – Interview with Dr. Lars Hvid about the scope and projects

Today I talk to Dr. Lars Hvid from Aarhus University in Denmark about his role as Communications Officer for RIMS – the Rehabilitation in Multiple Sclerosis Network. It was originally focused on Europe to share best practice and research findings on the symptomatic treatment of MS. However, it is increasingly becoming an international network as the need for rehabilitation is universal. After a general overview, we will go into more specific details, such as the different stakeholders (SIGs) and how collaboration takes place and how patients can benefit from the research results.

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Table of Contents

Introduction – Who is Dr. Lars Hvid?

Dr. Lars Hvid: I’m an Associate Professor at Aarhus University in Denmark, working in the exercise biology department. I work together with Professor Urlik Dalgas if people know his name. We mostly work on Exercise and MS at Aarhus University. In addition to that, I’m also a senior researcher at the Danish MS Rehabilitation Hospitals. So these are two hospitals we have in Denmark where you can be referred to as an MS patient and go and receive multidisciplinary rehabilitation, depending on whatever goals and aims you have. So that’s where I work now. My background is I’m an exercise physiologist. So I started working a lot with some of the exercise studies, started working in aging research, and then in 2017, I moved into MS research. That’s the only thing I work on these days, that is MS.

Personal motivation for your career choice?

Dr. Lars Hvid: Well, I think actually when I did study sports science or exercise physiology, I didn’t want to work with athletes, I wanted to work with patients or individuals that could gain something from improving their physical function through exercise. That’s why I quite early on started working in the aging area. So in older individuals, you also experience a lot of some of the same symptoms actually that you see in MS, you see impairments in walking performance, cognitive performance, fatigue, and so on. So that was more my motivation that I could bring some knowledge to the table that could help people in their everyday life instead of a more luxurious type of world that is the sports scene. And that’s also what motivates me today, that I can contribute, hopefully, with research that can play a small part in improving aspects of the lives of MS patients.

Nele Handwerker: Absolutely. And for us, it feels so important to be active and not just take medication, but to be active. I love that part of my life with MS. So let’s go a bit into the details of RIMS. 

About RIMS (Rehabilitation in Multiple Sclerosis)

What is the RIMS network and why was it founded in the first place?

Dr. Lars Hvid: Well, it was founded now more than 30 years ago, I think 32 years, something like that, back in the start 90s. The idea was actually to bring together researchers and practitioners across the MS rehabilitation field to share knowledge and to help each other improve whatever rehab we are offering MS patients. And so, that was the goal when it started and it’s still, one of the primary goals of the organization.

So the RIMS organization itself represents a lot of different healthcare professionals, researchers, and patient organizations from different settings. So the aim of the RIMS organization is to enhance the activity, participation, and autonomy of persons with MS. And the way we do that or try to do that is to develop and advocate for evidence-based rehabilitation. Of course, I would say that the long-term goal in that sense is that people with MS across Europe, and the world, can have access to evidence-based rehabilitation when they need it.

Nele Handwerker: Yeah, yeah. I always like that quote, “Sports or exercise is the best disease-modifying treatment without more or less any side effects, negative side effects.“ 

Dr. Lars Hvid: Yeah. Well, there is an abundance of evidence supporting that, not just in MS, but across a lot of different populations, also in general for everybody. And it is, well, you could see it as some sort of a multimodal medication because it has so many beneficial effects. It affects your cardiovascular system, your neuromuscular system, your nervous system, your bones, and stuff. So there’s so much, but also your mood, of course. So it affects a lot of stuff going on in the brain. And that’s, of course, where it becomes very interesting when you talk about MS.

But that said, I would say that when you talk about the RIMS organization itself, rehabilitation is of course much broader than just exercise or physical rehabilitation. It could also be cognitive rehabilitation. It could be speech therapy. So there are so many different areas to address in the rehabilitation. That’s also why it’s extremely complex. I think one of the ideas about the RIMS is also to bring together that complexity and try to share knowledge to understand some of the complexity that an MS patient can– Each MS patient can be in a quite complex situation sometimes, having different problems that they want to work with and address.

Nele Handwerker: Absolutely.

Dr. Lars Hvid: That is the idea of the RIMS, to be as broad as possible in that sense. 

Who is organized in the RIMS network and how does the exchange take place?

Dr. Lars Hvid: Yeah, yeah, we have a lot of countries. Well, historically, it was founded as a European organization. I know it’s still called the EURIMS on the webpage and stuff like that. It originated in Belgium, The RIMS organization was registered in Belgium. So there is still a rule that you have to have Belgians on the board in that sense. But the idea now is actually that we don’t see it as a European network. We see it as a worldwide network. So we try to bridge and invite people across the world to come and join this network. We don’t see other types of networks addressing rehabilitation from a researcher and practitioner point of view in MS.

 And to some of the conferences, we do have Americans coming, we do have Australians coming, people from Israel. So we have a lot of countries outside Europe, but it can, of course, evolve much more than that. In addition to that, some European countries are not strongly represented in the RIMS organization. And then that may be cultural differences. It may be the tradition. It may also be something about money and funding, because, of course, if you go with the way it’s organized each year we have a conference where you can join in and present some of the work you’re doing, and you can get feedback, and there’s a lot of networking, of course. That’s one of the main goals of the conference as well. So that’s one of the activities that we have that has a lot of focus, of course.

In addition to that, we have these Special Interest Groups, The SIG, where we address more, let’s say, specific, depending on the practitioner’s or researcher’s background. It could be physiotherapy, occupational therapy, neuropsychology, exercise physiology, and stuff like that. So we try to broaden these areas a little bit more and do specific meetings each year. And for these SIG meetings, we just had the SIG…

Nele Handwerker: Occupational one, I think. I saw it on LinkedIn. 

Dr. Lars Hvid: A SIG occupation that was a joint SIG with the SIG psychology and neuropsychology in Hagerdalen, Norway. They tried to bridge these topics to some of the psychological aspects, occupational aspects, in terms of more vocational rehabilitation. So how can you have the best work-life balance as an MS patient? So that was just to give an example that you try to join forces because sometimes it makes sense to do the SIG alone, like the SIG mobility. Then you talk a lot about exercise, for instance, and how an exercise intervention works and stuff like that. So you can go very detailed into one area of the rehab setting. But of course, when you want to address the patient as a complete person and having different types of problems, most likely need a multidisciplinary team to address that.

So, one thing is to have a neurologist, you have nurses that can help provide medication, but on the other hand, you also need physiotherapists, occupational therapists, and psychologists to address some of the other aspects that the medication does not necessarily work on that efficiently. So, you need a multidisciplinary team to address the problems. I think that’s also what MS patients encounter and experience, of course, that they meet a lot of different backgrounds of researchers and practitioners.

Special Interest groups (SIGs) under RIMS

What is the purpose of a special interest group (SIG) and how did you come up with the six defined groups?

Nele Handwerker: Yes, which is good and interesting and is important to have a fulfilling life despite MS. Can you maybe just list the SIG special interest groups, the so-called SIG for us, and just give a little bit of insight into why they were formed or why you choose on these topics. Even so, sometimes you group them for special conferences or meetings. 

Dr. Lars Hvid: Yes, yes. Well, we have the SIG mobility that’s mostly focusing on physical rehabilitation. We have SIG bladder bowel and sexuality that of course addresses issues about bladder bowel and sexuality. We have SIG psychology and neuropsychology that have a lot of focus on some of the cognitive rehabilitation or neuropsychological interventions. We have SIG communication and swallowing that addresses some of these issues that are also quite prevalent challenges or problems for MS patients. We have a SIG occupation that is mostly targeting the occupational therapy area. And then you have SIG patient autonomy about how people can independently live their lives and areas like that.

So these are the SIGs we have now. Historically, it started with a little bit fewer, and then we are now at these numbers, two, four, and six different SIG groups. The reason why these developed is that based on the meetings we had in the RIMS organization, based on some of the conferences, based on the board meetings, it was using a lot of input from patient organizations and researchers and practitioners, it was decided some time ago that these were the areas that we wanted to address more in-depth between the big RIMS conference.

But that being said, it’s not a fixed entity in that sense, because we are discussing it all the time, should we add more SIGs? We are discussing right now whether we should have a SIG technology, for instance, because there is so much focus on applying new technology and approaches in the rehab setting. But of course, all of these SIGs are overlapping. That’s for sure. None of them can stand alone. And the example with the technology is that in SIG mobility, the physical rehabilitation, there’s a lot of use of technology. So, it’s embedded in all the others, but it’s more to give a chance to work directly into one area that is a little bit overlooked. And of course, I think also if there’s a lot of interest in new SIGs, then the RIMS is very keen on listening to these ideas. That’s for sure.

Nele Handwerker:  Sounds good. Yes, and digital stuff and technology are getting interesting and I try to– I think so far I did not focus on the English podcast but on the German quite a lot, and yeah. 

Dr. Lars Hvid: Well, there are some quite strong groups across Europe, across the world, that are trying to understand how we can use technology in the best way to improve it without counteracting some of the good experience we already have, the good evidence we already have about rehab. One thing is that it shouldn’t be technology for the technology itself. It should be that it adds something extra to the rehab setting. 

Nele Handwerker: Absolutely.

Dr. Lars Hvid: I think sometimes one issue that exists, is that people are also excited about new technologies, but if it doesn’t– I’m completely the same.

Nele Handwerker: It looks so good.

Dr. Lars Hvid: Of course it does, but we need– The RIMS organization is trying to push that we can do interventions or studies that provide evidence that it does add something extra. 

Nele Handwerker: Yeah. I use, for example, a tool for brain training and I just had my neuropsychology test and it was really good because training the brain is like exercising the muscles. It helps. 

Dr. Lars Hvid: Exactly. That is one example that has so many opportunities to advance even more. And of course, I think that the next step is also to make it accessible to everybody. That it shouldn’t be costly, it should be easy to use, and it should be effective. These issues are the same as traditional rehabilitation in that sense. But I think there’s so much, the next five, 10 years, that is one area that’s going to…

Nele Handwerker: Kind of explode. 

Dr. Lars Hvid: Yeah, exactly. But we have some pretty strong interests or collaborators for the RIMS organization that are spearheading that field. So we try to put that on the agenda for the RIMS organizations as well, the RIMS conference. We had a complete session last year. We also have a complete session next year about the application of technology in rehab. 

Sharing the data obtained

How do you try to bring best rehabilitation practices and new evidence-based data into the field so that every MS neurologist and therapist can use this knowledge and patients can benefit?

Dr. Lars Hvid: Yeah, of course, that is the ultimate goal. That is the patients can benefit from it. That is the ultimate goal of the RIMS as well. Of course, the structure and organization of the RIMS is that we want to bring together researchers and practitioners. So the idea is also that when the researchers and practitioners meet together, the practitioners get an update and they can bring that knowledge back to their different rehab settings and integrate it in that way.

In addition to that, we have a close collaboration with some of the ARC patient organizations, the MSIF, and the EMSP, and we try to do some joint activities as well. We had a joint session at the last conference where we tried to raise some of the issues that the patient organizations want to target in terms of research and developing practical rehabilitation. So we try to do as much as we can in that sense. Of course, patient involvement is also quite a hot topic right now, but it’s something that all organizations need to rethink a little bit. How can we improve the involvement of patients in deciding what we’re doing and setting the mission, the vision, the strategies, and so on? And we are working on some of these aspects in the RIMS organization as well. So we’re trying to advance that even more.

So it’s always a balance because I think we would like to keep the format of our conferences where you can meet up as researchers and practitioners, but the patient involvement and the presence of patients is also crucial for us to do the best type of rehab we can do.

Which informational resources exist for patients on the RIMS website?

Dr. Lars Hvid: Well, on the RIMS website, we have news and events where you can read updates and summaries of different activities that have been going on. We also have some summaries from the SIGs, the special interest group when they’ve had annual meetings or between the conference meetings. And then in addition, we have some sort of an e-learning site where we do a lot of webinars. So each month, that’s the plan at least. We try to set up a webinar where patients can meet up, not patients, but researchers, and practitioners can meet up and discuss whatever topics that they find of interest.

Just an example, on Monday, we have a webinar where we have a topic addressing how rehabilitation should be viewed and could be integrated in patients, early diagnosed with MS, so newly diagnosed MS patients. How should and how could, how can we set up rehab for that population, and which problems are more prevalent than others and stuff like that? So that’s one other activity that we have. We have these webinars. And we’ve also had some recordings from some of the conferences that are put on the website. So if you’re interested in more of the, let’s say, scientific or practical point of view in terms of rehabilitation, then we have a lot of information on the site.

But of course, that’s also one of the areas that we would like to advance even more. How can we disseminate some of the knowledge that we gather at the conferences, that we collect at the conferences or meetings so that it can be accessible to patients as well? So that’s one of the things that I think in the next two, three, five years is going to change a little bit more. But of course, we also need to remember the RIMS organization is purely based on voluntary work from researchers and practitioners. So all the time that they invest in that, that’s also away from whatever work they have to do otherwise. So of course, it’s sometimes a little bit difficult to move that very fast. If we had a lot of money, of course, it could go even faster in a more professional setting. So we’re trying to do as much as we can with the funding we have. But I think that’s an issue for all these types of organizations like the RIMS.

Nele Handwerker: Yeah. All these people being involved are probably not bored by their normal job, but trying to do some additional on top in the evenings, on the weekends whatsoever. And of course, everybody has a normal life besides work as well. So it can’t be that fast.

Dr. Lars Hvid: Exactly. I think those who are part of the RIMS, it’s because they want to make a difference. So they invest a lot of spare time in that sense to help do that. So it’s based on voluntary work mostly, but of course, we do have some funding for the RIMS organization, and we do have some sponsors. As many others probably, we’d like to advance that aspect as well, because that would make our opportunities much bigger in terms of doing, let’s say, tools or setups that can provide more info for the patient, for instance. 

Nele Handwerker: Absolutely.

Dr. Lars Hvid: So the funding issue is always something that we work hard on too. 

Nele Handwerker: And a big thank you to everybody involved in putting all that extra effort into RIMS.

Dr. Lars Hvid: Of course, we are very happy with those who are funding some of the activities we have today. But of course, the difference between some of the let’s say medications versus the rehab setting is that who are the– who has the incentive to invest in the rehab setting. Of course, we as researchers and practitioners, find it interesting. The patient, of course, finds it of interest, but who is it that can gain something from a financial point of view? And that is something where…

Nele Handwerker: Governments should be interested. 

Dr. Lars Hvid: Yes, exactly. In a system like Denmark, where we pay a lot of taxes if you take a long-term perspective, like 5, 10, 15, 20 years if you do rehab, then you have a much better trajectory, likely. And it would be much cheaper in the long run. I think that is where some of the governments should try to invest a little bit more in that sense in the long-term. But of course, this can be a long discussion to go into because it’s a lot about politics, of course. But I think that is something that all rehab organizations are dealing with. RIMS as well. So what we’re pushing and we are trying to do as much as we can to find the funding to ensure that we can do the activities we want to do. 

Nele Handwerker: Very good. But just one more question on what you’ve mentioned. So there are recordings of the conferences and the webinars are open access. So I, as a patient, if I understand it and if it’s not too difficult for me, I could join and watch it. And are there recordings of the webinars as well or not?

Dr. Lars Hvid: Yeah, there are recordings of the webinars. It’s also something that we’re working on. We’re trying to let’s say get sponsors that sponsor some of the webinars or some of the conference presentations. And if they do that, then we, of course, should be free, and accessible to everybody. But we have an ongoing discussion right now about what should we have, in order to attract people to join the RIMS organization as well, we sometimes want to have you are a member to get access to some of these activities. So it’s a little bit of a challenge in that sense.

So far, the webinars have been recorded and they are on the webpage and they’re free of charge, as well as some of the conference presentations. But some of it may change a little bit in the coming future, perhaps, where we would require a membership. But of course, that is not ideal for a patient because they do not necessarily want to be part of the RIMS organization in that sense. After all, they’re not attending the conference and all of that. So it’s always a balance in that sense. But the main goal should be that it should be free of charge. So the knowledge should be accessible to everybody.

Nele Handwerker: Yeah, and I think probably it will go a bit in the direction of the big ECTRIMS meeting, where you have those highly sophisticated topics where you need to pay for and see, let’s say, more to the ground, more basic knowledge. They are kind of open exit, at least if you join the conference and there it would be a bit different. But yeah, that makes sense. It’s fine. I mean, you can’t offer everything for free. 

Dr. Lars Hvid: No, but I think it’s a tough discussion because if you talk about a researcher, the only currency they have is scientific. On the other hand, this type of knowledge should be freely accessible to patients. So that is the balance we are in right now, so trying to find out the best solution that can be free of charge for everybody, all the patients at least. But that’s always the balance, I think. 

Nele Handwerker: Yeah, fingers crossed that there are some volunteers to sponsor these very important knowledge-sharing platforms.

Why is it so important that patients with MS take part in rehabilitation studies?

Nele Handwerker: I ask that question because I think it’s important that we as a community understand that studies are so important, but please give your vote for it. 

Dr. Lars Hvid: Well, I think, of course, you can set up projects that patients do not find interest in. And I think that’s also, back to the discussion about patient involvement, that’s also the issue there. So that if you had involved patients, then you could find out whether it’s of need or not. But of course, if you work as a researcher, you are completely dependent on patient involvement in these types of studies. And I think one thing is that you as a patient, can gain some knowledge from these studies for yourself. Normally when we do research studies, we always provide feedback to each individual who participates, that individual. In addition to that, you can also help support our future patients should get access to rehabilitation.

If we talk about MS, of course, more and more is happening in terms of, let’s say, progressive MS and medication. But still, it’s not a normal procedure right now. So there are a lot of patients that only have rehab to rely on. I think that is one important issue to also take notice of. And especially if you progress more into the disease, as it is right now, yes, there may be a shift in how the medications are used more in the progressive phases as well, or when you’ve had it for many years. But just as an example, the patients that attend the Danish MS Rehab Hospitals in Denmark, well, half of them are not using medication. So what do they have left? You know, if you cannot— So I’m just saying here that medication and rehab should go hand in hand.

Nele Handwerker: Absolutely.

Dr. Lars Hvid: Because you cannot stand alone. And at some point, you only have the rehab left. Or you only have the rehab left if you don’t respond very well to medication, or you have side effects and stuff like that. So I think there are a lot of arguments for a patient to go into the research studies. And of course, it’s always a priority of time. I think sometimes it’s also, it can be time-consuming to participate. Of course, it can. You invest your time in it as well. And sometimes you don’t see the results yourself after five years. So that can be a difficult aspect to grasp. I think that’s also difficult for researchers to grasp. Sometimes they have to wait so many years. But I think there’s a lot of– We need the patience to go into the studies for us to achieve the best knowledge that we can do, all to improve different aspects of rehab for MS patients.

Nele Handwerker: Yeah. I mean, I joined lots of studies, which are all non-medication studies. And I always find it interesting when I see, let’s say, myself compared to a while before. And of course, for progressive status, it might be that it’s not getting worse. Maybe it’s not always the point that you are improving, because it’s maybe not possible at that point of disease stage, but if I see some data for myself, that’s also one thing where I say, “Okay, yeah.“ I keep in that study even though it takes me quite some time because I see some effect. 

Dr. Lars Hvid: I fully agree and I think the aspect you mentioned about that is not necessarily about improvement, but it’s about preservation. And if we talk about the aging research area that I was in, it was also about, if you look at a 10-year perspective, it’s not about improvement, it’s about preservation. So having the best possible preservation of your bodily systems, your different functions, and your ability to interact with society and friends and family. So of course, that’s one issue.

I think the ideal situation would be that you could do some sort of a large standardized test battery every second year or five years because then you have the reference values for yourself across different topics. It could be cognitive function, it could be physical function, it could be fatigue, it could be– But if you don’t have these individual values for yourself, it’s difficult to track back. MS patients or all other persons, I think very few can remember exactly how it was one year ago.

Nele Handwerker: Absolutely.

Dr. Lars Hvid: So I can barely remember what I did yesterday. So it’s good to have these reference points that you can bring out. I think that’s where the medication field is very strong. I think that’s where the rehab field can improve a lot. But then we’re back to funding. It’s all about funding because there’s a lot of interest in doing these studies. But it’s quite challenging to get funding for a five-year or a 10-year longitudinal study in, let’s say, 5,000 MS patients unless you have some sort of a monetary payoff at the end. 

Nele Handwerker: Yeah, the government should look into how costly it is to not offer good rehabilitation for the patients because if you can’t work anymore. And that happens quite often for MS patients on cognitive stuff. Cognitive is always related to mobility as well, in a way, because if you train yourself, you can train your cognitive issues. Ulrich pointed that out quite good. I hopefully get somebody on the CogEx Study, which is now finalized, I think, and very interesting, where you see the interaction of mobility and cognition. It would be so good if our governments re-allow us. 

Dr. Lars Hvid: Yeah, exactly.

Nele Handwerker: They can save so much money. 

Dr. Lars Hvid: But I think also the researchers, need to do the hard work and do these studies. I think a lot of researchers, I’m not pointing fingers, it’s just as well myself, I’m criticizing here, that we also need to do the tough studies. We need to set them out. We need to spend a lot of years applying for money. And then, let’s say we can do a large study where we try to understand how can people maintain work-life balance as best as possible. I think a lot of the MS patients would like to keep working.

Nele Handwerker: Absolutely. Maybe a bit less, but yes.

Dr. Lars Hvid: In an adjusted setting, fine. But that may mean that they can work 15 years more. And I think if you look at that from a money perspective, there’s a lot of money to gain from that from the societies and a lot of quality of life for the patients. Because as humans, work is just an integral part of being human for almost all of us. So yeah, I think the vocational rehabilitation areas, that is quite interesting to follow in the coming years. Because I think that there’s going to be some of these studies being done. So hopefully, at least. 

Nele Handwerker: Hopefully, yes, as our population is growing older, maybe it becomes more interesting. Governments don’t always look for the, “Let’s have happy citizens.“ But when it comes to money, they get interested. I’m a bit mean. 

Dr. Lars Hvid: There should be other arguments, of course. Quality of life could be one aspect. At most rehab site settings, quality of life is some sort of an ultimate goal, I think. I think that that’s also, if we talk about some of the major studies that may be needed in, let’s say, a RIMS setting or in a RIMS perspective, I think some of these large multidisciplinary rehabilitation studies where you try to do an intervention that represents what is being done in the real world. These types of studies are needed, but they’re extremely complex to run and they’re quite expensive.

So we’re back to the– so you need to do long-term studies, like one year or two years or more. And you need to have large samples and you need to have a quite detailed description of whatever rehab you’re doing. Because let’s say you have 10 patients. Then, in theory, they will receive 10 different versions of rehab. Some will have cognitive rehabilitation, some will have speech therapy. But I think to do these real-life setting studies, would move the field forward.


Which breakthrough in research or treatment for people living with MS would you like to see in the next 5 years?

Dr. Lars Hvid: Good question. I think some of the aspects of work-life balance move stuff ahead in terms of not just when MS patients are in rehab settings, but also when they’re in their everyday life. So I think that would be something that could move ahead. With my background as an exercise physiologist, I would like to see it, I probably think Ulrik may have mentioned some of the same stuff, but we would like to do large-scale studies where you do interventions for five years, for instance, in 400 MS patients, look at how the nervous system adapts. So really trying to see the disease-modifying potential of exercise, just as you can do with the medication in the large medical studies where you follow patients for five years or in 400 or 1000 patients, but it requires a lot of money. Of course, we know that exercise works in terms of physical function, but if we can also link it up to that it has disease-modifying effects, then we are getting somewhere.

I think there’s a lot of shared knowledge about Parkinson’s or Alzheimer’s. So it’s the same type of studies that are needed. And if we do one study in MS, it could also set an example of how to do it in other neurodegenerative disorders. From a rehab perspective, I think that vocational rehabilitation in the long term could be quite interesting. That would be a breakthrough, I think. The other one in the exercise field is more still, can we do a disease modification through exercise?

Nele Handwerker: Yeah. It can be very joyful and you can find new friends so some additional positive effects for life if you do exercise and play badminton, go walking, or whatever. Do wheelchair rugby or whatever. 

Dr. Lars Hvid: Exactly. I think also the beneficial effects on the mood, the mental health, there’s so much potential. And we need studies that are targeting that as the primary aim of the studies. Right now, it’s mostly secondary outcomes. It’s a secondary story in the different studies. But I think that that is one area that we can push forward as well in terms of exercise. As you say, I think the modality doesn’t matter. If you find motivation for doing resistance training or outdoor walking or yoga, that doesn’t matter as long as it has some beneficial effects. And of course, motivation. If you want to have people doing physical activity or exercise permanently, you should find something that motivates them.

So one thing is that we as researchers can say, “Okay, you need to do resistance training for these reasons.“ Yes, but if you don’t find it motivating, then we have a lot of other options to go for. I think that could also be an example of a real-life setting study where you just monitor whatever exercise modality that people prefer and see what are the long-term effects of this. And then you can understand, “Okay, if you do yoga, then you have these benefits. If you do resistance training, you have these benefits.“ But these like head-to-head studies of different modalities are also lacking extremely much.


How and where can interested people follow your research activities?

Dr. Lars Hvid: Yeah, well, of course, we have the RIMS web page called EURIMS, eurims.org. That’s one place you can see some of the information. We also have a Twitter or X account, X or Twitter account, where you can follow the RIMS organization. We try to post a lot of information about the meetings, the SIG meetings, the webinars, and whatever we are doing. We have a LinkedIn profile as well. The information on LinkedIn and X are overlapping. Some of them are the same, but these are the platforms that we try to communicate on. So you can easily follow us there.

I also have a LinkedIn profile and an X profile if you want to follow what I’m doing specifically, but for the RIMS, you can go to the webpage there‘s a link in the top left corner where you can click on the Twitter or X or the LinkedIn logo.

Is there anything else you would like to share with the listeners?

Dr. Lars Hvid: No, but I think a podcast like this is quite important because you target the audience that is the key audience, which are the patients, of course. But of course, it could also be researchers and practitioners, who do all they can to help to try to do research or practical stuff that are of benefit to MS patients. I think the dialogue between researchers, practitioners, and patients is the key to advancing even more in the coming years. This is one platform that is perfect for that setting, I would say. Thank you for inviting me, Nele. 

Nele Handwerker: Thank you for being here and giving us an inside view. And of course, thank you to, as I said before, the complete community that is putting so much spare time into improving our lives. Thanks a lot to everybody. I’m pretty sure I will try to grasp some of your colleagues to get them on dedicated interviews on the dedicated SIG topics. And yeah. 

Dr. Lars Hvid: I’m sure they are willing to participate. 

Nele Handerker: I’m sure they have to. I’m so charming. They can’t withstand. No. Okay, thank you. 

Dr. Lars Hvid: Thank you, Nele. 

Nele Handwerker: Bye-bye.

Many thanks to Lars and everybody how is involved in the RIMS network or contributes evidence based data that helps to improve the symptomatic treatment of existing disabilities or to prevent a disease worsening.

See you soon and try to make the best out of your life,

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Portraitbild Nele Handwerker

Nele Handwerker

Blogger & Patient Advocate

I show you how to make the best of your life with MS from family to career to hobbies. Thanks to science and research, a lot is possible nowadays.

Nele Handwerker


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