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Salamatullah HK, Alkhiri A, Ezzi S, Alghamdi G, Alharbi G, Alzahrani WS, Alghaythee HK, Almaghrabi AA, Alturki F, Alamri AF, Makkawi S. The interaction between exercise and neurofilament light chain in multiple sclerosis: a systematic review and meta-analysis. Mult Scler Relat Disord 2024; 90:105809. [PMID: 39151239 DOI: 10.1016/j.msard.2024.105809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/29/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Exercise in patients with multiple sclerosis (pwMS) found to improve symptom management and regain function. Whether exercise lowers neurofilament light chain (NfL), neuroaxonal injury biomarker, in MS remains unknown with conflicting findings. In this study, we aimed to assess the interaction between exercise and NfL levels in pwMS. METHODS Systematic search of Medline, CENTRAL, Embase, and Web of Science was conducted until March 2024 to identify relevant reports. We included studies that investigated the mean change in NfL levels pre- and post-training programs and compared them to different exercise programs or no exercise activity control groups. A standardized mean difference (SMD) with a 95 % confidence interval were applied using a random-effects model. RESULTS Of 222 articles, 7 studies met the inclusion criteria. Patients who underwent structured exercise programs had a significant decrease in blood NfL levels post-training (SMD -0.55; 95 % CI -1.00, -0.09). Specifically, outdoor Pilates and home-based trainings were significantly associated with blood NfL reduction (SMD -2.08; 95 % CI -2.99, -1.17) and (SMD -1.46; 95 % CI -2.28, -0.64), respectively. Patients in the control group did not show significant differences in blood NfL levels between the baseline and at the end of the study (SMD 0.04; 95 % CI -0.17, 0.24). Subgroup analysis based on duration revealed that 8 weeks of exercise significantly reduced blood NfL levels (SMD -0.73; 95 % CI -1.35, -0.11). CONCLUSION Our study provides preliminary evidence for the potential role of training in reducing blood NfL levels in pwMS. However, more rigorous, and well-designed studies are warranted to confirm these findings.
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Affiliation(s)
- Hassan K Salamatullah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ahmed Alkhiri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Suzana Ezzi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ghidaa Alghamdi
- College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ghadi Alharbi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Waleed S Alzahrani
- Department of Neuroscience, Ministry of The National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Himyan Kamel Alghaythee
- Department of Neuroscience, Ministry of The National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Ahmed A Almaghrabi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Fahad Alturki
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Aser F Alamri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Seraj Makkawi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Neuroscience, Ministry of The National Guard Health Affairs, Jeddah, Saudi Arabia.
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Gouider R, Souissi A, Mrabet S, Gharbi A, Abida Y, Kacem I, Gargouri-Berrechid A. Environmental factors related to multiple sclerosis progression. J Neurol Sci 2024; 464:123161. [PMID: 39137699 DOI: 10.1016/j.jns.2024.123161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/15/2024]
Abstract
Multiple Sclerosis (MS) is a complex neurological disease which prevalence is increasing worldwide. The impact of environmental factors on MS susceptibility has already been defined and highlighted in many previous reports, particularly vitamin D or ultraviolet B light exposure, Epstein-Barr virus (EBV) infection, obesity, and smoking. There is increasing evidence that environmental and lifestyle factors are not only important in triggering MS but are also implicated in MS progression. Low sun exposure and vitamin D deficiency exhibit a strong relationship with disease progression in both animal and human studies. The gestational period seems also to impact long-term disease progression as January's babies had a higher risk of requiring walking assistance than those born in other months. The implication of EBV in neurodegeneration and MS progression was also suggested even though its specific targets and mechanisms are still unclear. Cigarette smoking is correlated with faster clinical progression. The association of obesity and smoking seems to be associated with a faster progression and an increased rate of brain atrophy. Although the effect of air pollution on MS pathogenesis remains not fully understood, exposure to polluted air can stimulate several mechanisms that might contribute to MS severity. People with MS with active disease have an altered microbiota compared to patients in the remission phase. Cardiovascular comorbidities, epilepsy, and depression are also associated with a more severe disability accrual. Knowledge about MS modifiable risk factors of progression need to be incorporated into everyday clinical practice in order to ameliorate disease outcomes.
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Affiliation(s)
- Riadh Gouider
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, Tunis, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia.
| | - Amira Souissi
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, Tunis, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia
| | - Saloua Mrabet
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, Tunis, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia
| | - Alya Gharbi
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, Tunis, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia
| | - Youssef Abida
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, Tunis, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia
| | - Imen Kacem
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, Tunis, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia
| | - Amina Gargouri-Berrechid
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, Tunis, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia
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Huynh TLT, Neal WN, Barstow EA, Motl RW. Physical Activity in Individuals Newly Diagnosed With Multiple Sclerosis Through the Lens of the COM-B Model. Int J MS Care 2024; 26:49-56. [PMID: 38482516 PMCID: PMC10930808 DOI: 10.7224/1537-2073.2022-095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Physical activity (PA) is a promising intervention for disease modification and symptom management in multiple sclerosis (MS); however, there is a lack of research focusing on PA behavior change interventions for persons newly diagnosed with MS. Such PA behavior change interventions should be developed based on a strong empirical foundation of understanding the behavior and its determinants (ie, what to target for changes to occur). To that end, this qualitative study examined factors explaining PA in persons newly diagnosed with MS and identified potential targets for future behavior change intervention development based on the Capability-Opportunity-Motivation-Behavior (COM-B) model. METHODS Twenty individuals diagnosed with MS within the past 2 years underwent one-on-one semistructured interviews using questions developed based on the COM-B model. Data were analyzed using reflective thematic analysis, and the identified themes were then mapped with the COM-B model. RESULTS Factors explaining PA in the study sample were identified across the COM-B components. The typical factors include knowledge and skills to sufficiently engage in PA with appropriate approaches, ability to adapt and navigate through new environmental and social difficulties after diagnosis, and motivation resulting from a combination of factors, such as outcome expectation, belief of capabilities, role/identity, reinforcement, and emotions. CONCLUSIONS The COM-B model was applied successfully in this study to understand PA behavior and identify potential targets for behavior change in individuals newly diagnosed with MS. Future behavior change interventions should consider addressing these factors to generate effective PA behavior change in this population.
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Affiliation(s)
- Trinh L. T. Huynh
- From the Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA (TLTH, RWM)
| | - Whitney N. Neal
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA (WNN)
| | - Elizabeth A. Barstow
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA (EAB)
| | - Robert W. Motl
- From the Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA (TLTH, RWM)
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Mansoubi M, Learmonth YC, Mayo N, Collet J, Dawes H. The MoXFo Initiative: Using consensus methodology to move forward towards internationally shared vocabulary in multiple sclerosis exercise research. Mult Scler 2023; 29:1551-1560. [PMID: 37880961 PMCID: PMC10637107 DOI: 10.1177/13524585231204460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) exercise terminology lacks consistency across disciplines, hindering research synthesis. OBJECTIVE The 'Moving exercise research in MS forward initiative' (MoXFo) aims to establish agreed definitions for key MS exercise terms. METHODS The Lexicon development methodology was employed. A three-step process identified key exercise terminology for people with multiple sclerosis (pwMS): (1) consensus and systematic review, (2) Delphi round 1 and consideration of existing definitions and (3) Delphi round 2 for consensus among MoXFo steering group and exercise experts. Final definitions and style harmonisation were agreed upon. RESULTS The two-stage Delphi process resulted in the selection and scoring of 30 terminology definitions. The agreement was 100% for resistance exercise, balance and physical activity. Most terms had agreement >75%, but 'posture' (60%) and 'exercise' (65%) had a lower agreement. CONCLUSION This study identified key terms and obtained agreement on definitions for 30 terms. The variability in agreement for some terms supports the need for clearly referencing or defining terminology within publications to enable clear communication across disciplines and to support precise synthesis and accurate interpretation of research.
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Affiliation(s)
- Maedeh Mansoubi
- Medical School, University of Exeter, Exeter, UK
- NIHR Exeter Biomedical Research Centre, Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- INTERSECT, Medical School, University of Exeter, Exeter, UK
| | - Yvonne Charlotte Learmonth
- Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Healthy Futures Institute, Murdoch University, Perth, WA, Australia
- Centre for Healthy Ageing, Healthy Futures Institute, Murdoch University, Perth, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Nancy Mayo
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Johnny Collet
- Centre for Movement, Occupational and Rehabilitation Science (MOReS), Oxford Brookes University, Oxford, UK
| | - Helen Dawes
- Medical School, University of Exeter, Exeter, UK
- NIHR Exeter Biomedical Research Centre, Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- INTERSECT, Medical School, University of Exeter, Exeter, UK
- Centre for Movement, Occupational and Rehabilitation Science (MOReS), Oxford Brookes University, Oxford, UK
- Oxford Health Biomedical Research Centre, University of Oxford, Oxford, UK
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Jacot de Alcântara I, Voruz P, Allali G, Fragnoli C, Antoniou MP, Lalive PH, Péron JA. Personality as a Predictor of Disability in Multiple Sclerosis. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2023:7034215. [PMID: 36764662 PMCID: PMC10369360 DOI: 10.1093/arclin/acad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE As personality changes and personality disorders are frequently observed in multiple sclerosis (MS), personality may be a prognostic factor for this disease. The present study investigated the influence of personality on disability, progression, and treatment adherence in MS. METHOD Personality was assessed in 41 patients with Relapsing-Remitting MS (30 females; mean age = 42.63 years) using the NEO Personality Inventory-3rd edition. Disability was measured with the Expanded Disability Status Scale, and treatment adherence information was collected from the Swiss MS Cohort. Correlation, multiple linear and partial least square regressions were performed to examine relations between personality, disability, and treatment adherence in MS. RESULTS After accounting for age and time since disease onset, our analysis revealed that Neuroticism (β = 0.32, p = 0.01) and its Vulnerability facet (β = 0.28, p < 0.05) predicted greater disability, whereas Extraversion (β = -0.25, p = 0.04) and its Activity facet (β = -0.23, p < 0.05) predicted milder disability. Regarding disability progression, correlational analysis revealed that it was negatively correlated with Extraversion (r = -0.44, p = 0.02) and the Feelings facet of Openness (r = -0.41, p = 0.03), but regressions failed to highlight any predictive links. No significant results could be demonstrated for treatment adherence. CONCLUSIONS Overall, our study showed that some personality traits can impact disability in MS, indicating that these should be considered in clinical practice, as they could be used to adapt and improve patients' clinical support.
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Affiliation(s)
- Isabele Jacot de Alcântara
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Switzerland
| | - Philippe Voruz
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland.,Neurology Department, Geneva University Hospitals, Switzerland.,Faculty of Medicine, University of Geneva, Switzerland
| | - Gilles Allali
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Chloé Fragnoli
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland
| | - Maria Paraskevi Antoniou
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland
| | - Patrice Henri Lalive
- Neurology Department, Geneva University Hospitals, Switzerland.,Faculty of Medicine, University of Geneva, Switzerland
| | - Julie Anne Péron
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland.,Neurology Department, Geneva University Hospitals, Switzerland
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Sastre-Garriga J, Rovira A, García-Vidal A, Carbonell-Mirabent P, Alberich M, Vidal-Jordana A, Auger C, Tintore M, Montalban X, Pareto D. Spinal cord reserve in multiple sclerosis. J Neurol Neurosurg Psychiatry 2023:jnnp-2022-330613. [PMID: 36690430 DOI: 10.1136/jnnp-2022-330613] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND The spinal cord (SC) is a preferential target of multiple sclerosis (MS) damage highly relevant towards disability. Differential impact of such damage could be due to the initial amount of SC tissue, as described for the brain parenchyma (brain reserve concept). We aimed to test the existence of SC reserve by using spinal canal area (SCaA) as a proxy. METHODS Brain sagittal three-dimensional T1-weighted scans covering down to C5 level were acquired in 2930 people with MS and 43 healthy controls (HCs) in a cross-sectional, multicentre study. SC area (SCA) and SCaA were obtained with the Spinal Cord Toolbox. Demographical data and patient-derived disability scores were obtained. SC parameters were compared between groups with age-adjusted and sex-adjusted linear regression models. The main outcome of the study, the existence of an association between SCaA and Patient Determined Disease Steps, was tested with scaled linear models. RESULTS 1747 persons with MS (mean age: 46.35 years; 73.2% female) and 42 HCs (mean age: 45.56 years; 78.6% female) were analysed after exclusion of post-processing errors and application of quality criteria. SCA (60.41 mm2 vs 65.02 mm2, p<0.001) was lower in people with MS compared with HC; no differences in SCaA were observed (213.24 mm2 vs 212.61 mm2, p=0.125). Adjusted scaled linear models showed that a larger SCaA was significantly associated with lower scores on Patient Determined Disease Steps (beta coefficient: -0.12, p=0.0124) independently of spinal cord atrophy, brain T2 lesion volume, age and sex. CONCLUSIONS A larger SCaA may be protective against disability in MS, possibly supporting the existence of SC reserve.
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Affiliation(s)
- Jaume Sastre-Garriga
- Servei de Neurologia / Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Alex Rovira
- Secció de Neuroradiologia, Servei de Radiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Aran García-Vidal
- Secció de Neuroradiologia, Servei de Radiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Pere Carbonell-Mirabent
- Servei de Neurologia / Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Manel Alberich
- Secció de Neuroradiologia, Servei de Radiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Angela Vidal-Jordana
- Servei de Neurologia / Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Cristina Auger
- Secció de Neuroradiologia, Servei de Radiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mar Tintore
- Servei de Neurologia / Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Xavier Montalban
- Servei de Neurologia / Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Deborah Pareto
- Secció de Neuroradiologia, Servei de Radiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Macdonald E, Buchan D, Cerexhe L, Renfrew L, Sculthorpe N. Accelerometer measured physical activity and sedentary time in individuals with multiple sclerosis versus age matched controls: A systematic review and meta-analysis. Mult Scler Relat Disord 2023; 69:104462. [PMID: 36521386 DOI: 10.1016/j.msard.2022.104462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND People with Multiple Sclerosis (PwMS) find it more difficult to engage in physical activity (PA) than healthy controls. Accelerometers can be used to measure sedentary time and free-living physical activity, understanding the differences between PwMS and controls can help inform changes such as interventions to promote a more active lifestyle. This in turn will help prevent secondary conditions and reduce symptom progression. OBJECTIVE To conduct a systematic review and meta-analysis on accelerometer measured sedentary behavior and physical activity between PwMS and healthy controls. METHODS A systematic search of five databases (PubMed, Web of Science, Ovid, Science Direct and CINAHIL) from inception until 22nd November 2019. Inclusion criteria was (1) included a group of participants with a definite diagnosis of multiple sclerosis of any type; (2) have 3 or more days of PA monitoring using accelerometers during free living conditions; (3) include age matched healthy controls; (4) assess adults over the age of 18; (5) reported data had to have been reported in a manner suitable for quantitative pooling including: percent of time spent sedentary, minutes per day of sedentary, light, moderate, vigorous activity (moderate and vigorous totaled together), steps per day or counts per day. RESULTS Initial search produced 9021 papers, after applying inclusion criteria 21 eligible papers were included in the study. One paper was a longitudinal study from which only baseline data was included. One paper was a reliability and validity study, with data for PwMS versus controls in the validity section. All other papers are cross sectional, with one being a pilot study and another a random control study. One paper used two devices in unison, only one set of data is included in the statistics. Outcome data was available for 1098 participants, 579 PwMS and 519 healthy controls. Significant differences were seen in all categories tested: (1) sedentary time (min/day), standard mean difference -0.286, P = 0.044, n = 4 studies; (2) relative sedentary time (%/day), standard mean difference -0.646, P = 0.000, n = 5 studies; (3) LPA (min/day), standard mean difference 0.337, P = 0.039, n = 5 studies; (4) relative LPA (%/day), standard mean difference 0.211, P = 0.152, n = studies; (5) MVPA (min/day), standard mean difference 0.801, P = 0.000, n = 8 studies; (6) relative MVPA (%/day), mean difference 0.914, P = 0.000, n = 5 studies; (7) step count, standard mean difference 0.894, P = 0.000, n = 8 studies; (8) activity count, standard mean difference 0.693, P = 0.000, n = 13 studies. CONCLUSION PwMS are more sedentary and engage in less LPA, MVPA, steps per day and accelerometer counts per day than healthy controls when measured using accelerometers during free-living conditions.
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Affiliation(s)
- Eilidh Macdonald
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom.
| | - Duncan Buchan
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom
| | - Luke Cerexhe
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom
| | - Linda Renfrew
- Douglas Grant Rehabilitation Unit, Ayrshire Central Hospital, Kilwinning Road, Irvine, Ayrshire, Scotland KA12 8SS, United Kingdom
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom
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Smith M, Williams G, Jordan M, Willson A, Barker R. The feasibility of a flexible exercise participation programme (FEPP) for individuals with multiple sclerosis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 28:e1988. [PMID: 36536530 DOI: 10.1002/pri.1988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Individuals with multiple sclerosis (MS) want health advice regarding participation in their choice of exercise. To address this need, a flexible exercise participation programme (FEPP) was developed, underpinned by the MS aerobic exercise guidelines and supported by a physiotherapist using behaviour change techniques. The aim of this study was to investigate the feasibility of the FEPP for individuals with minimal disability from MS. METHODS A feasibility study utilising a single group pre/post-intervention design was conducted. The 12-week FEPP was completed by 10 individuals with MS (EDSS 0-3.5). Exercise progression in duration, intensity or frequency of exercise (in line with MS exercise guidelines) was guided by a self-perceived weekly energy level score, and weekly telephone coaching sessions using behavioural change techniques. Trial feasibility was assessed via measures of process (recruitment and retention), resources/management (communication time; data entry) and scientific feasibility (safety; compliance). Secondary FEPP feasibility outcomes included the Goal Attainment Scale (GAS) T-score, exercise participation (weekly exercise diary), high-level mobility (HiMAT), vitality (Subjective Vitality Scale), biomarkers for inflammation (cytokines levels [IL2, IL4, IL6, IL10, TNF and IFNγ]), and acceptability (participant survey). RESULTS Process: In total, 11 (85%) of 13 eligible participants enroled at baseline with 10 (91%) completing the study. Resources/management: Coaching sessions included a baseline interview-mean 39 min (SD: 6.6) and telephone coaching-mean 10 min (SD: 3.8) per week. Outcome measure data collection time-mean 44 min (SD: 2.1). Scientific feasibility: Two participants experienced a fall during their exercise participation. Self-reported compliance was high (99%). GAS T-scores increased significantly, indicating achievement of exercise participation goals. Secondary outcomes showed trends towards improvement. DISCUSSION The FEPP was feasible, safe and highly acceptable for use with individuals with MS and warrants a larger trial to explore effectiveness.
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Affiliation(s)
- Moira Smith
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Gavin Williams
- Discipline of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Margaret Jordan
- College of Public Health, Medical and Vet Sciences, James Cook University, Townsville, Queensland, Australia
| | - Annie Willson
- College of Public Health, Medical and Vet Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ruth Barker
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
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Huynh TLT, Silveira SL, Motl RW. Systematic review of participant characteristics in theory-based behavior change interventions for physical activity in multiple sclerosis: are we missing those with the greatest potential for lifelong benefits? Disabil Rehabil 2022; 44:5784-5803. [PMID: 34334057 DOI: 10.1080/09638288.2021.1954705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study examined participant characteristics, particularly disease duration, in theory-based physical activity behavior change trials in multiple sclerosis (MS) and summarized theoretical frameworks and changes in physical activity outcomes. MATERIALS AND METHODS PubMed, CINAHL, Embase, and Scopus were searched to identify potential trials. One reviewer screened titles and abstracts, and two reviewers then independently screened full-text articles based on predetermined eligibility criteria. Data were extracted by one reviewer and checked by a second reviewer. RESULTS Among 33 trials reviewed, only one trial reported a mean disease duration of less than five years (i.e., 4.5 years) for the sample. The remaining trials included samples with a mean disease duration of 6.7 years or longer. The most common theories used were Social Cognitive Theory, Trans-theoretical Model, and Motivational Interviewing. The effects on physical activity were heterogeneous; device-measured outcomes increased in 41.4% of studies, self-reported outcomes improved in 72.4%. Adherence (≥80%) was reported in 34.5% of studies. CONCLUSIONS There is little focus on persons with MS in the early disease course in physical activity behavior change interventions. Future research should include comprehensive theoretical approaches for more homogeneous effects across outcome measures when targeting those in the early stage and all MS populations.IMPLICATIONS FOR REHABILITATIONTheory-based physical activity behavior change interventions have not included persons with multiple sclerosis (MS) in the early disease course (<5 years since diagnosis).Disease duration has not been a criterion used to include or exclude participants in the reviewed theory-based behavior change interventions for physical activity in people with MS.The theory-based behavior change interventions in this review positively affected short-term physical activity levels in people with MS.
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Affiliation(s)
- Trinh L T Huynh
- Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Robert W Motl
- Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
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Spaas J, Goulding RP, Keytsman C, Fonteyn L, van Horssen J, Jaspers RT, Eijnde BO, Wüst RCI. Altered muscle oxidative phenotype impairs exercise tolerance but does not improve after exercise training in multiple sclerosis. J Cachexia Sarcopenia Muscle 2022; 13:2537-2550. [PMID: 35929063 PMCID: PMC9530506 DOI: 10.1002/jcsm.13050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 06/05/2022] [Accepted: 06/13/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Patients with multiple sclerosis (MS) experience reduced exercise tolerance that substantially reduces quality of life. The mechanisms underpinning exercise intolerance in MS are not fully clear. This study aimed to determine the contributions of the cardiopulmonary system and peripheral muscle in MS-induced exercise intolerance before and after exercise training. METHODS Twenty-three patients with MS (13 women) and 20 age-matched and sex-matched healthy controls (13 women) performed a cardiopulmonary exercise test. Muscle fibre type composition, size, succinate dehydrogenase (SDH) activity, capillarity, and gene expression and proteins related to mitochondrial density were determined in vastus lateralis muscle biopsies. Nine MS patients (five women) were re-examined following a 12 week exercise training programme consisting of high-intensity cycling interval and resistance training. RESULTS Patients with MS had lower maximal oxygen uptake compared with healthy controls (V̇O2peak , 25.0 ± 8.5 vs. 35.7 ± 6.4 mL/kg/min, P < 0.001). The lower gas exchange threshold (MS: 14.5 ± 5.5 vs. controls: 19.7 ± 2.9 mL/kg/min, P = 0.01) and slope of V̇O2 versus work rate (MS: 9.5 ± 1.7 vs. controls: 10.8 ± 1.1 mL/min/W, P = 0.01) suggested an intramuscular contribution to exercise intolerance in patients with MS. Muscle SDH activity was 22% lower in MS (P = 0.004), and strongly correlated with several indices of whole-body exercise capacity in MS patients (e.g. V̇O2peak , Spearman's ρ = 0.81, P = 0.002), but not healthy controls (ρ = 0.24, P = 0.38). In addition, protein levels of mitochondrial OXPHOS complexes I (-40%, P = 0.047) and II (-45%, P = 0.026) were lower in MS patients versus controls. Muscle capillary/fibre ratio correlated with V̇O2peak in healthy controls (ρ = 0.86, P < 0.001) but not in MS (ρ = 0.35, P = 0.22), and did not differ between groups (1.41 ± 0.30 vs. 1.47 ± 0.38, P = 0.65). Expression of genes involved in mitochondrial function, such as PPARA, PPARG, and TFAM, was markedly reduced in muscle tissue samples of MS patients (all P < 0.05). No differences in muscle fibre type composition or size were observed between groups (all P > 0.05). V̇O2peak increased by 23% following exercise training in MS (P < 0.001); however, no changes in muscle capillarity, SDH activity, gene or protein expression were observed (all P > 0.05). CONCLUSIONS Skeletal muscle oxidative phenotype (mitochondrial complex I and II content, SDH activity) is lower in patients with MS, contributing to reduced exercise tolerance. However, skeletal muscle mitochondria appeared resistant to the beneficial effects of exercise training, suggesting that other physiological systems, at least in part, drive the improvements in exercise capacity following exercise training in MS.
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Affiliation(s)
- Jan Spaas
- University MS Center (UMSC) Hasselt - Pelt, Hasselt, Belgium.,SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Richie P Goulding
- Laboratory for Myology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Charly Keytsman
- University MS Center (UMSC) Hasselt - Pelt, Hasselt, Belgium.,SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Lena Fonteyn
- University MS Center (UMSC) Hasselt - Pelt, Hasselt, Belgium.,SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Jack van Horssen
- University MS Center (UMSC) Hasselt - Pelt, Hasselt, Belgium.,Department of Molecular Cell Biology and Immunology, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Richard T Jaspers
- Laboratory for Myology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Bert O Eijnde
- University MS Center (UMSC) Hasselt - Pelt, Hasselt, Belgium.,SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Rob C I Wüst
- Laboratory for Myology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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11
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Huynh T, Jeng B, Motl RW. Physical activity and vascular comorbidity in black and white persons with multiple sclerosis: A cross-sectional study. Disabil Health J 2022; 15:101314. [DOI: 10.1016/j.dhjo.2022.101314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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12
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Longoria V, Parcel H, Toma B, Minhas A, Zeine R. Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination. Biomedicines 2022; 10:539. [PMID: 35327341 PMCID: PMC8945692 DOI: 10.3390/biomedicines10030539] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 12/22/2022] Open
Abstract
Despite current therapeutic strategies for immunomodulation and relief of symptoms in multiple sclerosis (MS), remyelination falls short due to dynamic neuropathologic deterioration and relapses, leading to accrual of disability and associated patient dissatisfaction. The potential of cannabinoids includes add-on immunosuppressive, analgesic, neuroprotective, and remyelinative effects. This study evaluates the efficacy of medical marijuana in MS and its experimental animal models. A systematic review was conducted by a literature search through PubMed, ProQuest, and EBSCO electronic databases for studies reported since 2007 on the use of cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) in MS and in experimental autoimmune encephalomyelitis (EAE), Theiler's murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD), and toxin-induced demyelination models. Study selection and data extraction were performed by 3 reviewers, and 28 studies were selected for inclusion. The certainty of evidence was appraised using the Cochrane GRADE approach. In clinical studies, there was low- and moderate-quality evidence that treatment with ~1:1 CBD/THC mixtures as a nabiximols (Sativex®) oromucosal spray reduced numerical rating scale (NRS) scores for spasticity, pain, and sleep disturbance, diminished bladder overactivity, and decreased proinflammatory cytokine and transcription factor expression levels. Preclinical studies demonstrated decreases in disease severity, hindlimb stiffness, motor function, neuroinflammation, and demyelination. Other experimental systems showed the capacity of cannabinoids to promote remyelination in vitro and by electron microscopy. Modest short-term benefits were realized in MS responders to adjunctive therapy with CBD/THC mixtures. Future studies are recommended to investigate the cellular and molecular mechanisms of cannabinoid effects on MS lesions and to evaluate whether medical marijuana can accelerate remyelination and retard the accrual of disability over the long term.
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Affiliation(s)
- Victor Longoria
- Basic Medical Sciences, St. Vincent Campus, Saint James School of Medicine, 1480 Renaissance Drive, Park Ridge, IL 60068, USA; (V.L.); (H.P.); (B.T.); (A.M.)
| | - Hannah Parcel
- Basic Medical Sciences, St. Vincent Campus, Saint James School of Medicine, 1480 Renaissance Drive, Park Ridge, IL 60068, USA; (V.L.); (H.P.); (B.T.); (A.M.)
| | - Bameelia Toma
- Basic Medical Sciences, St. Vincent Campus, Saint James School of Medicine, 1480 Renaissance Drive, Park Ridge, IL 60068, USA; (V.L.); (H.P.); (B.T.); (A.M.)
| | - Annu Minhas
- Basic Medical Sciences, St. Vincent Campus, Saint James School of Medicine, 1480 Renaissance Drive, Park Ridge, IL 60068, USA; (V.L.); (H.P.); (B.T.); (A.M.)
| | - Rana Zeine
- School of Natural Sciences, Kean University, 1000 Morris Ave., Union, NJ 07083, USA
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13
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Learmonth YC, Motl RW. Exercise Training for Multiple Sclerosis: A Narrative Review of History, Benefits, Safety, Guidelines, and Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413245. [PMID: 34948854 PMCID: PMC8706753 DOI: 10.3390/ijerph182413245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/26/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022]
Abstract
Background: There have been significant advances in the medical treatment and management of multiple sclerosis pathogenesis, relapse and disease progression over the past 30 years. There have been advancements in the symptomatic treatment of multiple sclerosis, including management of secondary multiple sclerosis expressions such as walking, cognitive dysfunction, fatigue and depression. Scientific evidence and expert opinion suggest that exercise may be the single most effective non-pharmacological symptomatic treatment for multiple sclerosis. This article presents the historical context of exercise training within the multidisciplinary management of multiple sclerosis. We guide neurologists and healthcare providers on the recommended prescription of exercise and practical, theoretical methods to overcome barriers to exercise. Method: We undertook a critical search of the historical and current literature regarding exercise and multiple sclerosis from the viewpoint of exercise promotion by neurologists and the multidisciplinary care team. Results: We highlight the ever-strengthening body of research indicating that exercise is safe and effective for improving symptoms of multiple sclerosis. Further, exercise training may be necessary for reducing disease progression. Conclusion: We seek to encourage neurologists and specialists in multidisciplinary healthcare teams to prescribe and promote exercise at diagnosis and across all stages of the disease trajectory using prescriptive guidelines as part of comprehensive MS care. Available tools include clinical education to dispel any historical myths related to exercise in multiple sclerosis, clinical exercise guidelines and behaviour change theory to overcome patients barriers to exercise.
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Affiliation(s)
- Yvonne Charlotte Learmonth
- Discipline of Exercise Science, Murdoch University, Murdoch, WA 6150, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-8-9360-3000
| | - Robert Wayne Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL 60612, USA;
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14
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A Pilot Study of 24-h Motor Activity Patterns in Multiple Sclerosis: Pre-Planned Follow-Up at 2 Years. Clocks Sleep 2021; 3:366-376. [PMID: 34203507 PMCID: PMC8293228 DOI: 10.3390/clockssleep3030023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
Early multiple sclerosis (MS) predictive markers of disease activity/prognosis have been proposed but are not universally accepted. Aim of this pilot prospective study is to verify whether a peculiar hyperactivity, observed at baseline (T0) in early relapsing-remitting (RR) MS patients, could represent a further prognostic marker. Here we report results collected at T0 and at a 24-month follow-up (T1). Eighteen RRMS patients (11 females, median Expanded Disability Status Scale-EDSS score 1.25, range EDSS score 0–2) were monitored at T0 (mean age 32.33 ± 7.51) and T1 (median EDSS score 1.5, range EDSS score 0–2.5). Patients were grouped into two groups: responders (R, 14 patients) and non-responders (NR, 4 patients) to treatment at T1. Each patient wore an actigraph for one week to record the 24-h motor activity pattern. At T0, NR presented significantly lower motor activity than R between around 9:00 and 13:00. At T1, NR were characterized by significantly lower motor activity than R between around 12:00 and 17:00. Overall, these data suggest that through the 24-h motor activity pattern, we can fairly segregate at T0 patients who will show a therapeutic failure, possibly related to a more active disease, at T1. These patients are characterized by a reduced morning level of motor activation. Further studies on larger populations are needed to confirm these preliminary findings.
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15
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Eustis H, Plummer P. Self-efficacy training as an adjunct to exercise in a person with progressive multiple sclerosis: a case report. Physiother Theory Pract 2021; 38:3126-3135. [PMID: 34081567 DOI: 10.1080/09593985.2021.1934921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Increasing self-efficacy to exercise and minimizing disease-related barriers has been shown to improve physical activity levels and quality of life (QOL) in persons with multiple sclerosis (MS). Currently, little research has examined exercise self-efficacy in persons with more advanced MS. Purpose: Explore the effects of a self-efficacy plus exercise intervention on physical activity endurance and level, QOL, and fatigue in an individual with advanced MS and low self-efficacy.Methods: The participant was a 60-year-old, severely disabled female with secondary progressive MS and an Expanded Disability Status Score (EDSS) of 8. The 8-week intervention consisted of weekly discussions and MS-related education; four one-on-one sessions with a MS "mentor;" daily journal to record sleep quality, fatigue level, and physical activity. Outcomes included a modified 5-meter walk test (5MWT), MS Impact Scale (MSIS-29), Exercise Self-Efficacy Scale (EX-ES), Modified Fatigue Impact Scale (MFIS), MS Self-Efficacy Scale (MS-SES), Patient Health Questionnaire-9 (PHQ-9), and daily physical activity monitoring. Outcomes were assessed at baseline (week 0), post-intervention (week 8), and 8 weeks post intervention (week 16). The participant continued her regular exercise routine independently throughout the study period.Results: There were notable improvements in EX-ES, MFIS, PHQ-9, MSIS-29 psychological subscale, sleep quality, and morning fatigue ratings post intervention, some of which were retained at follow up.Conclusion: The findings illustrate that an 8-week self-efficacy intervention increased exercise self-efficacy, QOL, and reduced perceived fatigue in a severely disabled individual with progressive MS. Future research should examine self-efficacy interventions in a larger sample size of persons with progressive MS.
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Affiliation(s)
- Heather Eustis
- Department of Physical Therapy and Occupational Therapy, Duke University Hospital, Durham, NC, United States
| | - Prudence Plummer
- Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, United States
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16
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Kever A, Buyukturkoglu K, Riley CS, De Jager PL, Leavitt VM. Social support is linked to mental health, quality of life, and motor function in multiple sclerosis. J Neurol 2021; 268:1827-1836. [PMID: 33392637 DOI: 10.1007/s00415-020-10330-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate associations of social support to psychological well-being, cognition, and motor functioning in patients with multiple sclerosis (MS). Secondarily, we were interested in exploring sex differences in these relationships, based on a bioevolutionary theoretical justification. METHODS Social support was assessed in 185 recently diagnosed patients (RADIEMS cohort), and in an independent validation sample (MEMCONNECT cohort, n = 62). Patients also completed a comprehensive neurobehavioral evaluation including measures of mental health, fatigue, quality of life, cognition, and motor function. Correlations tested links between social support and these variables, along with potential gender differences. RESULTS In both samples, higher social support was associated with better mental health, quality of life, subjective cognitive function, and less fatigue. In the RADIEMS cohort, higher social support was associated with better motor functions, particularly grip strength and gait endurance in women. CONCLUSIONS These findings highlight associations of social support to overall psychological health and motor functioning in persons with MS, underlining the potential opportunity of evaluating and promoting social engagement in novel treatment strategies.
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Affiliation(s)
- Anne Kever
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, New York, NY, 10032, USA
| | - Korhan Buyukturkoglu
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, New York, NY, 10032, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip L De Jager
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.,Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Victoria M Leavitt
- Translational Cognitive Neuroscience Laboratory, Department of Neurology, Columbia University Irving Medical Center, 630 W. 168th Street, New York, NY, 10032, USA. .,Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
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17
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Motl R, Ehde D, Shinto L, Fernhall B, LaRocca N, Zackowski K. Health Behaviors, Wellness, and Multiple Sclerosis Amid COVID-19. Arch Phys Med Rehabil 2020; 101:1839-1841. [PMID: 32868038 PMCID: PMC7455788 DOI: 10.1016/j.apmr.2020.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Robert Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama
| | - Dawn Ehde
- Department of Rehabilitation Medicine University of Washington, Seattle, Washington
| | - Lynne Shinto
- Department of Neurology, Oregon Health & Science University, Portland, Oregon
| | - Bo Fernhall
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois
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18
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Levin SN, Riley CS, Dhand A, White CC, Venkatesh S, Boehm B, Nassif C, Socia L, Onomichi K, Leavitt VM, Levine L, Heyman R, Farber RS, Vargas WS, Xia Z, De Jager PL. Association of social network structure and physical function in patients with multiple sclerosis. Neurology 2020; 95:e1565-e1574. [PMID: 32769139 DOI: 10.1212/wnl.0000000000010460] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/18/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To test the association between physical function and the social environment in multiple sclerosis (MS), we quantified personal social networks. METHODS In this cross-sectional study, we analyzed data from 2 academic MS centers, with center 1 serving as a discovery group and center 2 as the extension group. We performed a meta-analysis of the centers to extend the analysis. We used responses from a questionnaire to map the structure and health habits of participants' social networks as well as the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) physical function scale (0-100, mean 50 for US general population) as the primary outcome. We applied multivariable models to test the association between network metrics and physical function. RESULTS The discovery cohort included 263 patients with MS: 81% were women, 96% non-Hispanic European, 78% had relapsing MS, average age was 50 (12.4) years, and mean disease duration was 17 (12.3) years. The extension group included 163 patients, who were younger, more racially diverse, and less physically disabled, and had shorter disease duration. In the meta-analysis, higher network constraint, a measure of tightly bound networks, was associated with worse physical function (β = -0.163 ± 0.047, p < 0.001), while larger network effective size, a measure of clustered groups in the network, correlated with better physical function (β = 0.134 ± 0.046, p = 0.003). CONCLUSIONS Our study highlights personal networks as an important environmental factor associated with physical function in MS. Patients with close-knit networks had worse function than those with more open networks. Longitudinal studies are warranted to evaluate a causal relationship between network structure and physical impairment.
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Affiliation(s)
- Seth N Levin
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Claire S Riley
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Amar Dhand
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Charles C White
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Shruthi Venkatesh
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Blake Boehm
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Caren Nassif
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Lauren Socia
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Kaho Onomichi
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Victoria M Leavitt
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Libby Levine
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Rock Heyman
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Rebecca S Farber
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Wendy S Vargas
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Zongqi Xia
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Philip L De Jager
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA.
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19
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Learmonth YC, Chan Z, Correia H, Hathorn D, Kermode A, Smith C, Walker D. Exercise participation and promotion in the multiple sclerosis community; perspectives across varying socio-ecological levels. Disabil Rehabil 2020; 43:3623-3638. [PMID: 32393076 DOI: 10.1080/09638288.2020.1743778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose: We undertook a qualitative study that explored exercise participation and exercise promotion in the multiple sclerosis (MS) community who live in regional or remote areas of Australia. By simultaneously gathering views from persons with MS, carers, healthcare providers and healthcare managers we aimed to gather unique perspectives which represented views from across socio-ecological levels of MS healthcare.Methods: We used interpretive description methodology, and conducted semi-structured interviews or focus groups with people with MS (n = 28), carers (n = 8), healthcare providers (n = 12) and managers/supervisors of MS healthcare systems (n = 16). Data were analysed using thematic analysis.Results: We identified three themes with 10 subthemes. The first theme was "Factors associated with exercise engagement" for the people with MS, from individual, interpersonal, organisational and community/public policy perspectives. The second theme was "Factors influencing the MS community's promotion of exercise" focusing on carers, healthcare providers and healthcare systems. The third theme was "Motivators to increase exercise promotion" which should be delivered by the MS community across varying socio-ecological levels of healthcare to encourage exercise participation.Conclusion: We identified new evidence on the factors which influence the MS community's promotion of exercise and we now better understand that training on exercise should be provided to the wider MS community, and exercise services should be considered locally and perhaps delivered via teleheath.IMPLICATIONS FOR REHABILITATIONCohesive healthcare campaigns, and clinical guidelines based on empirical evidence should be established for symptom management in MS with a focus on the role of exercise.Symptom management strategies should consider the whole MS community, including patients, carers, healthcare professional and healthcare co-ordinators.Internal factors (e.g., emotion and motivation) and broader factors (e.g., funding and location) must be considered when designing exercise interventions in persons with MS.
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Affiliation(s)
- Yvonne C Learmonth
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Zita Chan
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Helen Correia
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Dave Hathorn
- Multiple Sclerosis Western Australia, Wilson, WA, Australia
| | - Allan Kermode
- Perron Institute for Neurological and Translational Science, Perth, WA, Australia.,University of Western Australia, Crawley, WA, Australia.,Institution of Immunology and Infectious Diseases Murdoch University, Murdoch, WA, Australia.,Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Catherine Smith
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Diana Walker
- University of Western Australia, Crawley, WA, Australia
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20
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Castelli L, De Giglio L, Haggiag S, Traini A, De Luca F, Ruggieri S, Prosperini L. Premorbid functional reserve modulates the effect of rehabilitation in multiple sclerosis. Neurol Sci 2020; 41:1251-1257. [PMID: 31919697 DOI: 10.1007/s10072-019-04237-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Premorbid physically and intellectually enriching lifestyles have increasingly been recognized as able to mitigate the risk of disease-related disability in patients with multiple sclerosis (MS). OBJECTIVE To explore if premorbid physical activity, cognitive reserve and trait personality act as proxies for functional reserve that contributes to rehabilitation outcome. METHODS We recruited all patients previously enrolled in two pilot trials investigating the effect of home-based video game training in improving balance (Study 1) and attention (Study 2) for additional assessments with the Historical Leisure Activity Questionnaire (HLAQ; a proxy for premorbid physical activity), Cognitive Reserve Index Questionnaire (CRIQ), and Temperament and Character Inventory (TCI). Hierarchical logistic regression (HLR) analyses tested the association of HLAQ, CRIQ, and TCI with training effect on balance (static posturography) and on attention (Symbol Digit Modalities Test). RESULTS We identified 94% (34/36) and 74% (26/35) of patients participating at the original Study 1 and Study 2, respectively. HLR analyses showed an exclusive "intra-modal" modulation of rehabilitation outcome by functional reserve, given that (1) larger training effect on balance was associated with higher HLAQ (OR = 2.03, p = 0.031); (2) larger training effect on attention was associated with higher CRIQ (OR = 1.27, p = 0.033). Furthermore, we found specific personality traits associated with (1) greater training effect on balance (self-directedness; OR = 1.40, p = 0.051) and lower training effect on attention (harm avoidance; OR = 0.66, p = 0.075). CONCLUSION We hypothesize that premorbid physical and intellectual activities not only act as a buffer for limiting the MS-related damage but also as functional reserve that can be retrieved by task-oriented training to promote recovery through rehabilitation.
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Affiliation(s)
- Letizia Castelli
- IRCCS Don Carlo Gnocchi Foundation, Piazzale Morandi 6, 20121, Milan, Italy
| | - Laura De Giglio
- S. Filippo Neri Hospital, Via G. Martinotti 20, 00135, Roma, Italy.,Department of Human Neuroscience, Sapienza University, viale dell'Università 30, 00185, Rome, Italy
| | - Shalom Haggiag
- S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy
| | - Arianna Traini
- Physical Therapy Unit, S. Andrea Hospital, Via di Grottarossa 1035, 00189, Rome, Italy
| | - Francesca De Luca
- Department of Psychology, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy
| | - Serena Ruggieri
- S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy
| | - Luca Prosperini
- S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy.
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21
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Fasczewski KS, Cook HM, Campbell KE, Anderes B. I ride for MS: The impact of bike MS participation on motivation for physical activity in individuals with multiple sclerosis. Disabil Health J 2019; 13:100853. [PMID: 31679952 DOI: 10.1016/j.dhjo.2019.100853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 10/07/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic neurodegenerative disease that results in deficits in physical and cognitive functioning. Research supports the use of physical activity (PA) to aid in MS symptom management and slow disease progression, however individuals diagnosed with MS are generally physically inactive. Social support has been shown to increase PA behavior in group exercise settings. Events such as Bike MS, a charity bicycle ride where individuals raise money for MS, could increase motivation for participation and therefore may be an ideal setting to introduce PA to individuals diagnosed with MS. OBJECTIVE /Hypothesis: The objective of the current research was to explore motives for participation in a Bike MS event in individuals diagnosed with MS and their family members, and examine if their Bike MS participation has translated to long-term PA behavior change and positive quality of life outcomes. METHODS A descriptive qualitative approach using semi-structured focus group, individual, and phone interviews, combined with observational field notes, was used to explore the experiences of seven individuals diagnosed with MS and four family members from two regional self-help groups who all actively participated in a Bike MS event. RESULTS Participants reported important social bonds, raising awareness for the cause, fundraising, long-term physical benefits, and overall increased quality of life as motives for participation. All participants reported long-term PA participation as a result of Bike MS participation. CONCLUSION Results support using Bike MS to increase long-term PA participation in individuals with MS, resulting in positive quality of life outcomes.
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Affiliation(s)
- Kimberly S Fasczewski
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA.
| | - Hannah M Cook
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA
| | - Katie E Campbell
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA
| | - Blair Anderes
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA
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22
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Prakash KC, Neupane S, Leino-Arjas P, Härmä M, von Bonsdorff MB, Rantanen T, von Bonsdorff ME, Hinrichs T, Seitsamo J, Ilmarinen J, Nygård CH. Trajectories of mobility limitations over 24 years and their characterization by shift work and leisure-time physical activity in midlife. Eur J Public Health 2019; 29:882-888. [PMID: 31008505 DOI: 10.1093/eurpub/ckz069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs). METHODS Subjects who responded MLs questionnaires (1985-2009, N = 3048) in Finnish Longitudinal Study on Aging Municipal Employees were included in this prospective cohort study. LTPA and shift work were measured during baseline. International Classification of Functioning was used to code MLs. Growth mixture modeling was used to identify the trajectories of MLs. Odds ratio (OR) and their 95% Confidence interval (CI) were assessed by using multinomial logistic regression. RESULTS We identified four trajectories of MLs, namely low persistent, low increasing, high decreasing and high persistent. Among the SP recipients, shift work with night shifts was associated with an increased risk (adjusted OR 1.49; 95% CI 1.03-2.14) of belonging to the high persistent MLs trajectory. The inactive LTPA (SP: OR 5.99, 95% CI 3.39-10.58, DP: OR 6.81, 95% CI 2.52-18.43) was similarly associated with high persistent MLs trajectory. CONCLUSION Nearly two-thirds of the people retired due to disability belonged to high MLs trajectory. High persistent MLs trajectory was associated with physical inactivity in midlife among those retired on SP and on DP. Shift work with night shift predicted high persistent MLs in SP strata. Active involvement in LTPA during midlife could be beneficial to spend MLs free later life.
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Affiliation(s)
- K C Prakash
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
| | - Subas Neupane
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
| | | | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikaela B von Bonsdorff
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Monika E von Bonsdorff
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
- School of Management, Kokkola University Consortium Chydenius, University of Vaasa, Kokkola, Finland
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jorma Seitsamo
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Clas-Håkan Nygård
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
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23
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Sadeghi Bahmani D, Razazian N, Motl RW, Farnia V, Alikhani M, Pühse U, Gerber M, Brand S. Physical activity interventions can improve emotion regulation and dimensions of empathy in persons with multiple sclerosis: An exploratory study. Mult Scler Relat Disord 2019; 37:101380. [PMID: 32173007 DOI: 10.1016/j.msard.2019.101380] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Persons with multiple sclerosis (PwMS) report difficulties with emotion regulation and empathy. Regular physical activity (RPA) improves dimensions of psychological well-being in PwMS, but it remains unclear if regular physical activity has effects on emotion regulation and empathy. The present study investigated the effect of regular physical activity on emotion regulation and empathy, and explored, if endurance training or coordinative training are better than an active control condition. METHODS 92 female PwMS (mean age: 37.4 years; age range: 20-57 years; mean EDSS: 2.43) took part in this study. Participants were randomly assigned into endurance training, coordinative training, or active control conditions that all lasted 8 weeks and were yoked on frequency, duration, and social contact. Participants completed questionnaires on emotion regulation, empathy, depression and fatigue before and after the 8-week conditions. RESULTS Regulation and control of emotions and empathy improved over time, but more so in the exercising groups, compared to the active control group. No changes over time and between groups were observed for perception and acknowledgement of emotions, emotional expressivity, and empathy, as measured with Reading in the Eyes test. These changes were not influenced by control for depression and fatigue as covariates. CONCLUSIONS Both endurance and coordinative exercise training had favorable effects on some aspects of emotion regulation and social cognition such as empathy in PwMS. Such initial results support for examination of exercise training for the treatment of issues of emotion regulation and social interactions in PwMS.
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Affiliation(s)
- Dena Sadeghi Bahmani
- University of Basel, Psychiatric Clinics (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Department of Psychiatry, Sleep Disorders Research Center, Kermanshah, Iran; Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
| | - Nazanin Razazian
- Kermanshah University of Medical Sciences, Neurology Department, Kermanshah, Iran
| | - Robert W Motl
- Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vahid Farnia
- Kermanshah University of Medical Sciences (KUMS), Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah, Iran
| | - Mostafa Alikhani
- Kermanshah University of Medical Sciences (KUMS), Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah, Iran
| | - Uwe Pühse
- University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland
| | - Markus Gerber
- University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland
| | - Serge Brand
- University of Basel, Psychiatric Clinics (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Department of Psychiatry, Sleep Disorders Research Center, Kermanshah, Iran; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
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24
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Sadeghi Bahmani D, Razazian N, Farnia V, Alikhani M, Tatari F, Brand S. Compared to an active control condition, in persons with multiple sclerosis two different types of exercise training improved sleep and depression, but not fatigue, paresthesia, and intolerance of uncertainty. Mult Scler Relat Disord 2019; 36:101356. [PMID: 31521917 DOI: 10.1016/j.msard.2019.07.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/23/2019] [Accepted: 07/28/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND In persons with multiple sclerosis (MS), physical activity favorably impacts on psychological well-being. The aims of the present study were to investigate the influence of physical activity on depression, fatigue, sleep, paresthesia, and personality traits (intolerance of uncertainty), and to explore, if endurance training or coordinative training are superior to an active control condition. METHODS 92 female individuals with MS (mean age: 37.36 years; mean EDSS: 2.43) took part in this intervention study. Participants were randomly assigned either to endurance training, coordinative training, or to an active control condition. At baseline, 4 weeks, and 8 weeks later at the end of the study, participants completed questionnaires on sleep, depression, fatigue, paresthesia and intolerance of uncertainty. Exercise training interventions took place three times/week for 45 min/session. Participants in the active control condition also met with the same duration and frequency. RESULTS Sleep complaints and symptoms of depression decreased over time, but more so in the exercising groups, compared to the active control group. No changes over time and between groups were observed for fatigue, paresthesia, and intolerance of uncertainty. CONCLUSIONS Both endurance and coordinative exercising had the potential to favorably impact on some aspects of cognitive-emotional processing, while also an active control condition appeared to have a positive impact.
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Affiliation(s)
- Dena Sadeghi Bahmani
- University of Basel, Psychiatric Clinics (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Health Institute, and Sleep Disorders Research Center, Kermanshah, Iran; Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazanin Razazian
- Kermanshah University of Medical Sciences, Neurology Department, Kermanshah, Iran
| | - Vahid Farnia
- Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Health Institute, and Sleep Disorders Research Center, Kermanshah, Iran.
| | - Mostafa Alikhani
- Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Health Institute, and Sleep Disorders Research Center, Kermanshah, Iran
| | - Faezeh Tatari
- Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Health Institute, and Sleep Disorders Research Center, Kermanshah, Iran
| | - Serge Brand
- University of Basel, Psychiatric Clinics (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Health Institute, and Sleep Disorders Research Center, Kermanshah, Iran; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland
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25
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Smith M, Barker R, Williams G, Carr J, Gunnarsson R. The effect of exercise on high-level mobility in individuals with neurodegenerative disease: a systematic literature review. Physiotherapy 2019; 106:174-193. [PMID: 31477333 DOI: 10.1016/j.physio.2019.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 02/27/2019] [Accepted: 04/25/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate the effect of exercise on high-level mobility (i.e. mobility more advanced than independent level walking) in individuals with neurodegenerative disease. DATA SOURCES A systematic literature search was conducted in Medline, CINAHL, Scopus, SportDiscus and PEDro. STUDY SELECTION Randomised controlled trials of exercise interventions for individuals with neurodegenerative disease, with an outcome measure that contained high-level mobility items were included. High-level mobility items included running, jumping, bounding, stair climbing and backward walking. Outcome measures with high-level mobility items include the High Level Mobility Assessment Tool (HiMAT); Dynamic Gait Index; Rivermead Mobility Index (RMI) or modified RMI; Functional Gait Assessment and the Functional Ambulation Category. STUDY APPRAISAL Quality was evaluated with the Cochrane Risk of Bias Tool. RESULTS Twenty-four studies with predominantly moderate to low risk of bias met the review criteria. High-level mobility items were included within primary outcome measures for only two studies and secondary outcome measures for 22 studies. Eight types of exercise interventions were investigated within which high-level mobility tasks were not commonly included. In the absence of outcome measures or interventions focused on high-level mobility, findings suggest some benefit from treadmill training for individuals with multiple sclerosis or Parkinson's disease. Progressive resistance training for individuals with multiple sclerosis may also be beneficial. With few studies on other neurodegenerative diseases, further inferences cannot be made. CONCLUSION Future studies need to specifically target high-level mobility in the early stages of neurodegenerative disease and determine the impact of high-level mobility interventions on community participation and maintenance of an active lifestyle. Systematic review registration number PROSPERO register for systematic reviews (registration number: CRD42016050362).
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Affiliation(s)
- Moira Smith
- College of Healthcare Sciences, Building 043-114, James Cook University, Townsville, Queensland 4811, Australia.
| | - Ruth Barker
- College of Healthcare Sciences, James Cook University, Cairns, Queensland 4878, Australia.
| | | | - Jennifer Carr
- College of Healthcare Sciences, James Cook University, Cairns, Queensland 4878, Australia.
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26
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Sadeghi Bahmani D, Kesselring J, Papadimitriou M, Bansi J, Pühse U, Gerber M, Shaygannejad V, Holsboer-Trachsler E, Brand S. In Patients With Multiple Sclerosis, Both Objective and Subjective Sleep, Depression, Fatigue, and Paresthesia Improved After 3 Weeks of Regular Exercise. Front Psychiatry 2019; 10:265. [PMID: 31130879 PMCID: PMC6510171 DOI: 10.3389/fpsyt.2019.00265] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/08/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Multiple sclerosis (MS) patients suffer from various difficulties including sleep complaints, symptoms of depression and fatigue, paresthesia, and cognitive impairments. There is growing evidence that regular physical activity has a positive effect on both sleep and psychological functioning, though there is limited evidence of this kind for MS patients. The aim of the present study was therefore to investigate the impact on this patient group of a regular exercise program with respect to subjective and objective sleep, depression, paresthesia, fatigue, and cognitive performance. Methods: A total of 46 patients [mean age: 50.74 years; Expanded Disability Status Scale (EDSS): mean: 5.3, 78.4% females] completed this 3-week intervention study. At baseline and 3 weeks later, they answered questionnaires covering sociodemographic information, subjective sleep, depression, fatigue, paresthesia, and subjective physical activity. Objective sleep [sleep electroencephalogram (EEG) recordings] and cognitive performance were also assessed at both time points. Patients participated in a regular exercise activity every weekday for about 60 min. Results: Compared to the baseline, by the end of the study, objective sleep had significantly improved (sleep efficiency, sleep onset latency, and wake time after sleep onset), and symptoms of sleep complaints, depression, fatigue, and paresthesia were significantly reduced. Subjective physical activity (moderate and vigorous) and cognitive performance also increased over the course of the intervention. Conclusions: In patients with MS, participation in regular exercise impacted positively on their objective and subjective sleep, depression, paresthesia, fatigue, and cognitive performance.
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Affiliation(s)
- Dena Sadeghi Bahmani
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | | - Uwe Pühse
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Motl RW. Promotion of physical activity and exercise in multiple sclerosis: Importance of behavioral science and theory. Mult Scler J Exp Transl Clin 2018; 4:2055217318786745. [PMID: 30090642 PMCID: PMC6077908 DOI: 10.1177/2055217318786745] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/07/2018] [Accepted: 05/30/2018] [Indexed: 12/29/2022] Open
Abstract
There is an obvious disconnect between evidence of benefits and rates of participation in exercise and physical activity among people living with multiple sclerosis (MS). We propose that the problem with exercise behavior in MS (i.e. lack of broad or increasing participation by people with MS despite evidence of meaningful benefits) might be ameliorated through the inclusion of behavior change theory in the design of exercise programs and promotion efforts, as has been undertaken in other populations such as breast cancer survivors. This paper reviews Social Cognitive Theory as an example approach for informing interventions for increasing exercise and physical activity behavior outside of MS and provides an overview of current knowledge regarding the application of this theory for physical activity in MS. We then outline future research necessary for informing trials that design, implement, and test theory-based interventions for physical activity promotion in MS. If theories of behavior change are adopted for informing exercise and physical activity research in MS, we can take a major step forward in addressing the problem of exercise and physical activity participation that has plagued the field for more than 25 years.
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Affiliation(s)
- Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, 336 SHPB, 1720 2nd Ave. S., Birmingham, AL 35294, USA.
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Sadeghi Bahmani D, Esmaeili L, Shaygannejad V, Gerber M, Kesselring J, Lang UE, Holsboer-Trachsler E, Brand S. Stability of Mental Toughness, Sleep Disturbances, and Physical Activity in Patients With Multiple Sclerosis (MS)-A Longitudinal and Pilot Study. Front Psychiatry 2018; 9:182. [PMID: 29867606 PMCID: PMC5966704 DOI: 10.3389/fpsyt.2018.00182] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 04/19/2018] [Indexed: 01/30/2023] Open
Abstract
Background: Previous research of patients with multiple sclerosis (MS) focused prevalently on fatigue, depression, and cognitive dysfunction during the clinical course. By contrast, research on the longer-term characteristics of physical activity (PA), psychological functioning, and sleep problems is scarce. The aims of the present study were therefore to examine changes in PA, mental toughness (MT) as a proxy of psychological functioning, and sleep disturbances over a 2-year period of time after disease onset. Methods: A total of 18 patients with diagnosed MS (mean age: M = 34.29 years) took part in this longitudinal study. First, 1-4 weeks after the first symptoms, a neurologist diagnosed the MS. Second, they completed a series of questionnaires covering socio-demographic data, PA, MT, and sleep disturbances. Third, the same questionnaires were completed again 2 years later (follow-up). Last, a neurologist assessed the degree of disability with the Expanded Disability Status Scale (EDSS). Results: Two years after MS onset, patients had lower levels of vigorous PA, but no statistically significant changes in moderate PA were observed. Further, walking time increased and sedentary time decreased. Patients with sleep disturbances at disease onset also reported poor sleep 2 years later. MT scores remained stable over time. EDSS scores worsened, though, change in EDSS was not associated with PA, MT, or sleep. Conclusions: Two years after disease onset, patients with MS reported similar MT levels and sleep disturbances. PA shifted from vigorous PA toward walking and a less sedentary lifestyle, while moderate PA remained unchanged. The pattern of results of the present pilot study suggests that at the early stage of the MS course, there is no obstacle for being physically active, nor did sleep and MT as a proxy of psychological functioning decrease in a substantial way.
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Affiliation(s)
- Dena Sadeghi Bahmani
- Center for Affective-, Stress- and Sleep Disorders, Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Sleep Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila Esmaeili
- Department of Psychology, Education & Psychology Faculty, University of Isfahan, Isfahan, Iran
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Markus Gerber
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Undine E Lang
- Center for Affective-, Stress- and Sleep Disorders, Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Center for Affective-, Stress- and Sleep Disorders, Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Serge Brand
- Center for Affective-, Stress- and Sleep Disorders, Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Sport Science Section, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center and Substance Abuse Prevention Research Center, Kermanshah, Iran
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Motl RW, Sandroff BM, Kwakkel G, Dalgas U, Feinstein A, Heesen C, Feys P, Thompson AJ. Exercise in patients with multiple sclerosis. Lancet Neurol 2017; 16:848-856. [DOI: 10.1016/s1474-4422(17)30281-8] [Citation(s) in RCA: 204] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/06/2017] [Accepted: 07/18/2017] [Indexed: 01/04/2023]
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Merkt H, Sadeghi Bahmani D, Calabrese P, Naegelin Y, Gerber M, Pühse U, Holsboer-Trachsler E, Brand S. Multiple Sclerosis: Associations Between Physical Disability and Depression Are Not Mediated by Self-Reported Physical Activity. Percept Mot Skills 2017; 124:974-991. [DOI: 10.1177/0031512517711851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the interrelatedness of physical disability, physical activity, and depression among patients with multiple sclerosis (MS). We hypothesized that self-reported physical activity would mediate the effect of disability on depressive symptoms. Twenty-seven patients with MS (mean age: 49 years; 44.5% females) completed self-rating scales covering sociodemographic variables, intake of antidepressants, physical activity, and symptoms of depression; disability was measured by the Expanded Disability Status Scale. We found a higher level of disability to be significantly associated with more symptoms of depression. While higher reported physical activity was descriptively associated with lower depression scores and unrelated to Expanded Disability Status Scale, physical activity levels did not mediate the effect of disability on depressive symptoms.
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Affiliation(s)
- Helene Merkt
- Division of Molecular and Cognitive Neurosciences, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Dena Sadeghi Bahmani
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, Basel, Switzerland
| | - Pasquale Calabrese
- Division of Molecular and Cognitive Neurosciences, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Yvonne Naegelin
- Department of Neurology, University Hospital, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, Basel, Switzerland
| | - Serge Brand
- Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, Basel, Switzerland
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Faculty of Medicine, University of Basel, Basel, Switzerland
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31
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Cortese M, Riise T, Bjørnevik K, Myhr KM. Body size and physical exercise, and the risk of multiple sclerosis. Mult Scler 2017; 24:270-278. [PMID: 28287051 DOI: 10.1177/1352458517699289] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Whether large body size increases multiple sclerosis (MS) risk in men is not well understood. Concurrently, physical exercise could be an independent protective factor. OBJECTIVE To prospectively investigate the association between body mass index (BMI) and aerobic fitness, indicators of body size and exercise, and MS risk in men. METHODS We performed a population-based nested case-control study within the historical cohort of all Norwegian men, born in 1950-1975, undergoing mandatory conscription at the age of 19 years. 1016 cases were identified through linkage to the Norwegian MS registry, while 19,230 controls were randomly selected from the cohort. We estimated the effect of BMI and fitness at conscription on MS risk using Cox regression. RESULTS Higher BMI (≥25 vs 18.5-<25 kg/m2) was significantly associated with increased MS risk (adjusted relative risk (RRadj) = 1.36, 95% confidence interval (CI): 1.05-1.76). We also found a significant inverse association between aerobic fitness (high vs low) and MS risk independent of BMI (RRadj = 0.69, 95% CI: 0.55-0.88, p-trend = 0.003), remaining similar when men with MS onset within 10 years from conscription were excluded ( p-trend = 0.03). CONCLUSION These findings add weight to evidence linking being overweight to an increased MS risk in men. Furthermore, they suggest that exercise may be an additional modifiable protective factor for MS.
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Affiliation(s)
- Marianna Cortese
- Department of Clinical Medicine and Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway/The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Trond Riise
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway/The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Kjetil Bjørnevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway/The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Kjell-Morten Myhr
- The Norwegian MS Registry and Biobank and The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway/The KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Hempel S, Graham GD, Fu N, Estrada E, Chen AY, Miake-Lye I, Miles JNV, Shanman R, Shekelle PG, Beroes JM, Wallin MT. A systematic review of modifiable risk factors in the progression of multiple sclerosis. Mult Scler 2017; 23:525-533. [PMID: 28151053 DOI: 10.1177/1352458517690270] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The presenting symptoms and rate of progression of multiple sclerosis (MS) are very heterogeneous. The diverse clinical manifestations and the clinical course of the disease may vary with modifiable risk factors. OBJECTIVE To systematically review modifiable risk factors and exposures associated with MS progression. METHODS We searched six databases till March 2015, reference-mined reviews, and consulted with experts (PROSPERO 2015:CRD42015016461). Two reviewers screened and extracted data. We used random meta-analysis models and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the quality of evidence. RESULTS In total, 59 studies met inclusion criteria. Lower vitamin D levels were associated with higher Expanded Disability Status Scale (EDSS) scores ( r = -0.22; confidence interval (CI) = -0.32, -0.12; 11 studies; I2 = 66%), smokers had an increased risk of MS progression (hazard ratio (HR) = 1.55; CI = 1.10, 2.19; I2 = 72%; seven studies), and there was no association of MS progression with the use of epidural analgesics during childbirth delivery (three studies). There was insufficient evidence to draw conclusions for 11 risk factors due to conflicting results or use of different predictor and outcome measures. CONCLUSION MS progression was consistently associated with low vitamin D levels, and smoking was associated with a more rapid decline in MS disability. Studies used a variety of methods, predictors, and outcomes making it difficult to draw conclusions. Future studies should focus on prospective assessments.
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Affiliation(s)
- Susanne Hempel
- Southern California Evidence-based Practice Center, RAND Corporation, Santa Monica, CA, USA
| | - Glenn D Graham
- Specialty Care Services, U.S. Department of Veterans Affairs, Washington, DC, USA/Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ning Fu
- Southern California Evidence-based Practice Center, RAND Corporation, Santa Monica, CA, USA
| | - Elena Estrada
- Evidence-based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Annie Y Chen
- Evidence-based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Isomi Miake-Lye
- Evidence-based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Jeremy N V Miles
- Southern California Evidence-based Practice Center, RAND Corporation, Santa Monica, CA, USA
| | - Roberta Shanman
- Southern California Evidence-based Practice Center, RAND Corporation, Santa Monica, CA, USA
| | - Paul G Shekelle
- Southern California Evidence-based Practice Center, RAND Corporation, Santa Monica, CA USA/Evidence-based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Jessica M Beroes
- Evidence-based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Mitchell T Wallin
- Multiple Sclerosis Centers of Excellence-East, U.S. Department of Veterans Affairs, Washington, DC, USA/Department of Neurology, School of Medicine, Georgetown University, Washington, DC, USA
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Physical Activity and Its Correlates in Youth with Multiple Sclerosis. J Pediatr 2016; 179:197-203.e2. [PMID: 27717498 DOI: 10.1016/j.jpeds.2016.08.104] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/29/2016] [Accepted: 08/31/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate physical activity levels in youth with multiple sclerosis and monophasic acquired demyelinating syndromes ([mono-ADS], ie, children without relapsing disease) compared with healthy controls and to determine factors that contribute to engagement in physical activity. We hypothesized that greater physical activity goal setting and physical activity self-efficacy would be associated with greater levels of vigorous physical activity in youth with multiple sclerosis. STUDY DESIGN A total of 68 consecutive patients (27 multiple sclerosis, 41 mono-ADS) and 37 healthy controls completed fatigue, depression, Physical Activity Self-Efficacy Scale, perceived disability, Exercise Goal-Setting scale, and physical activity questionnaires, and wore an accelerometer for 7 days. All patients had no ambulatory limitations (Expanded Disability Status Scale, scores all <4). RESULTS Youth with multiple sclerosis engaged in fewer minutes per day of vigorous (P = .009) and moderate and vigorous physical activity (P = .048) than did patients with mono-ADS and healthy controls. A lower proportion of the group with multiple sclerosis (63%) reported participating in any strenuous physical activity than the mono-ADS (85%) and healthy control (89%) groups (P = .020). When we adjusted for age and sex, the Physical Activity Self-Efficacy Scale and Exercise Goal-Setting scale were associated positively with vigorous physical activity in the group with multiple sclerosis. Fatigue and depression did not predict physical activity or accelerometry metrics. CONCLUSIONS Youth with multiple sclerosis participate in less physical activity than their counterparts with mono-ADS and healthy controls. Physical activity self-efficacy and exercise goal setting serve as potentially modifiable correlates of physical activity, and are measures suited to future interventions aimed to increase physical activity in youth with multiple sclerosis.
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Motl RW, Pilutti LA. Is physical exercise a multiple sclerosis disease modifying treatment? Expert Rev Neurother 2016; 16:951-60. [DOI: 10.1080/14737175.2016.1193008] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Measurement and maintenance of reserve in multiple sclerosis. J Neurol 2016; 263:2158-2169. [DOI: 10.1007/s00415-016-8104-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 11/27/2022]
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Grover SA, Aubert-Broche B, Fetco D, Collins DL, Arnold DL, Finlayson M, Banwell BL, Motl RW, Yeh EA. Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis. Neurology 2015; 85:1663-9. [PMID: 26268901 DOI: 10.1212/wnl.0000000000001939] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/24/2015] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To evaluate the association between physical activity (PA) and multiple sclerosis (MS) disease activity, depression, and fatigue in a cohort of children with MS and monophasic acquired demyelinating syndrome (mono-ADS). METHODS In this cross-sectional study of consecutive patients attending a specialized pediatric MS clinic, we administered the PedsQL Multidimensional Fatigue Scale, Center for Epidemiological Studies Depression Scale, and Godin Leisure-Time Exercise Questionnaire. Quantitative MRI analysis was performed to obtain whole brain and T2 lesion volume in a subset of participants (n = 60). RESULTS A total of 110 patients (79 mono-ADS; 31 MS; 5-18 years; M:F 1:1.2) were included. Patients with MS reported less strenuous (33.21 ± 31.88 metabolic equivalents [METs] vs 15.97 ± 22.73 METs, p = 0.002) and total (44.48 ± 39.35 METs vs 67.28 ± 59.65 METs; p = 0.0291) PA than those with mono-ADS. Patients with MS who reported greater amounts of moderate PA METs had fewer sleep/rest fatigue symptoms (r = -0.4). Participation in strenuous PA was associated with smaller T2 lesion volumes (r = -0.66) and lower annualized relapse rate (r = -0.66). No associations were found between total brain volume and participation in PA. CONCLUSIONS Children with MS are less physically active than children with mono-ADS. Reasons for this are unclear, but may be related to ongoing disease activity, perceived limitations, or symptoms such as depression or fatigue. Children with MS reporting higher levels of strenuous PA had lower T2 lesion volumes and lower relapse rates, suggesting a potential protective effect of strenuous PA in this population. Further longitudinal studies are needed to establish the relationship of PA to MS symptoms and disease activity in this population.
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Affiliation(s)
- Stephanie A Grover
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - Berengere Aubert-Broche
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - Dumitru Fetco
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - D Louis Collins
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - Douglas L Arnold
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - Marcia Finlayson
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - Brenda L Banwell
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - Robert W Motl
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign
| | - E Ann Yeh
- From the Division of Neurology (S.A.G., E.A.Y.), Department of Pediatrics, Hospital for Sick Children, University of Toronto, and Program in Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; Montreal Neurological Institute (B.A.-B., D.F., D.L.C., D.L.A.), McGill University; the School of Rehabilitation Therapy (M.F.), Faculty of Health Sciences, Queen's University, Kingston, Canada; the Division of Neurology (B.L.B.), the Children's Hospital of Philadelphia, PA; and the Department of Kinesiology and Community Health (R.W.M.), University of Illinois at Urbana-Champaign.
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Heine M, Wens I, Langeskov-Christensen M, Verschuren O, Eijnde BO, Kwakkel G, Dalgas U. Cardiopulmonary fitness is related to disease severity in multiple sclerosis. Mult Scler 2015; 22:231-8. [PMID: 26014607 DOI: 10.1177/1352458515581437] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 03/17/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND In persons with MS (pwMS), a lower cardiopulmonary fitness has been associated with a higher risk for secondary disorders, decreased functional capacity, symptom worsening and reduced health-related quality of life. OBJECTIVE To investigate the association between disease severity and cardiopulmonary fitness. METHODS Data from cardiopulmonary exercise tests, previously conducted in three different countries, were pooled. The association between disease severity (Expanded Disability Status Scale (EDSS)) and cardiopulmonary fitness (peak oxygen uptake (VO2peak)) was adjusted for age, sex and the country of origin. RESULTS The combined sample comprised 116 ambulant pwMS having a mean (± SD) EDSS score of 2.7 ± 1.3. There was a significant correlation (r = -0.418, p < .01) between VO2peak and EDSS. A multiple regression model (R(2) = 0.520, p < .01) was constructed to describe VO2peak (mL∙kg(-1)∙min(-1)); VO2peak = 36.622 - 5.433 (Sex (1=men)) - 0.124 (Age) - 2.082 (EDSS) + 2.737 (Belgium) + 8.674 (Denmark). CONCLUSION There was a significant association between disease severity and cardiopulmonary fitness. The close relation between cardiopulmonary fitness and chronic conditions associated with physical inactivity, suggest a progressive increase in risk of secondary health conditions in pwMS.
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Affiliation(s)
- Martin Heine
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands
| | - Inez Wens
- Rehabilitation Research Center (REVAL), Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | | | - Olaf Verschuren
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands
| | - Bert O Eijnde
- Rehabilitation Research Center (REVAL), Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Gert Kwakkel
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Neurorehabilitation, Centre of Rehabilitation and Rheumatology READE, Amsterdam, The Netherlands
| | - Ulrik Dalgas
- Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark
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Motl RW. Lifestyle physical activity in persons with multiple sclerosis: the new kid on the MS block. Mult Scler 2014; 20:1025-9. [DOI: 10.1177/1352458514525873] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 02/02/2014] [Indexed: 01/28/2023]
Abstract
Supervised exercise training has substantial benefits for persons with multiple sclerosis (MS), yet 80% of those with MS do not meet recommended levels of moderate-to-vigorous physical activity (MVPA). This same problem persisted for decades in the general population of adults and prompted a paradigm shift away from “exercise training for fitness” toward “physical activity for health.” The paradigm shift reflects a public health approach of promoting lifestyle physical activity through behavioral interventions that teach people the skills, techniques, and strategies based on established theories for modifying and self-regulating health behaviors. This paper describes: (a) the definitions of and difference between structured exercise training and lifestyle physical activity; (b) the importance and potential impact of the paradigm shift; (c) consequences of lifestyle physical activity in MS; and (d) behavioral interventions for changing lifestyle physical activity in MS. The paper introduces the “new kid on the MS block” with the hope that lifestyle physical activity might become an accepted partner alongside exercise training for inclusion in comprehensive MS care.
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