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Reina-Gutiérrez S, Meseguer-Henarejos AB, Torres-Costoso A, Álvarez-Bueno C, Cavero-Redondo I, Núñez de Arenas-Arroyo S, Guzmán-Pavón MJ, Sánchez-López M, Martínez-Vizcaíno V. Effect of different types of exercise on fitness in people with multiple sclerosis: A network meta-analysis. Scand J Med Sci Sports 2023; 33:1916-1928. [PMID: 37226414 DOI: 10.1111/sms.14407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND It is assumed that people with multiple sclerosis (MS) who participate in programs of physical exercise improve their physical fitness. OBJECTIVE The aim of this network meta-analysis (NMA) was to analyze the effect of different types of exercise on muscular fitness and cardiorespiratory fitness (CRF) among people with MS and to determine the best type of exercise according to disease severity. METHODS MEDLINE, the Physiotherapy Evidence Database, the Cochrane Library, SPORTDiscus, Scopus, and Web of Science were searched from inception to April 2022 to identify randomized controlled trials (RCTs) concerning the effect of physical exercise on fitness in people with MS. We ranked the types of physical exercise by calculating the surface under the cumulative ranking (SUCRA). RESULTS We included 72 RCTs involving 2543 MS patients in this NMA. A ranking of five types of physical exercise (aerobic, resistance, combined [aerobic and resistance], sensorimotor training, and mind-body exercises) was achieved. Combined and resistance training had the highest effect sizes (0.94, 95% CI 0.47, 1.41, and 0.93, 95% CI 0.57, 1.29, respectively) and the highest SUCRA (86.2% and 87.0%, respectively) for muscular fitness. The highest effect size (0.66, 95% CI 0.34, 0.99) and SUCRA (86.9%) for CRF was for aerobic exercise. CONCLUSIONS Combined and resistance training seem to be the most effective exercises to improve muscular fitness and aerobic exercise for CRF in people with MS.
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Affiliation(s)
- Sara Reina-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | - Ana Torres-Costoso
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
- Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Santiago, Chile
| | | | | | - Mairena Sánchez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- School of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Naisby J, Wilson-Menzfeld G, Baker K, Morris R, Robinson J, Barry G. Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PLoS One 2023; 18:e0288319. [PMID: 37467234 DOI: 10.1371/journal.pone.0288319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/25/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Physical activity is encouraged for people with Multiple Sclerosis. Yoga is a popular form of physical activity and is chosen by some people with Multiple Sclerosis. However, little is known about the impact of yoga for this population, alongside what influences ongoing engagement. AIM The aim of this study is to qualitatively explore the impact of online home-based yoga on people with Multiple Sclerosis and to explore factors that influence engagement. METHODS A qualitative study using semi-structured interviews and focus groups with people with Multiple Sclerosis and a yoga teacher. Thematic analysis was used to analyse the data. Ethical Approval was gained from Northumbria University. FINDINGS Three overarching themes emerged from the analysis. 'Yoga as engagement in physical activity' captured the reasoning for participating in yoga and how this method of physical activity was an alternative to physical activity done prior to diagnosis. Frustration was apparent within this theme that some individuals were unable to engage in the range of physical activity that they wished to. 'Yoga is a personalised approach' demonstrated the flexibility and inclusivity of yoga, for individuals with varying symptoms to be able to engage with. Finally, 'yoga impacts individuals both physically and psychologically' captured the focus on the psychological impact of yoga, improving wellbeing and control. CONCLUSIONS Yoga gives people with Multiple Sclerosis the feeling of control over their symptoms and a means to engage with meaningful physical activity. Prior involvement in physical activity influenced engagement in yoga and wanting to push themselves. There was reluctance among this group to engage with aerobic activity, which warrants future investigation and support from health and exercise professionals.
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Affiliation(s)
- Jenni Naisby
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Gemma Wilson-Menzfeld
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katherine Baker
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rosie Morris
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jonathan Robinson
- School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom
| | - Gill Barry
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
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3
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Robert MK, Hales Reynolds MA, Eisenberg M, Rocha A. Exploring an 8-Week Online Adaptive Yoga Program for Multiple Sclerosis: A Pilot Study. Holist Nurs Pract 2023; 37:62-70. [PMID: 36790420 DOI: 10.1097/hnp.0000000000000568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
This pretest-posttest, descriptive pilot study examined the feasibility and perceived impact of an 8-week online adaptive yoga program on patients diagnosed with multiple sclerosis. The program incorporated yoga poses, breathing practices, and relaxation techniques. Participants rated their perceived and actual symptom severity, overall quality of life, and perception of program impact, and contributed open-ended narrative comments about the program. All participants reported an overall perceived benefit from study participation and expressed enjoyment in interacting with other patients with multiple sclerosis. The program was found to be safe and rewarding for all participants.
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Affiliation(s)
- Mindy K Robert
- Annie Taylor Dee School of Nursing, Weber State University, Ogden, Utah (Drs Robert, Hales Reynolds, and Rocha); and Yoga Moves MS, Franklin, Michigan (Ms Eisenberg)
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Andreu-Caravaca L, Ramos-Campo DJ, Chung LH, Martínez-Rodríguez A, Rubio-Arias JÁ. Effects and optimal dosage of resistance training on strength, functional capacity, balance, general health perception, and fatigue in people with multiple sclerosis: a systematic review and meta-analysis. Disabil Rehabil 2022; 45:1595-1607. [PMID: 35579532 DOI: 10.1080/09638288.2022.2069295] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To analyze the effectiveness of resistance training programs (RTP) on strength, functional capacity, balance, general health perception, and fatigue for people with Multiple Sclerosis (MS) and to determine the most effective dose of RTP in this population. METHODS Studies examining the effect of RTP on strength, functional capacity, balance, general health perception, and fatigue in MS patients were included. 44 studies were included. The meta-analysis, subgroup analysis and meta-regression methods were used to calculate the mean difference and standardized mean difference. RESULTS Significant group differences were observed in knee extensor (p = 0.01) and flexor (p < 0.001), but not in 1-repetition maximum. Regarding functional capacity and balance, differences between groups, in favour of the RTP group, were found in the Timed Up and Go Test (p = 0.001), walking endurance, (p = 0.02) gait speed (p = 0.02) and balance (p = 0.02). No significant differences between groups were observed in fatigue or general health perception. The results regarding the optimal dose are inconsistent. CONCLUSIONS RTP improves strength, functional capacity, balance, and fatigue in people with MS. Registration: (PROSPERO): CRD42020182781Implications for rehabilitationResistance training is a valid strategy to improve isometric strength and functional capacity in MS patients.RTP using long durations (more than 6 weeks), high intensity (more than 80% 1-RM) and two-day weekly training frequency may be a correct stimulus to improve strength, functional capacity, balance, and fatigue in people with MS.Trainers and rehabilitators should consider these indicators in order to maximize muscular and functional adaptations in this population.
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Affiliation(s)
- Luis Andreu-Caravaca
- International Chair of Sports Medicine, Catholic University of Murcia, Murcia, Spain.,Faculty of Sport, Catholic University of Murcia, Murcia, Spain.,LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Madrid, Spain
| | - Domingo J Ramos-Campo
- Faculty of Sport, Catholic University of Murcia, Murcia, Spain.,LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Madrid, Spain
| | - Linda H Chung
- UCAM Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
| | - Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Sciences Faculty of Sciences, University of Alicante, Alicante, Spain
| | - Jacobo Á Rubio-Arias
- Health Research Centre, Department of Education, Faculty of Educational Sciences, University of Almería, Almería, Spain
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5
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Wilson-Menzfeld G, Naisby J, Baker K, Morris R, Robinson J, Barry G. Yoga provision for individuals living with Multiple Sclerosis: Is the future online? PLoS One 2022; 17:e0266786. [PMID: 35486611 PMCID: PMC9053771 DOI: 10.1371/journal.pone.0266786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Yoga has multiple benefits for individuals living with Multiple Sclerosis (MS), including reduced pain, depression, fatigue, strength, and improved quality of life. During the COVID-19 pandemic, home-based delivery of yoga increased. However, no studies to date have explored online home-based yoga for individuals living with MS, more specifically the motivations, experiences, or the sustainability of home-based yoga practice for individuals living with MS.
Aim
This study aimed to explore the facilitators and barriers of online yoga provision for individuals living with MS.
Methods
One focus group and three semi-structured interviews were carried out online via Zoom with one yoga instructor and seven yoga participants living with MS. Thematic Analysis was used to analyse this data.
Findings
Two themes were generated from the interviews, the environment and future provision, each with their own sub-themes. The themes reflect various facilitators and barriers of home-based yoga provision which differed depending upon the individuals home environment, social connections, physical ability, and confidence practising yoga. Furthermore, preferences of home provision fluctuated over time depending upon symptoms of MS.
Conclusions
Home-based yoga practice is a viable and enjoyable option for individuals living with MS. It is recommended that yoga studios offering home-based yoga provision consider individual differences in preference, as well as fluctuations in symptoms that may create inequitable access to services and may prevent participation for some.
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Affiliation(s)
- Gemma Wilson-Menzfeld
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
- * E-mail:
| | - Jenni Naisby
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katherine Baker
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rosie Morris
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jonathan Robinson
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Gill Barry
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
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6
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Arji G, Rezaeizadeh H, Moghadasi AN, Sahraian MA, Karimi M, Alizadeh M. Complementary and alternative therapies in multiple sclerosis: a systematic literature classification and analysis. Acta Neurol Belg 2022; 122:281-303. [PMID: 35060096 DOI: 10.1007/s13760-021-01847-3] [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: 05/09/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIM Multiple Sclerosis (MS) is a disease determined by inflammatory demyelination and neurodegeneration in the Central Nervous System (CNS). Despite the extensive utilization of Complementary and Alternative Medicine (CAM) in MS, there is a need to have comprehensive evidence regarding their application in the management of MS symptoms. This manuscript is a Systematic Literature Review and classification (SLR) of CAM therapies for the management of MS symptoms based on the International Classification of Functioning Disability and Health (ICF) model. METHOD Studies published between 1990 and 2020 IN PubMed, Science Direct, Scopus, Pro-Quest, and Google Scholar using CAM therapies for the management of MS symptoms were analyzed. RESULTS Thirty-one papers on the subject were analyzed and classified. The findings of this review clearly show that mindfulness, yoga, and reflexology were frequently used for managing MS symptoms. Moreover, most of the papers used mindfulness and yoga as a CAM therapy for the management of MS symptoms, which mostly devoted to mental functions such as fatigue, depression, cognition, neuromuscular functions such as gait, muscle strength, and spasticity, and sensory function such as balance, in addition to, reflexology is vastly used to management of mental functions of MS patients. CONCLUSION Evidence suggested that CAM therapies in patients with MS have the potential to target and enhancement numerous elements outlined in the ICF model. Although the use of CAM therapies in MS symptom management is promising, there is a need for strict clinical trials. Future research direction should concentrate on methodologically powerful studies to find out the potential efficacy of CAM intervention.
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Affiliation(s)
- Goli Arji
- School of Nursing and Midwifery, Health Information Technology Department, Saveh University of Medical Sciences, Saveh, Iran
| | - Hossein Rezaeizadeh
- Department of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Abdolrreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- Department of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mojtaba Alizadeh
- Department of Computer Engineering, Lorestan University, Khorramabad, Iran.
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Maza AR, Pionke JJ, Gothe NP. Mind-body interventions involving a home-based component to improve functional fitness outcomes in adults: A scoping review. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Schlagheck ML, Joisten N, Walzik D, Wolf F, Neil-Sztramko SE, Bansi J, Rademacher A, Zimmer P. Systematic Review of Exercise Studies in Persons with Multiple Sclerosis: Exploring the Quality of Interventions According to the Principles of Exercise Training. Neurol Ther 2021; 10:585-607. [PMID: 34520000 PMCID: PMC8571450 DOI: 10.1007/s40120-021-00274-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/17/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION The objective of this systematic review is to explore the application and reporting of (i) the principles of exercise training in exercise trials, (ii) the components of exercise prescription, and (iii) the adherence towards the prescribed programmes in randomised controlled trials (RCTs) in persons with multiple sclerosis (pwMS). METHODS The MEDLINE, CINAHL, SPORTDiscus, PubMed and Embase electronic databases were searched from 1 January 2000 to 16 October 2020. RCTs comprising at least 3 weeks of aerobic and/or resistance exercise intervention in pwMS that reported at least one physiological outcome and were published in peer-reviewed journals were eligible for inclusion. RESULTS Out of 52 RCTs included in this review, 58 intervention arms were examined. None applied more than four principles of exercise training. Specificity was addressed by 85%, progression by 33%, overload by 59%, initial values by 26%, reversibility by 0% and diminishing returns by 2% of trials. Fifty-two percent of trials reported all components of exercise prescription, and 3% of trials reported the level of adherence to the prescribed exercise. CONCLUSION This systematic review reveals that exercise training principles were not respected in the majority of included RCTs. The weak quality of reported exercise interventions limits the interpretation of the studies' results and potentially leads to an underestimation of 'exercise as medicine' in pwMS. Also, the vague descriptions of exercise prescription and adherence impede the reproducibility of results. Future studies must attend to all principles of exercise training and provide transparent information on the prescribed and performed programmes to develop specific and valid exercise recommendations for pwMS. SYSTEMATIC REVIEW REGISTRATION CRD42020162671, 28/04/2020, PROSPERO.
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Affiliation(s)
- Marit L Schlagheck
- Department of "Performance and Health (Sports Medicine)", Institute of Sport and Sport Science, Technical University Dortmund, Otto-Hahn-Str. 3, 44227, Dortmund, Germany
| | - Niklas Joisten
- Department of "Performance and Health (Sports Medicine)", Institute of Sport and Sport Science, Technical University Dortmund, Otto-Hahn-Str. 3, 44227, Dortmund, Germany.
| | - David Walzik
- Department of "Performance and Health (Sports Medicine)", Institute of Sport and Sport Science, Technical University Dortmund, Otto-Hahn-Str. 3, 44227, Dortmund, Germany
| | - Florian Wolf
- Neurological Rehabilitation Centre Godeshöhe, Bonn, Germany
| | - Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Jens Bansi
- Department of Neurology, Clinics of Valens, Rehabilitation Centre Valens, Valens, Switzerland
| | - Annette Rademacher
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Philipp Zimmer
- Department of "Performance and Health (Sports Medicine)", Institute of Sport and Sport Science, Technical University Dortmund, Otto-Hahn-Str. 3, 44227, Dortmund, Germany
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Legault Z, Znaty A, Smith S, Boudrias MH. Yoga Interventions Used for the Rehabilitation of Stroke, Parkinson's Disease, and Multiple Sclerosis: A Scoping Review of Clinical Research. J Altern Complement Med 2021; 27:1023-1057. [PMID: 34185577 DOI: 10.1089/acm.2021.0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objectives: The current body of literature was reviewed to compile and describe yoga interventions that have been applied in clinical research and neurologic rehabilitation settings with patients affected by stroke, Parkinson's disease (PD), and multiple sclerosis (MS). Design: Available literature on yoga therapy (YT) was mapped following a five-stage framework to identify key concepts, knowledge gaps, and evidence to inform practice. Publications were identified through Medline, CINAHL, EMBASE, and PsycINFO. Selected studies required subjects with a clinical diagnosis of stroke, PD, and MS to participate in a yoga intervention and have physical, cognitive, and/or psychosocial outcome measures assessed. Results: A total of 50 studies were included in this review. Study characteristics, patient demographics, description of the yoga intervention, reported outcome measures and the main findings were extracted from the studies. Conclusion: Implementing YT in neurorehabilitation can help health care professionals integrate a more holistic approach that addresses the fundamental physical and psychological challenges of living with a chronic and debilitating neurologic disorder. The included studies described yogic interventions consisting of group or individual therapy sessions lasting 60-75 min that were carried out one to three times per week for 8-12 consecutive weeks across all three conditions. All studies described in this scoping review used different yoga protocols confirming the lack of specific interventional parameters available for implementing yoga into the rehabilitation of individuals affected by stroke, PD, or MS.
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Affiliation(s)
- Zachary Legault
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Alizée Znaty
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Samantha Smith
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Marie-Hélène Boudrias
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,The Brain Lab, Feil and Oberfeld Research Centre of the Jewish Rehabilitation Hospital-CISSS Laval, a research site of the Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, Canada
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10
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Is Aerobic or Resistance Training the Most Effective Exercise Modality for Improving Lower Extremity Physical Function and Perceived Fatigue in People With Multiple Sclerosis? A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2021; 102:2032-2048. [PMID: 33901439 DOI: 10.1016/j.apmr.2021.03.026] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/10/2021] [Accepted: 03/25/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The purpose of this systematic review was to investigate whether aerobic training (AT) or resistance training (RT) is most effective in terms of improving lower limb physical function and perceived fatigue in persons with multiple sclerosis (PwMS). DATA SOURCES Nine databases (MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health, Allied and Complementary Medicine Database, Physiotherapy Evidence Database, SPORTDiscus, PsycINFO, Web of Science, and Scopus) were electronically searched in April 2020. STUDY SELECTION Included studies were randomized controlled trials (RCTs) involving PwMS attending 1 of 2 exercise interventions: AT or RT. Studies had to include at least 1 objective or self-reported outcome of lower extremity physical function and/or perceived fatigue. DATA EXTRACTION Data were extracted using a customized spreadsheet, which included detailed information on patient characteristics, interventions, and outcomes. The methodological quality of the included studies was independently assessed by 2 reviewers using the Tool for Assessment of Study Quality for Reporting on Exercise rating scale. DATA SYNTHESIS Twenty-seven articles reporting data from 22 RCTS (AT=14, RT=8) including 966 PwMS. The 2 modalities were found to be equally effective in terms of improving short walk test (AT: effect size [ES]=0.33 [95% confidence interval (CI), -1.49 to 2.06]; RT: ES=0.27 [95% CI, 0.07-0.47]) and long walk test performance (AT: ES=0.37 [95% CI, -0.04 to 0.78]; RT: ES=0.36 [95% CI, -0.35 to 1.08]), as well as in reducing perceived fatigue (AT: ES=-0.61 [95% CI, -1.10 to -0.11]; RT: ES=-0.41 [95% CI, -0.80 to -0.02]). Findings on other functional mobility tests along with self-reported walking performance were sparse and inconclusive. CONCLUSIONS AT and RT appear equally highly effective in terms of improving lower extremity physical function and perceived fatigue in PwMS. Clinicians can thus use either modality to target impairments in these outcomes. In a future perspective, head-to-head exercise modality studies are warranted. Future MS exercise studies are further encouraged to adapt a consensus "core battery" of physical function tests to facilitate a detailed comparison of results across modalities.
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Sarbaz Y, Beni KN, Hosseininejad A, Eftekharsadat B, Jahanjoo F. The effect of yoga practice on muscular strength improvement in patients with multiple sclerosis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2019.0097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background/Aims Multiple sclerosis is a common condition in the central nervous system where patients experience many issues, including muscle weakness. This study offers an investigation of continuous hatha yoga exercises on patients with multiple sclerosis. Methods A total of 22 participants with multiple sclerosis were selected, 11 were allocated to the intervention group, and 11 to the control group. In both groups, surface electromyography and dynamometer were performed at the beginning and the end of the study. The intervention group undertook 90-minute sessions of hatha yoga training three times a week for 6 months and the control group did not do any particular exercise during this period. Results Dynamometer results indicated that yoga significantly improved the muscle strength of the participants with multiple sclerosis (before the intervention: 40.00 Nm ± 14.66 Nm vs 56.82 Nm ± 20.28 Nm after the intervention, P=0.037). However, there was no significant difference in muscle strength changes between the intervention and control groups (16.82 Nm ± 23.26 Nm vs -2.86 Nm ± 23.36 Nm, P=0.171). Yoga significantly increased participants muscle strength according to the surface electromyography signals (before the intervention: 39.91 V ± 8.86 V vs 54.09 v ± 8.95 V after the intervention, P=0.007). The muscle strength of the control group participants with multiple sclerosis decreased after 6 months, however it was not statistically significant (41.55 Nm ± 9.3 Nm vs 34.55 Nm ± 8.36 Nm, P=0.073). The comparison of changes showed that the surface electromyography signals in the intervention group were significantly higher than those of the control group (P=0.001). Conclusions: Yoga exercises, in addition to common multiple sclerosis treatment methods, can be considered as a complementary therapy to improve the physical aspects of multiple sclerosis symptoms.
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Affiliation(s)
- Yashar Sarbaz
- Faculty of Electrical and Computer Engineering, University of Tabriz, Tabriz, Iran
| | - Kamran Naderi Beni
- Faculty of Electrical and Computer Engineering, University of Tabriz, Tabriz, Iran
| | - Azar Hosseininejad
- Faculty of Electrical and Computer Engineering, University of Tabriz, Tabriz, Iran
| | - Bina Eftekharsadat
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Jahanjoo
- Department of Biostatistics and Epidemiology, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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12
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Effect of a Combined Program of Strength and Dual Cognitive-Motor Tasks in Multiple Sclerosis Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176397. [PMID: 32887411 PMCID: PMC7503584 DOI: 10.3390/ijerph17176397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 12/29/2022]
Abstract
This study investigated the effects of a 24-week combined training program (CTP) based on strength exercises and cognitive–motor tasks performed concurrently in participants with multiple sclerosis. A randomized, controlled intervention study was carried out. In total, 31 subjects with a confirmed diagnosis of multiple sclerosis (14 men and 17 women) were stratified and randomized into an intervention group (17 subjects) and a control group (14 subjects). The intervention group completed three weekly training sessions for 24 weeks, while the control group pursued their normal daily activities. In this program, cognitive–motor tasks were completed at once (dual tasking). A 3D photogrammetry connected to a selective attention system designed for dual tasking while walking was used. Ground reaction forces were measured using two force plates, one for sit-to-stand testing, while the other was used for static force measurement. Postural equilibrium was examined using a stabilometric plate based for Romberg test assessment. The 24-week training program for multiple sclerosis patients improved their static peak force by 11% (p < 0 .05), their rate of force development by 36% (p < 0.05), and their balance (p < 0.05). Performance in daily activities such as walking or sitting-to-standing improved significantly in multiple sclerosis participants. CTP training was effective in reducing the dual-task costs of step length (48%) and walking velocity (54%), as compared to a matched control group.
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13
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Dennett R, Madsen LT, Connolly L, Hosking J, Dalgas U, Freeman J. Adherence and drop-out in randomized controlled trials of exercise interventions in people with multiple sclerosis: A systematic review and meta-analyses. Mult Scler Relat Disord 2020; 43:102169. [PMID: 32470858 DOI: 10.1016/j.msard.2020.102169] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The short-term benefits of exercise in people with multiple sclerosis (MS) are well established. To sustain benefits exercise needs to continue long-term. Despite important clinical implications, no systematic reviews have synthesized evidence on adherence and drop-out in MS exercise interventions. OBJECTIVES 1) To summarize reported adherence and drop-out data from randomized controlled trials (RCTs) of exercise interventions, and 2) identify moderators related to adherence and drop-out. METHODS Nine databases were electronically searched in October 2018. Included studies were RCTs of exercise interventions in adults with MS published from January 1993 to October 2018. Abstracts and full texts were independently screened and selected for inclusion by two reviewers. Methodological quality was assessed using the TESTEX rating scale. RESULTS Ninety three articles reporting 81 studies were included. Forty one studies (51%) reported both adherence and drop-out data during the intervention period with three (4%) also reporting follow-up data. Of the 41 studies, < 25% pre-defined adherence or described how adherence was measured. Meta-analyses of 59 interventions (41 studies) showed a pooled adherence estimate of 0.87 (95% CI 0.83 to 0.90) and 0.73 (CI 0.68-0.78) when including drop-outs. Mean age, proportion of females and intervention duration were inversely associated with adherence. CONCLUSION Little consensus existed on definition of adherence or determination of drop-out in MS exercise studies, with reporting generally of poor quality, if done at all. Hence it is largely unknown what can moderate adherence and whether exercise continued following an exercise intervention. Researchers should ensure clear transparent measurement and reporting of adherence and drop-out data in future trials.
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Affiliation(s)
- Rachel Dennett
- School of Health Professions, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK.
| | - Laurits T Madsen
- Exercise Biology, Dep. Public Health, Aarhus University, Denmark
| | - Luke Connolly
- School of Health Professions, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Joanne Hosking
- Medical Statistics, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth
| | - Ulrik Dalgas
- Exercise Biology, Dep. Public Health, Aarhus University, Denmark
| | - Jennifer Freeman
- School of Health Professions, Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
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