Harvard: For people with MS, can exercise change the brain?

Using exercise and physical therapy for recovery from the effects of MS, and for maintaining physical function.

Harvard: For people with MS, can exercise change the brain?

Postby jimmylegs » Wed Aug 15, 2018 7:19 am

one report on one study (hardly a position statement), but fwiw:

For people with MS, can exercise change the brain? (2017)
https://www.health.harvard.edu/blog/for ... 7083112304

"Multiple sclerosis (MS) is a condition of unknown cause in which the covering lining of nerve fibers (called myelin) is damaged. Myelin is like insulation on a wire — when it is damaged, nerve impulses are not transmitted properly. This leads to an array of symptoms including weakness, vision problems, numbness, tingling, and poor coordination or imbalance that can be debilitating.

MS is thought to develop when the immune system mistakenly attacks the central nervous system, including the brain and spinal cord. The severity of the disease varies. The most common pattern is one in which symptoms wax and wane. People who experience this are described as having “relapsing-remitting” disease.

Although there are more and better treatments for MS than ever before, there is no known cure. And the disease can progress even with the best treatments.

A new study suggests that exercise may alter the brain
A new study looks at exercise as a potential treatment for people with relapsing-remitting MS. What’s different, and exciting, about this study is that it not only analyzed the impact of exercise on symptoms of the disease, it also assessed how the brain changed with exercise treatment.

As published in the Multiple Sclerosis Journal, researchers enrolled 35 patients with relapsing-remitting MS. Half began a 24-week program of twice-weekly supervised exercise, while the other half continued to see their doctors for routine care. At the end of 24 weeks, the assignments reversed (although the group assigned to start with exercise could continue unsupervised exercise). The exercise program included progressive resistance training such as free weights, elastic bands, or exercise machines with increasing resistance over time. After the exercise program, researchers evaluated each study volunteer with measures of function, disability, and brain MRI.

Here’s what they found after the period of exercise.

Measures of overall function improved while measures of disability did not change.
Overall MRI findings (including brain volume and damage from MS) did not change. Since MRI findings of MS damage tend to worsen over time, this could suggest that exercise might keep MS from worsening, or slow its progression.
Certain parts of the brain appeared to “thicken” by MRI (suggesting preservation of brain tissue or even regeneration). However, this was observed for only 19 of 74 brain areas examined.
What does this mean?
These findings are intriguing and potentially quite important. And this is not the only study looking at the capacity of exercise to change the brain. Previous studies of the healthy elderly who exercise, those with Parkinson’s disease who exercise, and practitioners of tai chi have found evidence of brain changes by MRI.

Even so, the real importance of this study is uncertain because:

Even though the study subjects with MS improved with exercise, the overall appearance of the brain, including evidence of damage, did not improve.
The relevance of the MRI changes is not entirely clear. We don’t know whether areas of “cortical thickening” function normally or account for improved symptoms.
The study was quite small and short-term. Relapsing-remitting MS cycles through periods of improvement and worsening. So longer-term studies are needed before we know whether improvements associated with exercise are actually due to exercise, reflect the pattern of the disease, or have some other cause.
In conclusion…
Clearly, improvement in MS symptoms that seems related to exercise is reason to continue recommending physical activity for this condition. Supervised exercise may be helpful, with little chance of causing serious side effects. I think that in the future we will see more and more research into non-medication treatments of MS and other chronic diseases.

Many people, myself included, believe that the usefulness of non-medication approaches for chronic disease may be underrecognized. While it seems unlikely that exercise alone can reverse brain damage from MS or cure the disease, it might play an important role when combined with other standard treatments, including medications."

(emphasis added)
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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Re: Harvard: For people with MS, can exercise change the bra

Postby Zyklon » Wed Aug 15, 2018 7:50 am

Since MRI findings of MS damage tend to worsen over time, this could suggest that exercise might keep MS from worsening, or slow its progression.
Certain parts of the brain appeared to “thicken” by MRI (suggesting preservation of brain tissue or even regeneration


More research please. I still go to GYM (strength training) 3 days a week. I feel good. I hope more people can benefit from it.
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Re: Harvard: For people with MS, can exercise change the bra

Postby jimmylegs » Wed Aug 15, 2018 8:33 am

interesting to note 5770 scholar results on ms and exercise for 2018 alone. wonder how many of those made it into this related 2018 literature review (probably loads given the january pub date):

Multiple Sclerosis and Exercise: A Literature Review (2018)
fft: https://journals.lww.com/acsm-csmr/Full ... re.12.aspx

"Multiple sclerosis (MS) is the most common autoimmune disabling neurological conditions of young adults and affects more than 2.3 million people worldwide. Given the high likelihood for disability and decreased neurological function, there have been concerns about the role of exercise in MS patients with a fear of increased injury. This article looks at recent articles evaluating the role of exercise in MS and can hopefully be used by patients, caregivers, and health care providers to guide decision making about the role of exercise in patients with MS...

...Conclusion
Overall, it can be reasonably concluded based on current research that exercise should be a mainstay of treatment for patients with MS"
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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Re: Harvard: For people with MS, can exercise change the bra

Postby Petr75 » Sun Aug 26, 2018 7:14 am

2018 Aug 6
UAB/Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham
The Effects of Movement-to-Music (M2M) and Adapted Yoga on Physical and Psychosocial Outcomes in People with Multiple Sclerosis
https://www.ncbi.nlm.nih.gov/pubmed/30092206

Abstract
OBJECTIVE:
To investigate the effects of two 12-week exercise training interventions, movement-to-music (M2M) and adapted yoga (AY), on physical and psychosocial outcomes in people with multiple sclerosis (MS).
DESIGN:
Three-arm randomized controlled proof-of-concept trial.
SETTING:
A community-based fitness facility.
PARTICIPANTS:
Participants (N=81) with MS (Patient Determined Disease Steps [PDDS] self-reported disease status scores: 0-6) between ages of 18 and 65 years were randomized to: M2M (n=27), AY (n=26), or waitlist control (n=28).
INTERVENTIONS:
Both M2M and AY completed three 60-minute exercise sessions per week for 12 weeks. Waitlist controls received biweekly newsletters via mail that contained educational information on living with MS.
MAIN OUTCOME MEASURES:
Primary measures were Timed Up and Go (TUG, seconds), Six-minute Walk Test (6MWT, meters), and Five Times Sit-to-Stand Test (FTSST, seconds). Secondary measures were self-reported outcomes assessed using PROMIS Fatigue and Pain Interference Short Form 8a. Participants were evaluated at baseline and post-intervention. Primary analyses were performed using an intent-to-treat mixed model ANCOVA.
RESULTS:
Comparisons across all three groups revealed significant group differences in TUG and 6MWT. Post hoc analyses indicated significant improvements in TUG (LSM difference [95% CI]=-1.9s [-3.3, -0.5], p=0.01, d=0.7) and 6MWT (41.0m [2.2, 80.0], p=0.04, d=0.6; controlled for PDDS) in M2M compared to controls, while no significant differences were observed when compared AY to controls. No significant group differences were found on FTSST, fatigue and pain interference.
CONCLUSION:
Movement-to-music may be a useful and enjoyable exercise form for people with MS in improving mobility and walking endurance and merits long-term study in larger study populations.
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Re: Harvard: For people with MS, can exercise change the bra

Postby jimmylegs » Mon Sep 03, 2018 8:41 am

nice find, p
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Re: Harvard: For people with MS, can exercise change the bra

Postby Petr75 » Fri Oct 12, 2018 11:02 am

2018 Sep 18
Hotchkiss Brain Institute and the Department of Clinical Neurosciences University of Calgary, Calgary, AB, Canada
Multimodal Enhancement of Remyelination by Exercise with a Pivotal Role for Oligodendroglial PGC1α
https://www.ncbi.nlm.nih.gov/pubmed/30232000

Abstract
Remyelination is a multistep regenerative process that results in the reformation of myelin sheaths around demyelinated axons and is a critical therapeutic target. Here we show that immediate access to a running wheel following toxin-induced demyelination in mice enhances oligodendrogenesis, the rate of remyelination, and the proportion of remyelinated axons. RNA sequencing suggests broad activation of pro-remyelination pathways including phagocytosis by exercise and highlights peroxisome proliferator-activated receptor gamma co-activator 1-alpha (PGC1α) activation. By immunohistochemistry and cell type-specific conditional deletion, we confirmed PGC1α within oligodendrocytes as a transiently expressed factor required for the rate of myelin thickening by exercise. We validated the exercise-enhanced clearance of inhibitory lipid debris from lesions. Finally, exercise works in parallel with the remyelinating medication clemastine to produce complete remyelination of lesions. Our study demonstrates physical activity as an integrative means to enhance remyelination and details a multimodal mechanism including the pivotal PGC1α-dependent enhancement of myelin thickness.
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Re: Harvard: For people with MS, can exercise change the bra

Postby Zyklon » Fri Oct 12, 2018 11:26 am

Finally, exercise works in parallel with the remyelinating medication clemastine to produce complete remyelination of lesions.


Please please please more research. Tons of drugs research but very few exercise related ones.
Pain! You made me a, you made me a believer, believer
Pain! You break me down, you build me up, believer, believer
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Re: Harvard: For people with MS, can exercise change the bra

Postby jimmylegs » Sat Oct 13, 2018 8:50 am

ok time for some research wish list specifics.

without patents or citations, for 2018 alone it looks like we have 5490 results and counting:
https://scholar.google.ca/scholar?as_vi ... s_ylo=2018

yes, there are 5530 for interferon but who's counting ;)
https://scholar.google.ca/scholar?hl=en ... s%22&btnG=

so, where's the specific research gap of interest z?
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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Re: Harvard: For people with MS, can exercise change the bra

Postby Petr75 » Sat Oct 13, 2018 12:04 pm

Thanks
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Re: Harvard: For people with MS, can exercise change the bra

Postby Zyklon » Sun Oct 14, 2018 7:12 am

MS specialized exercise routines. Comparing different types of exercises. Remyelination promoting exercises. Exercise and dmd interactions.
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Re: Harvard: For people with MS, can exercise change the bra

Postby Petr75 » Sun Oct 14, 2018 8:57 am

What fight?
----------------------------------
Kickboxing: A creative approach to improving balance in patients with MS http://lermagazine.com/cover_story/kick ... -sclerosis
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Re: Harvard: For people with MS, can exercise change the bra

Postby jimmylegs » Sun Oct 14, 2018 9:28 am

i think there are a bunch but it's one thing to have an abstract and something else to have full text. without the latter, i'd probably still be seeing double!
take control of your own health
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ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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Re: Harvard: For people with MS, can exercise change the bra

Postby Petr75 » Wed Nov 07, 2018 9:10 am

2018 Sep 28
Neurorehabilitation, Fondazione Don Carlo Gnocchi Onlus (IRCCS), Milan, Italy
Intensive Multimodal Training to Improve Gait Resistance, Mobility, Balance and Cognitive Function in Persons With Multiple Sclerosis: A Pilot Randomized Controlled Trial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172314/

Abstract
Introduction: Persons with multiple sclerosis (MS) have deficits in many aspects of physical and cognitive functioning that can impact on mobility and participation in daily life. The effect of a 4 week intensive multimodal treadmill training on functional mobility, balance, executive functions and participation in persons with MS with moderate to severe disability was investigated. Methods: Thirty eight persons with MS admitted to a rehabilitation center participated in a two arm randomized 2:1 controlled trial. Participants in the experimental group received supervised intensive treadmill training including cognitive and motor dual tasks (DT-group, N = 26), 5 sessions per week and a control group received the same amount of supervised strength training (S-group, N = 12)....

Conclusion: A four week multimodal training on treadmill was highly effective in augmenting gait resistance and mobility in moderately to severely affected persons with MS.

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source img https://obehani.cz/bezecky-pas-vyhody-nem-trenovat/
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2018 Jul 25
Swedish Neuroscience Institute, Swedish Medical Center , Seattle
https://www.ncbi.nlm.nih.gov/pubmed/30044680

Abstract
INTRODUCTION:

Recently published studies show remarkable improvements in functional mobility after treadmill training with HAL® in patients with spinal cord injuries. The aim of this study was to evaluate the impact of HAL®-assisted treadmill training on quality of life. Patient/Method: A case series of six patients participating in a single-centre prospective, interventional pilot study, who were suffering neurologic motor deficits. The quality of life was assessed using the EQ-5D questionnaire and mobility was assessed using the PROMIS v1.2 Physical Function - Mobility Score before treadmill training, at 12-weeks, and at 6-months.
RESULTS:
Five out of six patients showed improvement in the PROMIS v1.2 Physical Function - Mobility score. Four patients did not show changes in the EQ-5D at 6 months follow-up, relative to baseline. The EQ-5D score of one patient worsened while improved in another patient at 6 months follow-up compared to the baseline.
CONCLUSION:
Our study details the first experience in a larger series regarding the effects of HAL®-assisted treadmill training on quality of life. Whereas five out of six patients showed improvements in mobility scores, only one patient showed improvement of life quality at 6 months follow-up. Life quality is influenced by a multitude of factors and lager randomized trials are needed to assess the effect of HAL®-assisted training on quality of life. Implications for Rehabilitation Treadmill training with HAL is safe and feasible for patients with neurologic disorders Treadmill training with HAL improved the functional mobility Improvements in the quality of life were unverifiable.

-------------------------------------------------
https://ereska.net/
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Re: Harvard: For people with MS, can exercise change the bra

Postby Petr75 » Sun Nov 11, 2018 9:56 am

2018 Oct 18
Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, Illinois, United States of America
Targeted ballet program mitigates ataxia and improves balance in females with mild-to-moderate multiple sclerosis.
PMC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193654/

Abstract
BACKGROUND:
Multiple sclerosis (MS) is a disease of the central nervous system that causes ataxia and deficits in balance. Exercise-based therapies have been identified as integral to the recovery of motor function in MS, but few studies have investigated non-traditional movement interventions. We examined a targeted ballet program (TBP) designed to mitigate ataxia and improve balance in females with mild-to-moderate relapsing-remitting MS.
METHODS AND FINDINGS:
Twelve females with mild-to-moderate disability due to MS were assessed for study eligibility for the study. Ten participants met the inclusion criteria. Two were lost to unrelated health complications. Eight participants completed the TBP. The TBP met twice a week for 60 minutes for 16 weeks. Assessments included (a) the International Cooperative Ataxia Rating Scale (ICARS), (b) the Mini-Balance Evaluations Systems Test (Mini-BESTest), (c) smoothness of movement during a five-meter walk, and (d) balance in a step to stand task before and after the TBP. There were no TBP-related adverse events. Single-tailed paired samples t-tests and Wilcoxon tests were conducted. Improvements were observed in ICARS (p = 7.11E-05), Mini-BESTest (p = 0.001), smoothness of movement in the left (p = 0.027) and right (p = 0.028) sides of the body, and balance in a step-to-stand task in the back (p = 0.025) direction. Results yielded 42% and 58% improvements in the mean Mini-BESTest and ICARS scores, respectively.
CONCLUSIONS:
This study adds to current research by providing support for a TBP intervention targeting ataxia and balance in MS. The TBP was well tolerated, improved balance, and mitigated ataxia. Clinical improvements were larger than those of previous studies on physical rehabilitation in MS with similar outcome measures.
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