Walk Downhill

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NHE
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Walk Downhill

Post by NHE » Sat Dec 01, 2018 11:40 pm

Want to maintain, or recover, physical function? According to the following paper, walking downhill helps to improve physical function.

Myelin status is associated with change in functional mobility following slope walking in people with multiple sclerosis.
Mult Scler J Exp Transl Clin. 2018 Apr 27;4(2):2055217318773540.
  • Background: The level of myelin disruption in multiple sclerosis patients may impact the capacity for training-induced neuroplasticity and the magnitude of therapeutic response to rehabilitation interventions. Downslope walking has been shown to increase functional mobility in individuals with multiple sclerosis, but it is unclear if myelin status influences therapeutic response.

    Objective:The current study aimed to examine the relationship between baseline myelin status and change in functional mobility after a walking intervention.

    Methods: The Timed Up and Go test was used to measure functional mobility before and after completion of a repeated, six-session slope walking intervention in 16 participants with relapsing-remitting multiple sclerosis. Multi-component T2 relaxation imaging was used to index myelin water fraction of overall water content in brain tissue compartments.

    Results: Results demonstrated that the ratio of the myelin water fraction in lesion to normal-appearing white matter (myelin water fraction ratio) significantly predicted 31% of the variance in change in Timed Up and Go score after the downslope walking intervention, where less myelin disruption was associated with greater intervention response.

    Conclusions: Myelin water content fraction ratio may offer a neural biomarker of myelin to identify potential responders to interventions targeting functional impairments in multiple sclerosis.
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zen2010
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Re: Walk Downhill

Post by zen2010 » Sun Dec 02, 2018 12:26 am

Thks NHE,

That's an additional info saying that physical activity is paramount.

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Re: Walk Downhill

Post by ElliotB » Sun Dec 02, 2018 12:52 pm

Since they didn't compare to other walking types like level and uphill, the conclusion the downhill walking is advantageous has little validity.

On another note, Table 1 which compares EDDS levels and lesion volume (among other things) is most interesting as some in the study with high EDDS levels had low lesion volume and some with low EDDS scores had high lesion volume.

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Scott1
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Re: Walk Downhill

Post by Scott1 » Mon Dec 03, 2018 12:33 pm

Hi Elliot,

That is a good observation. There is a long list of studies that demonstrate that, beyond the initial phase, there is almost no correlation between EDSS scores and lesions. That's why an MRI can't predict disease progression.

The study did divide MS into two phases : "early inflammatory demyelination followed by neurodegeneration" which, I imagine, is their way of saying the same thing.

The McDonald criteria uses an MRI to help determine in there is dissemination of lesions in space (more than one location) and dissemination in time (lesions occurred at different times). The 2017 update made it a lot easier for an MRI to meet the dissemination in time test.

Using an MRI, meeting both tests is a requirement for an MS diagnosis . Else, you are back to CSF testing and neurological examinations.

From my own perspective, all sorts of walking is a good idea. Some people, of course, struggle to do that.

Regards,

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NHE
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Re: Walk Downhill

Post by NHE » Tue Dec 04, 2018 2:34 am

ElliotB wrote:Since they didn't compare to other walking types like level and uphill, the conclusion the downhill walking is advantageous has little validity.

On another note, Table 1 which compares EDDS levels and lesion volume (among other things) is most interesting as some in the study with high EDDS levels had low lesion volume and some with low EDDS scores had high lesion volume.
Upon reading the paper, it immediately becomes apparent that the authors are building on previous research that did compare uphill vs. downhill walking and found downhill walking to be significantly better.

Here is their reference.


Uphill and Downhill Walking in Multiple Sclerosis: A Randomized Controlled Trial.
Int J MS Care. 2016 Jan-Feb;18(1):34-41.
  • BACKGROUND: Various exercise protocols have been recommended for patients with multiple sclerosis (MS). We investigated the effects of uphill and downhill walking exercise on mobility, functional activities, and muscle strength in MS patients.

    METHODS: Thirty-four MS patients were randomly allocated to either the downhill or uphill treadmill walking group for 12 sessions (3 times/wk) of 30 minutes' walking on a 10% negative slope (n = 17) or a 10% positive slope (n = 17), respectively. Measurements were taken before and after the intervention and after 4-week follow-up and included fatigue by Modified Fatigue Impact Scale; mobility by Modified Rivermead Mobility Index; disability by Guy's Neurological Disability Scale; functional activities by 2-Minute Walk Test, Timed 25-Foot Walk test, and Timed Up and Go test; balance indices by Biodex Balance System; and quadriceps and hamstring isometric muscles by torque of left and right knee joints. Analysis of variance with repeated measures was used to investigate the intervention effects on the measurements.

    RESULTS: After the intervention, significant improvement was found in the downhill group versus the uphill group in terms of fatigue, mobility, and disability indices; functional activities; balance indices; and quadriceps isometric torque (P < .05). The results were stable at 4-week follow-up.

    CONCLUSIONS: Downhill walking on a treadmill may improve muscle performance, functional activity, and balance control in MS patients. These findings support the idea of using eccentric exercise training in MS rehabilitation protocols.
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