Research: Exercise and Physiotherapy for MS

Using exercise and physical therapy for recovery from the effects of MS, and for maintaining physical function.
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Petr75
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2019 Jan 24
Department of Sport Injury & Corrective Exersices, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
The Effect of Total Body Resistance Exercise on Mobility, Proprioception and Muscle Strength of the Knee in People with Multiple Sclerosis
https://www.ncbi.nlm.nih.gov/pubmed/30676232

Abstract
CONTEXT::
Muscle weakness and sensory deficits cause impaired balance and walking abilities which are prerequisites for independent activity of daily living in people with multiple sclerosis. Recent physical exercises tailored to improve the activity of daily living people with multiple sclerosis have focused on the functional training.
OBJECTIVE::
The aim of this study was to investigate the effect of total body resistance exercise suspension training on mobility, proprioception and muscle strength of the knee in people with multiple sclerosis.
DESIGN::
Pre-test and post-test control group design, single-blind.
SETTING::
Referral Center of Multiple Sclerosis Society.
PARTICIPANTS::
Thirty-four women with relapsing-remitting multiple sclerosis were participated in this study. The Mean±SD of their age was (36.44±4.88) years; and the Expanded Disability Status Scale was (2.35±.94). The participants were divided into two groups: control group (n=15) and training group (n=19).
INTERVENTION::
The training group performed the total body resistance exercise program for 8 weeks, 3 sessions per week. The control group received their usual care and daily activities. Outcomes were measured pre- and post- sessions.
MAIN OUTCOME MEASURE::
Mobility was assessed with Timed Up and Go test, 10-Meter Walk Maximum test, 2-Minute Walk test, and 5-Time Sit to Stand test. Knee proprioception absolute error and isometric strength of knee flexor and extensor muscles were measured by using a biodex isokinetic dynamometer.
RESULTS::
In the training group, Mobility (P=0.001), maximal voluntary isometric contractions of knee flexor and extensor muscles in both legs (P>0.05), and the knee proprioception absolute error in non-dominant leg at 60° knee flexion (P=0.015) improved significantly compared with the control group.
CONCLUSION::
Total body resistance exercise is a functional and safe intervention that can improve the mobility and muscles strength of the knee in a short period in people with multiple sclerosis.
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2001 case study: MS exercise in 94 F (34.4 C) water

Post by jimmylegs »

headed to the pool in the not too distant future (maybe starting next week??). it's on the warm side but not THIS warm:

Exercise in 94 degrees F water for a patient with multiple sclerosis (2001)
https://www.ncbi.nlm.nih.gov/pubmed/11276186

"Abstract
BACKGROUND AND PURPOSE:
The purpose of this case report is to describe the examination, intervention, and outcome of a patient with multiple sclerosis (MS) who participated in a comprehensive rehabilitation program that included aquatic therapy with a pool temperature of 94 degrees F. There are few descriptions of aquatic exercise programs on muscle force, exercise tolerance, and functional outcomes in individuals with MS, and most authors recommend a water temperature of less than 85 degrees F to prevent an exacerbation of symptoms.

DESCRIPTION:
The patient was a 33-year-old woman. Before, during, and after the aquatic program, she was monitored for body temperature, heart rate, blood pressure, and perceived exertion. She was also assessed for muscle force and functional abilities.

OUTCOMES:
The patient did not experience heat sensitivity or fatigue throughout the program, and her manual muscle test grades and mobility improved.

DISCUSSION:
This patient's participation in aquatic therapy, in conjunction with land-based interventions, may have been associated with the improvement in functional abilities."
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Re: Research: Exercise and Physiotherapy for MS

Post by Zyklon »

My experience is the same. Even my core temperature rises during exercise, I don't feel anything bad. In the gym and pool.
Pain! You made me a, you made me a believer, believer
Pain! You break me down, you build me up, believer, believer
Pain! Oh let the bullets fly, oh let them rain
My life, my love, my drive, it came from... Pain!
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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

lucky you! since last yr's infection fiasco i'm a literal hot mess. aquafit has been deferred a couple times but i think next week will be go time! :D
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2019 meta-analysis: Exercise and Physiotherapy for MS

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The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis (2019)
link to abstract: https://www.sciencedirect.com/science/a ... 9918310021

Highlights
•Systematic review and meta-analysis were carried out from 1990 to 2017.
•Aerobic exercise and physiotherapy were found to be beneficial for MS patients.
•Complementary therapies need to be included as normal practice.
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2019 Mar 8
Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Germany
Influence of different rehabilitative aerobic exercise programs on (anti-) inflammatory immune signalling, cognitive and functional capacity in persons with MS - study protocol of a randomized controlled trial.
PMC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407211/

Abstract
BACKGROUND:
Studies have shown positive effects of therapeutic exercise on motor- and cognitive function as well as on psychosocial outcomes in persons with multiple sclerosis (MS). A reduction of inflammatory stress through physical exercise has been suspected as one key mechanism, mediating the positive effects of exercise in the context of MS. The primary objective of this trial is to investigate the acute and chronic effects of different exercise modalities on (anti-)inflammatory immune signalling as well as on cognitive and functional capacity in persons with MS.
METHODS:
A two armed single-blind randomized controlled design will investigate 72 persons with relapsing remitting or secondary progressive MS (EDSS 3.0-6.0), during 3 weeks of inpatient rehabilitation. Participants will be randomized into either a high-intensity interval training (HIIT) or a moderate continuous training group; the latter represents the local standard therapy (ST). Both groups will exercise 3x per week. The HIIT group will perform 5 × 1.5-min high-intensive exercise bouts at 95-100% of their maximum heart rate (HRmax) followed by active breaks of unloaded pedalling (60% HRmax) for 2 min. In contrast, the ST group will exercise for 24 min continuously at 65% of HRmax. The proportion of circulating regulatory T-cells will be measured as primary outcome. Secondary outcomes comprise numbers and proportions of further immune cells including Th17-cells, soluble factors ((anti-) inflammatory cytokines, tryptophan metabolites), endurance capacity, cognitive performance, processing skills for activities of daily living, fatigue, depression and healthcare-related quality of life. Outcomes will be assessed before (T0) and after (T3) the 3-week exercise intervention program. Blood samples of T0 will be taken immediately before the first exercise session. Additionally, blood samples for the soluble factors will be collected immediately after (T1) and three hours (T2) after the first exercise session of each group.
DISCUSSION:
This study will be the first to investigate both acute and chronic effects of aerobic exercise on immune function and disease associated biomarkers in persons with MS. Combining biological analyses with cognitive and functional capacity assessments may contribute to a better understanding of responses to rehabilitative training, needed to improve exercise recommendations for persons with MS.
TRIAL REGISTRATION:
This trial was prospectively registered at ClinicalTrials.gov ( NCT03652519 ; 29 August 2018).
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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

nice find, i'll be interested in results from this one
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Re: Research: Exercise and Physiotherapy for MS

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2019 Apr 30
Department of Physiology, School of Medicine, Western Gateway Building, University College Cork, Cork, Ireland
Cycle ergometer training enhances plasma interleukin-10 in multiple sclerosis
https://www.ncbi.nlm.nih.gov/pubmed/31041609

Abstract
The objective was to determine plasma levels of pro- (IL-12p70/IL-6) and anti-inflammatory (IL-10) cytokines before and after cycle ergometer training in healthy control (HC) and people with multiple sclerosis (pwMS), and to correlate plasma cytokines with physical/mental health. Study participants cycled for 30 min at 65-75% age-predicted maximal heart rate, twice a week for 8 weeks during supervised sessions. We determined that plasma IL-10 expression was lower in pwMS, compared to HCs, and that exercise augmented IL-10 in pwMS to baseline levels in HCs. Furthermore, plasma isolated from pwMS displayed enhanced expression of the pro-inflammatory cytokines IL-12p70/IL-6. Plasma cytokine signatures correlated with physical/mental health. Overall, this study highlights the potential of a short-term exercise programme to regulate circulating cytokine profiles with relevance to pwMS.
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Re: Research: Exercise and Physiotherapy for MS

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2019 Mar-Apr
Strength Training to Improve Gait in People with Multiple Sclerosis: A Critical Review of Exercise Parameters and Intervention Approaches.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489435/

Abstract
Background: There are mixed reports on the effectiveness of strength training to improve gait performance in people with multiple sclerosis (MS), yet the reasons for these inconsistent results are not clear. Therefore, a critical review was conducted to explore dosage, frequency, mode, position, and muscle targets of studies that have included strength training in people with MS.

Methods: An electronic search was conducted through July 2017. Randomized controlled trials involving people with MS were included that implemented strength training with or without other interventions and assessed 1) strength in the lower extremities and/or trunk and 2) gait speed and/or endurance. Strength and gait results were extracted, along with exercise frequency, intensity, duration, mode, position, and muscle targets.

Results: Thirteen trials met the inclusion criteria; nine used dosing consistent with recommended guidelines. Overall, six studies reported significant between-group strength improvements, and four reported within-group changes. Four studies reported significant between-group gait improvements for gait speed and/or endurance, and two reported within-group changes. Most exercises were performed on exercise machines while sitting, supine, or prone. The most common intervention target was knee extension.

Conclusions: Studies generally improved strength, yet only two studies reported potentially meaningful between-group changes in gait. Future strength intervention studies designed to improve gait might consider dosing beyond that of the minimum intensity to improve strength and explore muscles targets, positions, and modes that are task-specific to walking.

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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

good find. on the future interventions note, i have learned since the knee reconstruction how important the glutes are for gait on stairs in particular. i'd had no idea.
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2019
Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta
Effects of downslope walking on Soleus H-reflexes and walking function in individuals with multiple sclerosis: A preliminary study.
https://www.ncbi.nlm.nih.gov/pubmed/31256089

Abstract
BACKGROUND:
Downslope walking (DSW) is an eccentric-based exercise intervention that promotes neuroplasticity of spinal reflex circuitry by inducing depression of Soleus Hoffman (H)-reflexes in young, neurologically unimpaired adults.
OBJECTIVE:
The objective of the study was to evaluate the effects of DSW on spinal excitability (SE) and walking function (WF) in people with multiple sclerosis (PwMS).
METHODS:
Our study comprised two experiments on 12 PwMS (11 women; 45.3±11.8 years). Experiment 1 evaluated acute effects of a single 20-minute session of treadmill walking at three different walking grades on SE, 0% or level walking (LW), - 7.5% DSW, and - 15% DSW. Experiment 2 evaluated the effects of 6 sessions of DSW, at - 7.5% DSW (with second session being - 15% DSW) on SE and WF.
RESULTS:
Experiment 1 showed significantly greater acute % H-reflex depression following - 15% DSW compared to LW (p = 0.02) and - 7.5% DSW (p = 0.05). Experiment 2 demonstrated significant improvements in WF. PwMS who showed greater acute H-reflex depression during the - 15% DSW session also demonstrated greater physical activity, long-distance WF, and the ability to have greater H-reflex depression after DSW training. Significant changes were not observed in regards to SE.
CONCLUSIONS:
Though significant changes were not observed in SE after DSW training, we observed an improvement in WF which merits further investigation of DSW in PwMS.
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Re: Research: Exercise and Physiotherapy for MS

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2019 Sep
Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
Exercise intensity-dependent immunomodulatory effects on encephalomyelitis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764499/

Abstract
BACKGROUND:
Exercise training (ET) has beneficial effects on multiple sclerosis and its animal model experimental autoimmune encephalomyelitis (EAE). However, the intensity-dependent effects of ET on the systemic immune system in EAE remain undefined.
OBJECTIVE:
(1) To compare the systemic immune modulatory effects of moderate versus high-intensity ET protocols in protecting against development of EAE; (2) To investigate whether ET affects autoimmunity selectively, or causes general immunosuppression.
METHODS:
Healthy mice performed moderate or high-intensity treadmill running programs. Proteolipid protein (PLP)-induced transfer EAE was utilized to examine ET effects specifically on the systemic immune system. Lymph node (LN)-T cells from trained versus sedentary donor mice were transferred to naïve recipients and EAE severity was assessed, by clinical assessment and histopathological analysis. LN-T cells derived from donor trained versus sedentary PLP-immunized mice were analyzed in vitro for proliferation assays by flow cytometry analysis and cytokine and chemokine receptor gene expression using real-time PCR. T cell-dependent immune responses of trained versus sedentary mice to the nonautoantigen ovalbumin and susceptibility to Escherichia coli-induced acute peritonitis were examined.
RESULTS:

High-intensity training in healthy donor mice induced significantly greater inhibition than moderate-intensity training on proliferation and generation of encephalitogenic T cells in response to PLP-immunization, and on EAE severity upon their transfer into recipient mice. High-intensity training also inhibited LN-T cell proliferation in response to ovalbumin immunization. E. coli bacterial counts and dissemination were not affected by training.
INTERPRETATION:
High-intensity training induces superior effects in preventing autoimmunity in EAE, but does not alter immune responses to E. coli infection.
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Re: Research: Exercise and Physiotherapy for MS

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2019 Aug 14
Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials
https://www.ncbi.nlm.nih.gov/pubmed/31414194

Abstract
We performed a meta-analysis to synthesize evidence on the efficacy and safety of physical exercise as an add-on therapeutic intervention for quality of life (QoL), depressive symptoms and cognition across six chronic brain disorders: Alzheimer's disease, Huntington's disease, multiple sclerosis, Parkinson's disease, schizophrenia and unipolar depression. 122 studies ( = k) (n = 7231) were included. Exercise was superior to treatment as usual in improving QoL (k = 64, n = 4334, ES = 0.40, p < 0.0001), depressive symptoms (k = 60, n = 2909, ES = 0.78, p < 0.0001), the cognitive domains attention and working memory (k = 21, n = 1313, ES = 0.24, p < 0.009), executive functioning (k = 14, n = 977, ES = 0.15, p = 0.013), memory (k = 12, n = 994, ES = 0.12, p = 0.038) and psychomotor speed (k = 16, n = 896, ES = 0.23, p = 0.003). Meta-regression showed a dose-response effect for exercise time (min/week) on depressive symptoms (β = 0.007, p = 0.012). 69% of the studies that reported on safety, found no complications. Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders, with a positive dose-response correlation. Exercise also improved several cognitive domains with small but significant effects.
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Re: Research: Exercise and Physiotherapy for MS

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2019 Sep 4
Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
Exercise in multiple sclerosis and its models: Focus on the central nervous system outcomes.
https://www.ncbi.nlm.nih.gov/pubmed/31486115

Abstract
Multiple sclerosis (MS) is a central nervous system (CNS) disorder characterized by inflammation, demyelination, and neurodegeneration. Emerging research suggests that exercise has therapeutic benefits for MS patients but the clinical data have focused primarily on non-CNS outcomes. In this review, we discuss evidence in preclinical MS models that exercise influences oligodendrocyte proliferation and repopulation, remyelination, neuroinflammation, neuroprotection, axonal regeneration, and astrogliosis. Evidence for the therapeutic effects of exercise in MS is further supplemented by data from other CNS diseases, including Alzheimer's disease, Parkinson's disease, and spinal cord injury. These results motivate studies into the benefits that exercise confers within the CNS in MS.
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Re: Research: Exercise and Physiotherapy for MS

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2019 Sep 17
Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche) (STEBICEF), University of Palermo, Italy
Physical Activity and Brain Health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770965/

Abstract
Physical activity (PA) has been central in the life of our species for most of its history, and thus shaped our physiology during evolution. However, only recently the health consequences of a sedentary lifestyle, and of highly energetic diets, are becoming clear. It has been also acknowledged that lifestyle and diet can induce epigenetic modifications which modify chromatin structure and gene expression, thus causing even heritable metabolic outcomes. Many studies have shown that PA can reverse at least some of the unwanted effects of sedentary lifestyle, and can also contribute in delaying brain aging and degenerative pathologies such as Alzheimer's Disease, diabetes, and multiple sclerosis. Most importantly, PA improves cognitive processes and memory, has analgesic and antidepressant effects, and even induces a sense of wellbeing, giving strength to the ancient principle of "mens sana in corpore sano" (i.e., a sound mind in a sound body). In this review we will discuss the potential mechanisms underlying the effects of PA on brain health, focusing on hormones, neurotrophins, and neurotransmitters, the release of which is modulated by PA, as well as on the intra- and extra-cellular pathways that regulate the expression of some of the genes involved.

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2019 Sep 19
Exercise and metformin counteract altered mitochondrial function in the insulin-resistant brain.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795285/
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