Research: Exercise and Physiotherapy for MS

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

Post by Petr75 »

2021 Jan 28
Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
Cognitive Impairment Impacts Exercise Effects on Cognition in Multiple Sclerosis
https://pubmed.ncbi.nlm.nih.gov/33633658/

Abstract

Purpose: Exercise training reveals high potential to beneficially impact cognitive performance in persons with multiple sclerosis (pwMS). Research indicates that high-intensity interval training (HIIT) has potentially higher effects on physical fitness and cognition compared to moderate continuous exercise. This study (i) compares the effects of a 3-week HIIT and moderate continuous exercise training on cognitive performance and cardiorespiratory fitness of pwMS in an overall analysis and (ii) investigates potential effects based on baseline cognitive status in a subgroup analysis. Methods: Seventy-five pwMS were randomly assigned to an intervention (HIIT: 5 × 1.5-min intervals at 95-100% HRmax, 3 ×/week) or active control group (CG: 24 min continuous exercise at 65% HRmax, 3 ×/week). Cognitive performance was assessed pre- and post-intervention with the Brief International Cognitive Assessment for MS (BICAMS). (I) To examine potential within (time) and interaction (time × group) effects in the overall analysis, separate analyses of covariance (ANCOVA) were conducted. (II) For the subgroup analysis, participants were divided into two groups [intact cognition or impaired cognition (>1.5 standard deviation (SD) compared to healthy, age-matched norm data in at least one of the three tests of the BICAMS]. Potential impacts of cognitive status and intervention were investigated with multivariate analyses of variance (MANOVA). Results: Overall analysis revealed significant time effects for processing speed, verbal learning, rel. VO2peak, and rel. power output. A time*group interaction effect was observed for rel. power output. Subgroup analysis indicated a significant main effect for cognition (impaired cognition vs. intact cognition). Subsequent post-hoc analysis showed significant larger effects on verbal learning in pwMS with impaired cognition. Conclusion: Current results need to be confirmed in a powered randomized controlled trial with cognitive performance as primary endpoint and eligibility based on cognitive performance that is assessed prior to study inclusion.
https://www.eboro.cz/ms-ii/
Petr75
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2021 Mar 26
Fitness Shifts the Balance of BDNF and IL-6 from Inflammation to Repair among People with Progressive Multiple Sclerosis
https://pubmed.ncbi.nlm.nih.gov/33810574/

2021 Mar 16
Physical Exercise Moderates the Effects of Disability on Depression in People with Multiple Sclerosis during the COVID-19 Outbreak https://pubmed.ncbi.nlm.nih.gov/33809698/

2021 Mar 16
Strength Exercise Confers Protection in Central Nervous System Autoimmunity by Altering the Gut Microbiota
https://pubmed.ncbi.nlm.nih.gov/33796102/
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Petr75
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2021 May 6
Department of Sport Physiology, Tarbiat Modares University, Tehran, Iran
Physical activity may contribute to brain health in multiple sclerosis: An MR volumetric and spectroscopy study
https://pubmed.ncbi.nlm.nih.gov/33955618/

Abstract

Background and purpose: Physical activity may represent a disease-modifying therapy in persons with multiple sclerosis (pwMS). To date, there is limited research regarding mechanisms based on brain imaging for understanding the beneficial effects of physical activity in pwMS. This study examined the relationship between physical activity levels and thalamic and hippocampal volumes and brain metabolism in pwMS.

Methods: The sample of 52 pwMS (37.3 ± 9.6 years of age; 35 females, 17 males) underwent a combination of volumetric magnetic resonance imaging and magnetic resonance spectroscopy. Current and lifetime physical activity were assessed using actigraphy and the adapted version of the Historical Activity Questionnaire, respectively.

Results: Positive associations were observed between both actigraphy and self-reported levels of moderate-to-vigorous physical activity (MVPA) and thalamic and hippocampal volumes. Regarding brain metabolism, actigraphy and self-reported levels of MVPA were positively associated with higher hippocampal and thalamic levels of N-acetylaspartate/creatine ratio (NAA/Cr: marker of neural integrity and cell energy state).

Conclusions: This study provides novel evidence for a positive association between physical activity and thalamic and hippocampal volume and metabolism in pwMS. These findings support the hypothesis that physical activity, particularly MVPA, may serve as a disease-modifying treatment by improving brain health in pwMS.
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Petr75
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2021 May 24
Department of Physical Education and Sports Sciences, Faculty of Humanities, Rasht Branch, Islamic Azad University, Rasht, Iran
Changes in leptin, serotonin, and cortisol after eight weeks of aerobic exercise with probiotic intake in a cuprizone-induced demyelination mouse model of multiple sclerosis
https://pubmed.ncbi.nlm.nih.gov/34049259/

Abstract

Background: Multiple sclerosis (MS) is the most common non-traumatic neurological cause of disability in young adults. Physical activity, particularly exercise training, is an evidence-based approach to managing symptoms, restoring function, and improving overall wellness in people with MS. As well, the use of probiotics can be effective in reducing the damage from inflammation in MS patients.

Objective: The study aimed to address changes in leptin, serotonin, and cortisol following eight weeks of aerobic exercise along with probiotic intake in a cuprizone-induced demyelination mouse model of MS.

Methods: Mice were exposed to cuprizone for 12 weeks. After 5 weeks, beam and performance tests were performed on them. The mice (n = 5 per group) were randomly divided into five groups: control (C), MS, MS with exercise (MS + Exe), MS with probiotic (MS + Prob), and MS with probiotic and exercise (MS + Prob + Exe). Exercise groups performed aerobic exercises 5 days a week, 10 min in the first week, 20 min in the second week, and 30 min daily in the third week until the eighth week. In the probiotic groups, the mice received probiotic by gavage. They were sacrificed after 3 months. Biochemical and molecular biology analyses were performed.

Results: The results showed that leptin gene expression values in the MS + Prob + Exe, MS + Prob, and MS + Exe groups showed a decrease compared to the MS group, but the reduction was not significant (p > 0.05). Also, the leptin Elisa test in these intervention groups showed a significant decrease (P < 0.05). The serotonin gene expression values in the MS + Prob + Exe, MS + Prob, and MS + Exe groups were increased compared to the MS group, but the increase was not significant (p > 0.05). Furthermore, the serotonin Elisa test in these intervention groups showed a significant increase (P < 0.05). The cortisol Elisa test values in the MS + Exe and MS + Prob groups exhibited a decrease compared to the MS group, but the reduction was not significant (p > 0.05).

Conclusion: Overall, these results suggest that lifestyle interventions can be effective in improving pathological factors in patients with MS.
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Petr75
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2021 Nov 8
Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirate
The added value of cognition-targeted exercise versus symptom-targeted exercise for multiple sclerosis fatigue: A randomized controlled pilot trial
https://pubmed.ncbi.nlm.nih.gov/34748549/


Abstract

Background: Fatigue is considered one of the most common symptoms of multiple sclerosis (MS) and lacks a current standardized treatment. Therefore, the aim of this study was to examine the feasibility and effectiveness of a cognition-targeted exercise versus symptom-targeted exercise for MS fatigue.

Methods: In this Pilot, parallel-group, randomized controlled trial, sixty participants with multiple sclerosis, were randomly assigned to either a Cognition-Targeted Exercise (CTE) (N = 30, mean age 41) or a Symptom-Targeted Exercise (STE) (N = 30, mean age 42). The participants in the experimental group received eight, 50-minute sessions of weekly Cognitive Behavior Therapy (CBT) in addition to a CTE Program; whereas, participants in the control group received eight, 50-minute sessions of weekly CBT in addition to the standardized physiotherapy program (STE Program). Feasibility was assessed through recruitment rate, participant retention, adherence and safety, in addition to clinical outcome measures, including: (1) Modified Fatigue Impact Scale (MFIS), (2) Work and Social Adjustment Scale (WSAS), (3) Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS). All outcome measures were assessed at baseline (pretreatment), following completion of the eight visit intervention protocol, and at 3-months follow-up.

Results: The recruitment rate was 60% and 93% of participants completed the entire study. The recruited participants complied with 98% of the required visits. No adverse events were recorded. A Generalized Estimation Equation Model revealed a significant difference over time as an interaction term during the post and follow up visit for all clinical outcome measures (p < .001).

Conclusion: The addition of CTE to CBT exhibited positive and more lasting influence on MS fatigue outcomes compared to Symptom-Targeted Exercise (STE). Feasibility and efficacy data from this pilot study provide support for a full-scale RCT of CTE as an integral component of Multiple Sclerosis fatigue management.

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jimmylegs
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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

great finds here :) i just stumbled on

Fitness Shifts the Balance of BDNF and IL-6 from Inflammation to Repair among People with Progressive Multiple Sclerosis
posted above.
full text: https://www.mdpi.com/2218-273X/11/4/504/htm

"... fitness and exercise indicate a shift in the balance of blood biomarkers towards a repair phenotype even among people who have accumulated significant MS-related disability."

nice! fortunate in having access to an affordable, nearby, year-round, accessible public swimming pool.
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Petr75
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2021 Nov 12
Exercise Biology, Department of Public Health, Aarhus University, Denmark
Effects of Exercise Training on Neurotrophic Factors and Subsequent Neuroprotection in Persons with Multiple Sclerosis-A Systematic Review and Meta-Analysis
https://pubmed.ncbi.nlm.nih.gov/34827498/

Abstract

Background: Evidence indicates that exercise holds the potential to counteract neurodegeneration experienced by persons with multiple sclerosis (pwMS), which is in part believed to be mediated through increases in neurotrophic factors. There is a need to summarize the existing evidence on exercise-induced effects on neurotrophic factors alongside neuroprotection in pwMS.

Aim: To (1) systematically review the evidence on acute (one session) and/or chronic (several sessions) exercise-induced changes in neurotrophic factors in pwMS and (2) investigate the potential translational link between exercise-induced changes in neurotrophic factors and neuroprotection.

Methods: Five databases (Medline, Scopus, Web of Science, Embase, Sport Discus) were searched for randomized controlled trials (RCT) examining the effects of exercise (all modalities included) on neurotrophic factors as well as measures of neuroprotection if reported. The quality of the study designs and the exercise interventions were assessed by use of the validated tool TESTEX.

Results: From N = 337 identified studies, N = 14 RCTs were included. While only N = 2 of the identified studies reported on the acute changes in neurotrophic factors, all N = 14 RCTs reported on the chronic effects, with N = 9 studies revealing between-group differences in favor of exercise. This was most prominent for brain-derived neurotrophic factor (BDNF), with between-group differences in favor of exercise being observed in N = 6 out of N = 12 studies. Meta-analyses were applicable for three out of 10 different identified neurotrophic factors and revealed that exercise can improve the chronic levels of BDNF (delta changes; N = 9, ES = 0.78 (0.27; 1.28), p = 0.003, heterogeneity between studies) and potentially also ciliary neurotrophic factor (CNTF) (N = 3, ES = 0.24 (-0.07; 0.54), p = 0.13, no heterogeneity between studies) but not nerve growth factor (NGF) (N = 4, ES = 0.28 (-0.55; 1.11), p = 0.51, heterogeneity between studies). Indicators of neuroprotection (e.g., with direct measures of brain structure assessed by MRI) were assessed in N = 3 of the identified studies only, with N = 2 partly supporting and thus indicating a potential translational link between increases in neurotrophic factors and neuroprotection.

Conclusion: The present study reveals that exercise can elicit improvements in chronic levels of BDNF in pwMS, whereas the effects of exercise on chronic levels of other neurotrophic factors and on acute levels of neurotrophic factors in general, along with a potential translational link (i.e., with exercise-induced improvements in neurotropic factors being associated with or even mediating neuroprotection), are sparse and inconclusive. There is a need for more high-quality studies that assess neurotrophic factors (applying comparable methods of blood handling and analysis) concomitantly with neuroprotective outcome measures. Review Registration: PROSPERO (ID: CRD42020177353).
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Petr75
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Re: Research: Exercise and Physiotherapy for MS

Post by Petr75 »

2022 Feb 17
Faculty of Medicine, Masaryk University, Brno, Czech Republic; Department of Neurology, The University Hospital Brno, Czech Republic
Intensive circuit class therapy in patients with relapsing-remitting multiple sclerosis
https://pubmed.ncbi.nlm.nih.gov/35174869/


Abstract

Long-term physiotherapy is of considerable benefit to patients with motor dysfunction or gait impairment in patients with multiple sclerosis (MS). The aim of this study was to determine the effectiveness of 12-week intensive circuit class therapy (ICT) for patients with MS, with a wider focus on fatigue and gait ability.

Methods: A total of 46 relapsing-remitting MS patients were divided randomly: Twenty-three of them (mean Expanded Disability Status Scale (EDSS) 2.33±0.74) took part in an intensive 12-week course of ICT and 23 (mean EDSS 2.04±0.63) served as a control group. The EDSS, Timed Up and Go (TUG) test and Four-Stage Balance Test (FSBT) made up the physical testing part, supplemented by questionnaires such as the Modified Fatigue Impact Scale (MFIS), 12-Item Multiple Sclerosis Walking Scale (MSWS-12), Beck Depression Inventory (BDI) and 36-Item Short Form Survey (SF-36).

Results: Significant improvements were found among ICT-exercising patients in FSBT (p<0.05), TUG test (p<0.01), MFIS (p<0.01), BDI (p<0.05), MSWS-12 (p<0.05) and the three subscales of SF-36 after 12 weeks of ICT, while there were no significant changes in the control group. ICT-exercising patients exhibited significant improvements in FSBT (p=0.005), TUG test (p=0.005), MFIS (p=0.001), BDI (p=0.002), MSWS-12 (p=0.001) and the three subscales of SF-36 after 12 weeks of ICT compared to control group.

Conclusion: Intensive circuit class therapy is an effective therapeutic approach for improving gait and balance problems in patients with MS. It has also proved to alleviate fatigue and symptoms of depression.
https://www.eboro.cz/ms-ii/
jimmylegs
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MSVR??!

Post by jimmylegs »

ha who knew, i may actually develop an interest in VR!

Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report (2022)
https://games.jmir.org/2022/1/e31020/

i'm sold on rehab, especially after the internuclear ophthalmoplegia episodes.
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jimmylegs
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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

so today i started rebounding with eyes closed, to see what if anything that might contribute. did okay for the first hundred, things got sketchy fast in the second hundred! to be continued...
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Scott1
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Re: Research: Exercise and Physiotherapy for MS

Post by Scott1 »

What is rebounding?
jimmylegs
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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

for me, gentle bouncing on a rebounder - a tiny circular trampoline. i push down on it in a sort of pumping action moreso than actually trying to get air. it gets my blood moving and with practice, keeping my balance on it has gotten easier. i was going to just try to increase duration for as long as uhthoff lets me, but eyes closed really takes it up a notch :O
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jimmylegs
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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

this evening, i started out with eyes closed and made it to 90 before I had to open my eyes or go for a header. then did another 200 eyes closed, and was ok. one of these times, i might even try my luck with eyes-closed rebounding with arm circles. fancy lol :)
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Jaded
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Re: Research: Exercise and Physiotherapy for MS

Post by Jaded »

That's pretty impressive JL

Have you noticed an improvement in your day-to-day balance?

J :)
jimmylegs
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Re: Research: Exercise and Physiotherapy for MS

Post by jimmylegs »

aww, thanks! :) and yes, i think so!
yesterday, i got to 90 straight bounces and then had to open my eyes quick before continuing. then i did 100 more bounces, eyes closed, with arm circles as well.
this evening, i think i hit a personal best :D
eyes closed the entire time, i did:
-100 regular bounces,
-100 more with large forward arm circles,
then to sort of recalibrate i did about 50 straight bounces with no arm circles, and lastly,
another 100 bounces in sets of 20, alternating between forward and backward arm circles.
changing direction that often definitely took it up a notch lol

i have learned to really appreciate rehab, and i think this routine might be helping reroute some broken connections.
things are still off just walking around inside the house, but i'm definitely way, way, way better off than a few months ago :o
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