Can Exercise Improve MS-Related Cognitive Problems?

Can exercise help brain function in people with multiple sclerosis (MS)? A new study suggests that it is possible. The report appeared in the Journal of Clinical and Experimental Neuropsychology. Led by Robert Motl in the Department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign, the study investigators looked at the short-term effects of different forms of aerobic and non-aerobic exercise training on mental abilities in people living with relapsing-remitting MS.

Cognitive problems are a major difficulty experienced by many people with MS. In fact, problems with cognition may occur at some point in the course of their illness in more than 50% of people living with the disease. Problems with learning and memory, as well as difficulty in planning or making decisions, focusing attention, multi-tasking, and problem-solving are all possible consequences of impaired mental functions in MS. As a result of these issues, loss of independence and diminished quality-of-life often result. Unfortunately, there are no specific drug therapies for cognitive impairment in MS, and it is also not clear as to whether there are effective and clear rehabilitation strategies for this problem.

Exercise training is one possible treatment that may help people with MS and impaired cognition. However, studies focusing on exercise training for cognitive problems have had mixed results in the past, possibly because consistent exercise approaches have not been used in all studies.

The present study focused on the effect of exercise on cognition in 24 people with relapsing-remitting MS. First author Brian M. Sandroff and the study investigators used the Expanded Disability Status Scale (EDSS) to assess levels of disability. To participate in the study, subjects had to be able to walk with or without some minimal assistance, such as with a cane or crutch.

The researchers used standard tests to measure reaction time, attention and executive functions, including the ability to plan and problem-solve.

The study participants had five sessions, which included taking a test of cognition followed by one of three exercises: treadmill walking, stationary bicycle, or yoga. The participants could also have a period of quiet rest, which was used as a comparison to the exercises (control). After the exercise, all subjects took the cognitive test again.

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Treadmill walking was very effective at improving reaction time, and in contrast, quiet rest had no effect on this measurement. Stationary bicycling and guided yoga also improved reaction time. In contrast to the other exercises, treadmill walking was very effective when the subjects experienced a great deal of distracting information during the test, which seemed to indicate that this type of exercise was particularly effective, and could be the most relevant exercise for real life conditions in which distracting information is present.

In their report, the authors stated “The present results support treadmill walking as the modality of exercise that might exert the largest beneficial effects on executive control in persons with relapsing-remitting MS without impaired cognitive processing speed.”

The team is planning a longer term study to examine the effects of different types of exercise on cognition in MS.