Sensorimotor Exercise Linked to Better Overall Quality of Life
Sensorimotor exercise, which aims to improve the neuromuscular system with reduced pressure interventions, such as robotic-assisted training or aquatic exercises, was found to have the greatest total benefits on both mental and physical health-related quality of life (HRQoL) among people with multiple sclerosis (MS).
However, aerobic exercises — such as using a treadmill, cycling, or walking — are better at specifically improving physical HRQoL, the study found, and mind-body exercises, like pilates and yoga, had the greatest impact on mental health-related quality of life.
“Exercise represents a beneficial approach to improve the HRQoL of people with MS,” the researchers wrote. “Combining exercise aimed at improving strength, aerobic capacity and balance may be the best strategy.”
Physical activity, and specifically regular exercise, is essential for maintaining general health and well-being, and for helping manage some of the symptoms of MS, according to clinicians. While all MS patients are encouraged — per National MS Society guidelines, among other measures —to engage in regular exercise, the best type to engage in, with a goal of improving HRQoL, remains unclear.
Now, a team of researchers from Spain, Chile, and Paraguay conducted a meta-analysis to determine which form of exercise has the greatest effect on total HRQoL, as well as on the mental and physical components of quality of life. Figuring out what type of exercise is best suited to each disease stage also was a key goal for this analysis.
Information was collected from 45 randomized clinical trials involving a total of 2,428 participants. The patients’ mean age was 45, about three-quarters were women, and they had been living with the disease for 2.7 to 18.7 years.
Overall, the physical exercise interventions in each study were classified into five groups, which included aerobic exercise aimed at increasing energy expenditure and heart rate, and resistance training, designed to increase muscular strength and power combined.
Sensorimotor exercises, a type of training based on balance and coordination, which aims to restore motor control and may also include strength or aerobic exercise, was another intervention.
The two other categories were mind-body exercise, which is based on balance and strength, while focusing on breathing and postural control, and combined training, which uses both aerobic exercise and resistance training.
Results showed that all forms of exercise improved total, mental, and physical HRQoL, compared with the regimens used by the control groups. Those patients often received standard of care and were asked to continue their usual exercise routines.
Showing the greatest effect on total HRQoL was sensorimotor exercise, which ranked first. Aerobic exercise, on the other hand, had the highest effect on physical HRQoL, while mind-body exercise had the strongest impact on mental HRQoL.
“Sensorimotor training seems the most effective type of exercise to improve HRQoL as a whole and aerobic and mind-body exercises to improve physical and mental HRQoL, respectively,” the researchers wrote.
They suggested that sensorimotor exercise improved overall quality of life by reducing the risk of falls and spasticity, while aerobic interventions impacted physical HRQoL by boosting functional independence and reducing fatigue. The impact of mind-body on mental quality of life may be associated with a greater body and mental awareness, and an overall sense of well-being, the team said.
Next, the researchers asked which type of exercise is best for each stage of disease severity. They found that sensorimotor exercise was best for people with mild disease and aerobic exercise was optimal for those with severe disease.
“Sensorimotor training had the highest effect for mild disease, whereas aerobic exercise versus sensorimotor training was the best exercise intervention for severe disease in total HRQoL, perhaps because aerobic capacity and fatigue endurance are important for total HRQoL in this degree of disease severity,” they wrote.
One limitation of the meta-analysis is that the intensity, duration, frequency, and time of exercise were not compared because they varied widely across the studies.