exercise

A physiotherapist-supported exercise program using Nintendo Wii may be a feasible and cost-effective way of helping  people with multiple sclerosis (MS) be more physically active, researchers reported after performing a small pilot study. While findings showed some evidence that people improved — both in terms of self-reported health, gait and balance measurements — researchers underscored that more data needs to be gathered on the intervention’s effectiveness, as the study mainly intended to determine if such a program was feasible. Researchers at the Bournemouth University and Poole Hospital NHS Foundation Trust, both in the U.K., argued that a physical activity intervention using active gaming at home may overcome the many challenges MS patients face when attempting to be active. Barriers to it could be physical, but psychological factors, such as fear, embarrassment, or lack of confidence, can also prevent patients from attempting to increase their activity levels. Moreover, practical aspects — such as transport and cost — can hinder people from joining interventions. In the report, “Mii-vitaliSe: a pilot randomised controlled trial of a home gaming system (Nintendo Wii) to increase activity levels, vitality and well-being in people with multiple sclerosis,” researchers explained they used data generated in earlier Nintendo Wii studies to design an improved intervention program. Earlier studies showed that behavior change techniques, including motivational interviews and problem solving, would likely improve the impact of an intervention. These early studies also highlighted the importance of considering the functional levels, environment, and preferences of individual patients when prescribing a Wii-based program. The study (ISRCTN49286846), described in the journal BMJ Open, shows that among the 30 people who signed up, only two dropped out because of medical reasons. Patients either received the 12-month intervention, called Mii-vitaliSe, directly or after a six-month waiting period. Those on the waiting list group were given six months of intervention. Patients, who had low levels of physical activity when the study began, were instructed as to the benefits of physical activity and on how to use the Wii. During the personalized intervention, participants had access to regular support from a physiotherapist and were provided with a personal activity workbook, which aided participants in setting goals and monitoring progress, among other things. They were also asked to keep a log to track their activity, which showed an average use of the Wii two times per week, for 27 minutes each day. Results showed that patients who started the intervention immediately tended to report better physical activity levels, and better physical and psychological well-being. They also had numerical improvements in gait and balance. While no severe adverse reactions were seen, participants reported pain and worsening of scar tissue after some exercises, for which they received follow-up advice and care. The team also identified several problems or difficulties, including wrongly completed questionnaires, that will allow them to improve measurements once they launch a larger study. "Our study is the first to report on home-based use of the Wii for people with MS in the UK. Overall, findings from this study are promising and support proceeding to a full-scale trial of effectiveness and cost-effectiveness. We will refine the trial design, aspects of the intervention and finalize outcome measures in the light of our experiences from this pilot study" the researchers wrote.

Aerobic exercise strengthens brain connections in people with relapsing-remitting multiple sclerosis, Jan-Patrick Stellmann, with University Medical Center Hamburg-Eppendorf in Germany, reported at the 7th Joint ECTRIMS-ACTRIMS Meeting in Paris that ran from Oct. 25–28. According to Stellmann, "aerobic exercises are considered to improve mobility, fatigue, depression and cognition in MS," and also to "promote neuroprotective or neuroregenerative mechanisms." For the study, the team used MRI to examine how exercise affected different types of brain connections. They recruited 57 RRMS patients and 30 healthy controls to the study. Women made up more than two-thirds of the patient group, which had a mean age of 39. Patients only had mild disability, with a mean score of 1.5 on the Expanded Disability Status Scale. Researchers randomly assigned about half the group to a supervised and individually adapted aerobic exercise program, consisting of 22 sessions of up to one hour each. Others were assigned to a waiting list — with the intent of taking up exercise after three months — and served as a control group. MRI scans at the study's beginning revealed that patients had more so-called functional connections, but fewer structural ones, than healthy controls. It is known from earlier studies that most RRMS patients show abnormalities in functional connections, but some researchers find increases while others decreases in these connections. Functional and structural connections appear on different types of MRI scans — ones that make use either of blood flow changes or of the properties of water molecules in the white matter of the brain. The deviations were particularly pronounced in highly connected hub regions, the researchers said. After three months, functional connections increased across the entire brain among exercising patients, but decreased in those on the waiting list. Structural connections also increased among patients who exercised, while no change was detected among control patients. Researchers also noted that exercising patients grew more local connections, mostly in hub regions, compared to those who did not exercise. While it is generally accepted that aerobic exercise promotes neuroprotective and regenerative processes within the brain, the study demonstrated that exercise, in only three months, did indeed affect how the brain is wired. "Short-term aerobic exercise increases functional and structural connectivity," Stellmann concluded. "Already after three months, exercise lead to functional and structural reorganization of brain networks." The researcher highlighted the difficulties in obtaining financial support for trials on exercise. And he emphasized that patients should be encouraged by their doctors to exercise regularly.

A clear association was seen between the substantial pain that multiple sclerosis (MS) patients experience and lifestyle choices that either augment or ease that pain, like smoking habits, exercise, and diet and weight, researchers in Australia report. Common co-morbidities associated with MS, such as depression, anxiety, and fatigue, were also…

The Patient-Centered Outcomes Research Institute has awarded $38 million in grants for five projects that compare the effectiveness of different multiple sclerosis treatment strategies. A key aim of the research is to improve knowledge about the therapies to help doctors and patients choose the healthcare option that best meets patients’ needs. The…

The Multiple Sclerosis Society of Canada — with input from both experts and patients — has developed a "wellness toolbox" with strategies to help multiple sclerosis (MS) patients cope with their disease. Wellness is becoming a big area of research, particularly in patients with chronic diseases such as MS. With an estimated 291 cases per 100,000 inhabitants in 2013, according to the Multiple Sclerosis International Foundation, Canada has the world's highest incidence of MS. While pharmaceutical and scientific research are advancing in the therapeutic area, studies are also underway to determine the contribution of wellness factors such as nutrition, physical activity and emotional well-being -- to quality of life for MS patients. With that in mind, the Toronto-based MS Society of Canada conducted a Wellness Survey, which led to the launch of the Hermès Canada | MS Society Wellness Research Innovation Grant. These grants are awarded to scientists conducting research on MS and wellness factors. The University of Saskatchewan, which received one such grant in 2016, investigated the effect of Pilates in people with MS. The study recruited 30 MS patients. Half took Pilates classes twice a week and massage therapy once a week, while the other half only did once-a-week massage therapy. Results showed that patients who took Pilates classes saw an improvement in their overall condition, compared to patients in the control group. To create its wellness toolbox, the MS Society of Canada received input from MS patients about strategies that have helped them manage the disease and live a full life.

Believe me, I enjoy being active. As I’m sitting in a chair or a wheelchair, it may not appear that way, but I do. I have multiple sclerosis, and the fatigue and difficulty of moving can make it extremely laborious to be active. The thought of going on…

In a pilot study with patients with multiple sclerosis, high-intensity interval training combined with resistance training improved physical capacity and quality of life in a pilot study of multiple sclerosis (MS) patients — whether or not they were disabled. French researchers at the University of Strasbourg assessed physical capacity, strength and quality of life before the training started, and then again after completing a 12-week exercise program. They divided participants into two groups: one of 18 patients with no disabilities, and a group of eight with disabilities. Participants followed a personalized exercise program involving both high-intensity interval training — a kind of cardiovascular exercise strategy alternating short periods of intense anaerobic exercise with less intense recovery periods — and resistance training to improve muscular strength and endurance. Scientists used a French version of the Multiple Sclerosis Quality Of Life-54 test — a questionnaire filled out by MS patients to measure health-related quality of life — with five additional questions. After the exercise program, women improved significantly in vitality, general well-being and physical health composite scores in the quality of life assessment, while men showed no significant improvements. Vitality and general well-being only improved in the group with no disability. Peak oxygen consumption improved by 13.5 percent, and maximum tolerated power — a measure of maximum energy that can be expended — by 9.4 percent. Muscle strength increased in both quadriceps and hamstrings. Women showed better improvements than men in peak oxygen consumption, maximal tolerated power, strength in both quadriceps and hamstrings, and quality of life. Both groups showed increased peak oxygen consumption and strength. “Our study has shown that high-intensity interval training combined with resistance exercise training induced an improvement in physical capacity and quality of life. Moreover, this study allowed patients, irrespective of their sex or EDSS [Expanded Disability Status Scale] score, to resume exercise autonomously,” the team wrote. "High-intensity interval training is well tolerated too and can be used in clinical rehabilitation with resistance training, in both men and women with and without disabilities."

Earlier this year, I visited a physical therapist I’d seen way back in my running days to devise a home workout routine that could help me address not only foot drop-related issues, but also a routine I’d actually do. One of the challenges I have with PT is doing…

Note to readers: This is the last of a three-part series focusing on the valuable role Pilates has played in my life with MS. If you missed the first two, you’ll find them here and here. This column focuses on…

A new test can show how exercise is benefiting people with multiple sclerosis (MS) and other neurological conditions. The evaluation of muscle health in individuals with MS, spinal cord injuries and other severe nerve damage conditions is usually done with magnetic resonance imaging (MRI) and other expensive equipment. Researchers in the…

Music therapy has long been known for its healing powers — its use dates back to WWI, where it was used to help with the physical and emotional healing of the wounded. Music can also be of help to those of us with multiple sclerosis. An article from the…

Keeping motivated is a daily struggle, and honestly, most days I just don’t feel like moving. I feel better once I do, of course, but the motivation to move and be productive is lacking. Here are a few tips that I find helpful to help keep me motivated and…

Have you tried Pilates to improve your mobility?  When my wife and I tried it, a few years ago, I thought that it was sort of like doing yoga stretches using exercise equipment.  It felt good and, for the short time that I did keep it up, Pilates seemed…

In a large prospective study with validated measures of physical activity, researchers found no evidence that exercise reduced a woman’s risk of developing multiple sclerosis (MS). Although physical activity is known to have numerous health benefits, it seems unlikely to protect a person against the likelihood of developing MS, the study concludes. The study, published…

Interventions that aim to improve multiple sclerosis (MS) patients’ participation in physical activities need to take into account psychosocial constructs, such as their belief in their abilities and their expectations as to outcomes, in order to succeed. The finding, presented at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)…

In a fair world, reading books would burn the most calories, eating ice cream would be chock-full of antioxidants and vitamins, and no one would have multiple sclerosis. But, like many other people, I have MS and have to live with fatigue, cognitive issues, trouble walking, and so much more…

Clinical pilates can improve cognitive skills and life quality in multiple sclerosis (MS) patients, in addition to helping them physically. But the study, comparing clinical pilates with traditional exercise, also showed that other exercise forms offer important benefits, and more research is needed to determine if clinical pilates is a superior type of exercise for people with…

Exercise might improve sleep quality in people with multiple sclerosis (MS), according to a study presented at the Consortium of Multiple Sclerosis Centers (CMSC) 2016 annual meeting, June 1 – 4, at the Gaylord National Resort and Convention Center in National Harbor, Md. The study, “The Impact of…

Treadmill walking exercise training is beneficial for multiple sclerosis (MS) patients, increasing not only their cardiorespiratory fitness, but also their cognitive processing speed, according to the study “Systematically Developed Pilot Randomized Controlled Trial of Exercise and Cognition in Persons with Multiple Sclerosis,” recently presented at the Consortium of Multiple…

Exercises like yoga and aquatic programs can help ease some symptoms of multiple sclerosis (MS), especially fatigue, depression and paresthesia, researchers report in a study published in the journal Medicine & Science in Sports & Exercise, and titled “Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple…

Brian M. Sandroff from the Kessler Foundation and Robert W. Mot with the University of Illinois will present the results of a study on the effects of exercise in patients with multiple sclerosis (MS) today, Feb.18, at the Americas Committee for the Treatment and Research in Multiple Sclerosis (ACTRIMS)…

The National Multiple Sclerosis Society announced that a panel of experts led a comprehensive review of 142 published studies addressing rehabilitation in multiple sclerosis (MS), and found evidence suggesting that weekly in-home or outpatient physical therapy offers benefits — but, mostly, it found a lack of well-designed studies into…

Dr. Bradley Bowser, a South Dakota State University (SDSU) researcher and assistant professor, is investigating whether the practice of exercise, either by itself or together with cognitive behavioral therapy, can effectively improve mobility and quality of life in patients with multiple sclerosis (MS). MS is a neurodegenerative condition that often induces…

Several studies have shown that exercise can improve movement in multiple sclerosis (MS), but new research indicates that it specifically may also  improve reaction time, a measurement of cognitive impairment. The study, titled “Acute effects of varying intensities of treadmill walking exercise on inhibitory control in persons with…

Findings from a recent study published in the Journal of Neurologic Physical Therapy showed that standard approaches to evaluating muscular strength and cardiorespiratory fitness among patients with multiple sclerosis (MS) might be underestimating the patients’ capacities, encouraging clinicians to prescribe less effective exercises. In the study entitled “…

Results from a recent study published in the journal Rehabilitation Research and Practice showed the positive effects of community exercise programs in multiple sclerosis (MS) patients. Study participants showed physical improvements like higher energy levels and reduced fatigue, psychological benefits from those improvements and from group support and motivation, and…

Three “Hot Topic Sessions” on multiple sclerosis will take place this afternoon (17:00 – 17:45 h, GMT + 1h) at the 31st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), currently being held in Barcelona, Spain, October 7 – 10. The first session is entitled…

According to the National Multiple Sclerosis Society (NMSS), a high priority for people with multiple sclerosis (MS) is to achieve an overall feeling of well-being, or “wellness.” Increasingly, people with the disease want to know how can they feel their best, and if lifestyle interventions can affect the course of their…

A recently published study in the journal Neurology entitled “lower physical activity is associated with higher disease burden in pediatric multiple sclerosis” suggests pediatric patients with multiple sclerosis can benefit from engaging in regular moderate to strenuous activity, in that physical activity was linked to a…

A recent research study focused on whether regular exercise can benefit children with multiple sclerosis (MS). The article appeared in the August 12, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology. MS is characterized by inflammation, which manifests as an…