An estimated 85 percent of people with MS experience some type of spasticity due to the disease, according to a recent report (p/w) published in Multiple Sclerosis and Related Disorders. Why is that important? Because spasticity is behind many of the disease’s most debilitating physical, emotional and mental…
exercise
What I’m about to write will sound like I am tooting my own horn. I’m not. Really. But something is working for me in my battle to navigate the stairs in our house, something that might help others…
We all have heard that physical activity is important for maintaining health, strength and well-being. It may be even more important for people with MS. Exercise has been shown to improve balance, strengthen brain connections, improve sleep, reduce pain, help…
Well, 460.75 miles (741.5 km), to be exact. When I wrote about April Hester in late September, the headline on my column was “She Has MS and She’s Planning to Hike 500 Miles.” Well, she did it, hiking the Palmetto Trail from Walhalla, in the South…
MS News That Caught My Eye Last Week: Cannabis Studies, Oral Therapy Study, and Exercising with Wii
MMJ Hires Lead Investigator for Phase 2 Trials of Medicinal Cannabis to Treat Progressive MS The real news here is what hiring a lead investigator means. It means that Phase 2 trials of a medical marijuana product to treat MS pain and spasticity are closer to beginning.
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…
One Day at a Time
I was going to write about something else, then my MS got in the way. Intellectually, I know MS is very up-and-down, but often when the down hits, I think the worst has happened. I went to my exercise class this week and struggled. Got home and recovered.
April Hester has MS. She was diagnosed in 1996, just after she turned 20 years old. Like many of us, April has balance and fatigue issues. Her legs can become tired, her foot sometimes drops and she falls a lot. But unlike many of us, April and her…
Beth Kantor, 42, now knows what it really means to get down in the dirt. For the past four years, she’s volunteered as a first-aid assistant at the annual Twin Cities MuckFest, a fundraising event that the National Multiple Sclerosis Society organized in suburban Minneapolis. But this year, Kantor decided it…
Therapeutic horseback riding, also known as hippotherapy, when combined with standard care regimens significantly reduces fatigue and spasticity in multiple sclerosis. It also improves balance and quality of life, according to a German study. Hippotherapy takes advantage of a horse's natural movements to develop a patient's muscle tone and improve breathing, while strengthening the torso muscles. Horseback riding also improves balance control, coordination and gait, while boosting a patient's social communication skills, which can benefit self-esteem. “Hippotherapy as a complementary treatment can be defined as one-patient-one-horse physiotherapy treatment with and on the horse,” researchers wrote. Team leaders Vanessa Vermöhlen and Petra Schiller of the University of Cologne evaluated the benefits of half-hour weekly sessions of hippotherapy in combination with standard care. They randomly assigned 70 MS patients with lower limb spasticity to either an intervention group that did 12 weeks of hippotherapy, or a control group that received only standard therapy. The team evaluated the impact therapeutic horseback riding had on balance, measured by the Berg Balance Scale (BBS). They also measured its effect on other multiple sclerosis symptoms and signs, including fatigue, quality of life, pain, and spasticity. Overall, the team found that those who received hippotherapy plus standard care improved their BBS scores by 4.8 points after six weeks of therapy, and 6.4 by the trial's end. These increases were significantly higher than those achieved by the control group (2.9 points at six weeks and 3.1 points at 12 weeks). Although this represents a difference of only 3.3 points after 12 weeks, it still reflects a relevant change in patients' balance control capabilities, the authors said. In addition, the researchers also recognized significant improvements in fatigue, spasticity and quality of life of those undergoing hippotherapy plus standard care compared to those on the control group. The observed beneficial effects of hippotherapy validate previous reports that showing that activities with horses could help adults and children improve their balance, gait and psychomotor abilities.
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…
MS News That Caught My Eye This Week: Resistance Training, Tysabri Report, Cognigram, and Depression
Resistance Training Can Slow MS Patients’ Brain Shrinkage, Clinical Trial Indicates Over the years, studies have shown the benefits of various types of exercise in improving MS symptoms. But here, Alice Melão reports about a small…
Myobuddy Products has enlisted a rising fitness star to help it publicize its new Myobuddy Massager Pro, a massaging device that can help anyone from an elite athlete to a person with a muscle condition such as multiple sclerosis. Dakota Rager, who qualified for the national Reebok CrossFit Games competition, is a former Army diver who beat out more than 200,000 men in several regional competitions this year. CrossFit is a workout regimen aimed at improving the body's normal functional movements. The Massager Pro takes a multi-pronged massaging approach, including vibration, heat and percussion therapy, or applying tension to the body. The device's benefits including soothing sore muscles and helping relax tight fascia, or connective tissue surrounding muscles. Myobuddy started an MS Support Program in May to encourage MS patients to try massage therapy and to advance research on the approach. The company said some MS patients report that the Massage Pro helps them sleep better by alleviating their restless leg syndrome. They also report that it relieves muscle tension and fatigue, it added. Myobuddy's website includes information on how to use the Massage Pro for any muscle group. Those with questions can get answers by emailing [email protected] or calling (844) 696-2833. Rager (@ragerdakota), who at 5’4’’ and 169 lbs. is built like a fireplug, said he uses everything he can to give him an edge in competitions. If a massage therapy device is powerful enough to help MS patients, then it can help him, too, he has decided. "I really love the Myobuddy Massager, and have been using it throughout my training," he said in a press release. "It has the perfect combination of vibration and power and really goes deep to soothe my sore muscles and relax my tight ones after rigorous workouts. I highly recommend it for anyone who wants their muscles to feel and perform their very best." At only 25, Rager is already ranked as one of the top 100 CrossFit competitors worldwide. He was just one of 40 men to participate in the Reebok CrossFit Games in Madison, Wisconsin, Aug. 3-6. "We've had a lot of highly influential people in the sports and fitness world deliver organic endorsements for the Myobuddy, and we're extremely grateful for that," said Lillo Furca, Myobuddy's founder and CEO. "We've spent so much time and energy perfecting our massager to ensure that it delivers optimal results. The testimonies are a testament to our team and to our product." The company loves to "hear about how we're helping people who put their bodies in extreme situations on a regular basis," he added.
Resistance training like weight lifting can protect or even regenerate the nerve cells of relapsing-remitting multiple sclerosis patients, slowing the progression of the disease, according to a clinical trial. A hallmark of MS is the brain shrinking faster than normal, and findings from this trial indicates that resistance training can slow the shrinking or even make some brain areas grow. Research has shown that physical training benefits MS patients, helping them alleviate many symptoms, including excessive fatigue and balance control problems. Recent studies suggest that exercise can have a disease-modifying role in MS. This means physical activity can be an important adjuvant, or add-on therapy, for standard-of-care regimens. Researchers followed 35 patients with relapsing-remitting MS for 24 weeks. Eighteen patients did resistance training twice a week, consisting of four lower- and two upper-body exercises. The other 17 patients struck with their normal routines. Before and after the 24 weeks, doctors took magnetic resonance imaging scans, or MRIs, to evaluate patients' brain structures. After the 24 weeks, the scans showed less brain shrinkage in those who had resistance training. Some of their cortical brain regions were also thicker — an indication they were growing. It is not clear why exercise benefits MS patients' brains, nor if exercise has the same effect on all patients. Additional studies are needed to clarify its therapeutic effect, the researchers said. That knowledge could help improve current MS therapies.
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."
So, I recently signed up to join a new and much closer exercise class. The previous drive of nearly an hour each way had proved to be beyond my range. Actually doing exercise when I got there seemed bonkers! But I haven’t been there as of yet ― my…
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…
Like so many people with MS, Mariska Breland remembers the disease’s onset as a combination of strange, seemingly disparate maladies that included tingling in her left thigh, numb feet, skin that felt “too thick” around her toes, foot drop, and double vision. One left her…
Young multiple sclerosis (MS) patients who engage in physical activity can relieve symptoms of depression, concludes a Canadian study supported by the National Multiple Sclerosis Society. Researchers presented their study, “Longitudinal Relationships Between Moderate and Vigorous Physical Activity, Fatigue, and Depression in Pediatric Multiple Sclerosis,” at the 2017 Annual Meeting of the…
Patients with relapsing-remitting multiple sclerosis (RRMS) regain part of their balance control after a single training session of ball-throwing exercises, finds a study supported by the National Multiple Sclerosis Society. Researchers presented their study, “A Single-Session Training of Ball Throwing Exercise Improves Balance Control in Individuals with Multiple Sclerosis,” at…
Editor’s note: This is the first of a three-part series about Pilates and MS. When I was diagnosed with MS in December 2013, my most visible symptom was a waltzing shuffle that was slowly changing my once-purposeful gait into a wobble (leading some co-workers to believe…
In the summer of 2012 David Bowie’s song “Heroes” became the anthem of the London Olympics despite Bowie turning down an invitation from British director Danny Boyle to be part of the opening ceremony. Gracious as ever, Bowie agreed to a meeting. Boyle had a lot to thank him for. Bowie…
In pursuit of an answer for breathing difficulty The MRI of my cervical and thoracic spine showed no active lesions last week. That was good news. Other…
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…
Here`s my Pick of the Week’s News as published by Multiple Sclerosis News Today. Fitness Trainer and MS Patient, Dolly Stokes, Launches BFitLifestyles Website with Husband Looking after what you eat and exercising according to your abilities apparently can help alleviate symptoms of many chronic illnesses including…
Dolly Stokes, a fitness trainer and multiple sclerosis (MS) patient, and her husband, Jeff Stokes, have launched the website for their fitness and wellness company, BFitLifestyles, providing information on how to live an active and healthy life. The Stokes, owners of three fitness-related companies in Fairhope, Alabama – DollyBFitness, BFitLifestyles, and Stokes…
Back in September I told you about Cheryl Hile. Cheryl is a young woman with MS whose goal is to become the first person with MS to run in seven marathons on seven continents. In September she had just completed her first marathon, in Cape Town,…