physical therapy

The relationship between fatigue and patterns of physical activity in people with multiple sclerosis (MS) is not straightforward. New findings show that, among MS patients with similar fatigue levels, there are three different types — or “clusters” — of physical behavior. Clinicians should be aware of these behavioral…

People whose advanced progressive multiple sclerosis (MS) limits their mobility can strengthen their lower limbs and improve life quality by engaging in regular standing exercises in their homes, a U.K. study into physiotherapy programs for this patient group reports. The study, “Assessment…

A pilot study has been launched to assess the immediate and enduring benefits of tai chi and mindfulness meditation on the physical balance and mental wellness of people with multiple sclerosis (MS). This community-based study — currently enrolling participants — is being conducted by the Motor Control Lab directed by Richard van Emmerik, PhD, professor of kinesiology at the University of Massachusetts Amherst. The project was awarded a $54,972 one-year grant from the National Multiple Sclerosis Society. While many MS symptoms vary from patient to patient, depending on the extent and location of the damage in the brain and spinal cord, difficulty in maintaining physical balance is a generalized complaint. Several MS symptoms can have an effect on balance, including difficulties with coordination, tremor and muscle weakness, stiffness, or dizziness and vertigo. "Mind-body interventions are beneficial as they train dynamic balance, such as transitioning between postures, turning, reaching, etc., in a manner similar to movements in daily life," Julianna Averill, a doctoral student at van Emmerik’s lab, said in a press release. Postural control and balance confidence is crucial to prevent patients' falls and reduce their fear of falling. Finding strategies that help patients cope and overcome this limitation is crucial, Averill noted. Contrary to other studies, which focus on mental health benefits, this project will look mostly at the effects of mindfulness practice on physical balance. Tai chi also will be evaluated for its potential to improve patients’ balance, both while they are standing and as they move. Participants will be randomly assigned to either eight weeks of free tai chi at YMAA Western Mass Tai Chi or mindfulness meditation classes at Downtown Mindfulness, in Hampshire County, Massachusetts. Tai chi is a Chinese martial art that involves body stretching and slow, focused, flowing postures that keep the body in motion. Mindfulness meditation is based on mindfulness practices, including training on body scan meditation, and loving kindness meditation. Participants will attend classes for 2.5 hours per week, where they will receive training to complete an additional 2.5 hours at home each week. At home, participants are asked to listen to meditation podcasts, or watch tai chi videos via a website that also tracks their activity. “The participants will be trained, and they will be able to practice on their own,” Averill said. Patients' postural sway will be recorded by wearable sensors while performing distinct movements at the study start, at the end of all classes, and two weeks later. On the same visits, participants will be surveyed to assess the frequency of falls, balance confidence, level of fatigue, and ability to cope and adapt. “We’re taking a more holistic look, considering the whole person and overall quality of life,” Averill said. The team plans to enroll 30 participants with mild-to-moderate MS symptoms, aged 21 to 70, and who are able to stand and move without assistance for 15 minutes. For more information about the study and how to participate, contact Averill at [email protected].

Lowering body temperature helps to improve exercise and functional capability in multiple sclerosis (MS) patients by preventing disease worsening, researchers in  Greece report. The study with that finding, “Impact of pre-cooling therapy on the physical performance and functional capacity of multiple sclerosis patients: A systematic review,” was published in…

A non-traditional exercise program that incorporates movements used in ballet was found to improve motor control and balance in women with multiple sclerosis, leading its researchers to recommend dance movements be part of such interventions for MS patients. The study, “Targeted ballet program mitigates ataxia and improves…

A new conceptual framework, called PRIMERS, has been proposed as a way of better understanding how physical exercise works to improve cognition and mobility in people with multiple sclerosis, and using what’s learned to create new types of rehabilitation therapy for MS patients. PRIMERS, conceived by a team led by researchers the…

Constraint-induced movement therapy (CIMT), a rehabilitation technique originally developed for stroke patients, may also be effective in improving limb use in the daily activities of multiple sclerosis (MS) patients, results from a Phase 2 trial show. Findings were reported in the study, “Phase II Randomized Controlled Trial of…

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…

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…

I am on “house arrest.” Sort of. Let me explain. Earlier this year, I wrote Large and In Charge: Building a Better MS Care Team, a column about my frustration with my “MS…

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.

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…

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…

Multiple sclerosis (MS) patients given gentle electrical stimulation to their tongues during physical and cognitive rehabilitation training benefited more than those who did not have the stimulation, a small pilot study demonstrated. Those who received the weak stimulation had significant improvements in balance and better scores than controls in cognition and other…

The University of St. Augustine for Health Sciences (USAHS) recently installed a state-of-the-art SafeGait 360 Balance and Mobility Trainer on its Austin, Texas campus. The device is a ceiling-mounted body-weight support and fall protection system that tracks patient movements 2,500 times per second. The trainer was designed in collaboration with…

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…

When my doctor first recommended physical therapy for my MS, I must admit I was very hesitant —hesitant because I didn’t feel I could do it, and hesitant because I was afraid I would be embarrassed when I failed. As it turns out, I didn’t have anything to worry about. The…

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)…

When I first heard about MS “foot drop,” I assumed that the manifestation of this symptom would be a sudden and obvious inability to walk properly.  I knew many people with MS who used canes and walked with significant stiffness or a “dragging” limb. I filed “foot drop” away…

I love the water.  Good thing, since I live at the beach. Being in a swimming pool is also good therapy for my MS. It strengthens my core and arms and, when I do a little pool walking, my legs feel a bit stronger.  But, I’ve never done any…

Helius Medical Technologies announced results of a pilot study, demonstrating the benefits of PoNS Therapy — a combination of the investigational Portable Neuromodulation Stimulator (PoNS) device with physical therapy — in patients with advanced multiple sclerosis (MS). Specifically, the treatment was seen to improve both patients’ quality of life, and physical and…

As we age, the risk that small blood vessels will start leaking into brain tissue increases, raising our risk of dementia, stroke, and Parkinson’s disease. New research reveals that people with multiple sclerosis (MS) also have these so-called cerebral microbleeds, and links them to increased physical and cognitive disability. When Robert Zivadinov, a professor of…

There is a greater number of older people with multiple sclerosis than ever before, and the number is likely to continue growing. That combination, of old age with MS, puts people at risk of significantly reduced physical function than those without the disease. This was a key finding of a…

The use of assistive devices is ineffective for multiple sclerosis (MS) patients, a study recently presented at the Consortium of Multiple Sclerosis Centers (CMSC) 2016 Annual Meeting concluded. But physical training using such devices can help improve mobility and the result is usually accompanied by a lower level of signaling…

Researchers at Texas Woman’s University identified tai chi as a beneficial therapy for multiple sclerosis (MS) patients with impaired balance, as it can improve their endurance and strength and decrease fatigue. The results of the study, “The Benefit of Tai Chi for Balance and Gait in People with…

Two case reports from the Sheltering Arms Physical Rehabilitation Centers presented at the Consortium of Multiple Sclerosis Centers (CMSC) 2016 Annual Meeting demonstrated how a multiple sclerosis (MS) clinical practice guideline for rehabilitation was implemented through the rehab path, highlighting the importance of consistency of practice and continuity of care for…

Positive results from a home-based exercise intervention designed to target flexibility, toning, and balance for older adults with multiple sclerosis (MS), suggests that exercise is important for improving  patient quality of life. The study, “A Qualitative Study of a Home-Based DVD Exercise Intervention in Older Adults with Multiple Sclerosis,” was…

Understanding and combining decision-making processes of both patients with multiple sclerosis (MS) and physical therapists to improve balance and gait — the movement of the lower limbs for locomotion — may help optimize patient outcomes. The findings were recently shown in an oral presentation titled “Understanding Engagement Decisions to Maximize Gait…

Robot-assisted training may be an effective therapy to improve motor function in the lower limbs of patients with multiple sclerosis (MS), and help in rehabilitation, according to the study “Robot-Guided Rehabilitation Improves Sensorimotor Functions in Lower-Limb Impairments of Individuals with Multiple Sclerosis,” presented at the Consortium of Multiple Sclerosis Centers…