Meditation as an Adjunct to the Management of Multiple Sclerosis

Background. Multiple sclerosis (MS) disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS.Methods. Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, and mindfulness.Results. 12 pieces of primary literature fitting the selection criteria were selected: two were randomised controlled studies, four were cohort studies, and six were surveys. The current literature varies in quality; however common positive effects of meditation include improved quality of life (QOL) and improved coping skills.Conclusion. All studies suggest possible benefit to the use of meditation as an adjunct to the management of multiple sclerosis. Additional rigorous clinical trials are required to validate the existing findings and determine if meditation has an impact on disease course over time.

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Anorectal Dysfunction in Multiple Sclerosis: A Systematic Review

ISRN Neurology ◽

10.5402/2012/376023 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 22

Author(s):

Sanober Nusrat ◽

Elsie Gulick ◽

David Levinthal ◽

Klaus Bielefeldt

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Fecal Incontinence ◽

English Language ◽

Controlled Trial ◽

Neuromuscular Diseases ◽

Anorectal Dysfunction ◽

Pubmed Database ◽

Marginal Improvement

Constipation and fecal incontinence are common in patients with neuromuscular diseases. Despite their high prevalence and potential impact on overall quality of life, few studies have addressed anorectal dysfunction in patients with multiple sclerosis (MS). The goal of this paper is to define the prevalence, pathophysiology, impact, and potential treatment of constipation and incontinence in MS patients. Methods. The PubMed database was searched for English language publications between January 1973 and December 2011. Articles were reviewed to assess the definition of the study population, duration, type and severity of MS, sex distribution, prevalence, impact, results of physiologic testing, and treatments. Results. The reported prevalence of constipation and fecal incontinence ranged around 40%. Anorectal dysfunction significantly affected patients with nearly 1 in 6 patients limiting social activities or even quitting work due to symptoms. Caregivers listed toileting as a common and significant burden. The only randomized controlled trial showed a marginal improvement of constipation with abdominal massage. All other reports lacked control interventions and only demonstrated improvement in individuals with milder symptoms. Conclusion. Anorectal dysfunction is a common manifestation in MS that significantly affects quality of life. Therapies are at best moderately effective and often cumbersome, highlighting the need for simple and more helpful interventions.

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1057 Outcome Reporting Following Rectopexy Requires Standardisation for Reproducibility and Transparent Outcome Analysis

British Journal of Surgery ◽

10.1093/bjs/znab259.418 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

H Wa Katolo ◽

C Fleming ◽

G Wilkinson ◽

A Brannigan

Keyword(s):

Quality Of Life ◽

Rectal Prolapse ◽

English Language ◽

Cleveland Clinic ◽

Outcome Analysis ◽

Incontinence Score ◽

Outcome Reporting ◽

Randomised Controlled ◽

The Impact

Abstract Aim Rectopexy is a surgical procedure commonly used to correct rectal prolapse. Several studies have investigated different approaches (abdominal, perineal) and techniques (open, laparoscopic, robotic) in this field however reporting outcomes vary significantly among studies impeding comparison of techniques. We aimed to comprehensively analyse primary outcome reporting methods following rectopexy in published literature. Method A systematic search was performed in keeping with PRISMA guidelines and search protocol registered with PROSPERO. Published databases were searched using the following terms: “rectopexy”, “abdominal rectopexy” and “rectopexy outcomes”. Randomised controlled trials, comparative and non-comparative prospective and retrospective studies published between 1992 and 2019 were included for analysis. Review articles, letters, editorials, abstracts, and non-English language studies were excluded. A narrative description of outcomes was reported. Results A total of 1089 articles were screened, and 32 articles were identified as suitable for inclusion, reporting on 1780 patients who underwent rectopexy surgery. Over 30 unique methods of reporting outcomes were recorded, with the most common being the rate of recurrence (n = 15), Cleveland Clinic Faecal Incontinence score (CCIS) (n = 11), and customised symptom questionnaires (n = 10). Many studies recognised the impact of symptoms of rectal prolapse on patients’ quality of life (QoL) however, few utilised standardised quality of life scores to evaluate the outcome of the procedures. Conclusions As surgical technique evolves in rectopexy, incorporating minimally invasive surgery and robotic surgery, it is important that outcome reporting is standardised to facilitate transparent comparison. Improving patient QoL is the mainstay of surgical intervention and it is important that QoL outcome measures are incorporated.

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Individualised behaviour change strategies for physical activity in multiple sclerosis (IPAC-MS): protocol for a randomised controlled trial

Trials ◽

10.1186/s13063-019-3768-7 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Farren L. Goulding ◽

Charity D. Evans ◽

Katherine B. Knox ◽

Hyun J. Lim ◽

Michael C. Levin ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Multiple Sclerosis ◽

Randomised Controlled Trial ◽

Behaviour Change ◽

Controlled Trial ◽

Activity Level ◽

Change Strategies ◽

Randomised Controlled

Abstract Background Multiple sclerosis (MS) is a chronic, degenerative disease of the central nervous system. Because of the long-term and unpredictable nature of the disease, the burden of MS is significant from both a patient and societal perspective. Despite a recent influx of disease-modifying therapies to treat MS, many individuals continue to experience disability that negatively affects productivity and quality of life. Previous research indicates that physical activity has a positive impact on walking function in individuals with MS, in addition to the usual beneficial effects on overall health. However, most people with MS are not active enough to gain these benefits, and a lack of support to initiate and maintain physical activity has been identified as a major barrier. This study will evaluate the impact of a novel intervention involving individualised behaviour change strategies delivered by neurophysiotherapists on increasing physical activity levels in individuals with MS who are currently inactive. Methods/design This single-blind, parallel-group, randomised controlled trial will be conducted in Saskatchewan, Canada. Eligible participants include individuals with MS who are ambulatory but identified as currently inactive by the self-reported Godin Leisure-Time Exercise Questionnaire (GLTEQ). The intervention will be delivered by neurophysiotherapists and includes individualised behaviour change strategies aimed at increasing physical activity over a 12-month period. The control group will receive usual care during the 12-month study period. The primary outcome is the change in physical activity level, as measured by the change in the GLTEQ score from baseline to 12 months. Secondary outcomes include the change in patient-reported outcome measures assessing MS-specific symptoms, confidence and quality of life. Discussion Physical activity has been identified as a top research priority by the MS community. Findings from this novel study may result in new knowledge that could significantly impact the management and overall health of individuals with MS. Trial registration ClinicalTrials.gov, NCT04027114. Registered on 10 July 2019.

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Reflexology for the treatment of pain in people with multiple sclerosis: a double-blind randomised sham-controlled clinical trial

Multiple Sclerosis Journal ◽

10.1177/1352458509345916 ◽

2009 ◽

Vol 15 (11) ◽

pp. 1329-1338 ◽

Cited By ~ 32

Author(s):

CM Hughes ◽

S. Smyth ◽

AS Lowe-Strong

Keyword(s):

Multiple Sclerosis ◽

Primary Outcome Measure ◽

Controlled Clinical Trial ◽

Double Blind ◽

Positive Effects ◽

Vas Scores ◽

Clinically Significant ◽

Randomised Controlled

Multiple sclerosis (MS) results in pain and other symptoms which may be modified by conventional treatment, however, MS is still not curable. Several studies have reported positive effects of reflexology in the treatment of pain, however, no randomised controlled clinical trials for the treatment of pain have been conducted within this population. The objective of this study was to investigate the effectiveness of reflexology on pain in and MS population. We randomly allocated 73 participants to receive either precision or sham reflexology weekly for 10 weeks. Outcome measures were taken pre-and post-treatment with follow-up at 6 and 12 weeks by a researcher blinded to group allocation. The primary outcome measure recorded pain using a Visual Analogue Scale (VAS). A significant (p < 0.0001) and clinically important decrease in pain intensity was observed in both groups compared with baseline. Median VAS scores were reduced by 50% following treatment, and maintained for up to 12 weeks. Significant decreases were also observed for fatigue, depression, disability, spasm and quality of life. In conclusion, precision reflexology was not superior to sham, however, both treatments offer clinically significant improvements for MS symptoms via a possible placebo effect or stimulation of reflex points in the feet using non-specific massage.

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Pragmatic intervention for increasing self-directed exercise behaviour and improving important health outcomes in people with multiple sclerosis: a randomised controlled trial

Multiple Sclerosis Journal ◽

10.1177/1352458513519354 ◽

2014 ◽

Vol 20 (8) ◽

pp. 1112-1122 ◽

Cited By ~ 46

Author(s):

A Carter ◽

A Daley ◽

L Humphreys ◽

N Snowdon ◽

N Woodroofe ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Randomised Controlled Trial ◽

Health Outcomes ◽

Controlled Trial ◽

Home Exercise ◽

Exercise Behaviour ◽

Important Health ◽

Randomised Controlled

Background: Exercise programmes that can demonstrate evidence of long-lasting clinical effectiveness are needed for people with multiple sclerosis (P wMS). Objective: The objective of this study was to assess the effects of a practically implemented exercise programme on self-directed exercise behaviour and important health outcomes in P wMS to nine months of follow-up. Methods: We conducted a parallel-arm, randomised controlled trial: 120 P wMS (Expanded Disability Status Scale (EDSS) 1.0–6.5) randomised to a three-month exercise intervention plus usual care, or usual care only. Two supervised plus one home-exercise session (weeks 1–6) were followed by one supervised and two home-exercise sessions (weeks 7–12). Cognitive-behavioural techniques promoted long-term exercise behaviour change. Outcomes were blindly assessed at baseline and at three and nine months after randomisation. The primary outcome was self-reported exercise behaviour (Godin Leisure Time Exercise Questionnaire (GLTEQ)). Secondary outcomes included fatigue and health-related quality of life (HRQoL). Results: The intervention increased self-reported exercise (9.6 points; 95% CI: 2.0 to 17.3 points; p = 0.01) and improved fatigue ( p < 0.0001) and many HRQoL domains ( p ≤ 0.03) at three months. The improvements in emotional well-being ( p = 0.01), social function ( p = 0.004) and overall quality of life ( p = 0.001) were sustained for nine months. Conclusion: This pragmatic approach to implementing exercise increases self-reported exercise behaviour, improves fatigue and leads to a sustained enhancement of HRQoL domains in P wMS.

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Effect of Home-Based Aerobic Training and Vitamin D Supplementation on Fatigue and Quality of Life in Patients with Multiple Sclerosis During COVID-19 Outbreak

10.21203/rs.3.rs-655827/v1 ◽

2021 ◽

Author(s):

Elahe Bahmani ◽

Rastegar Hoseini ◽

Ehsan Amiri

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Vitamin D ◽

Aerobic Training ◽

Vitamin D Supplementation ◽

Control Group ◽

Significance Level ◽

Positive Effects ◽

Home Based

Abstract Background: Multiple sclerosis (MS)is the most common neurological disease that causes disability in the nervous system which reduces the quality of life(QoL). Studies have shown positive effects of therapeutic exercise with supplementation on motor- and cognitive functionandfatigue as well as on QoLin persons with MS. The purpose of this study was to the effect of home-based aerobic training (AT) and vitamin D(Vit D) supplementation on fatigue and QoL in patients with MS during the covid-19 outbreak. Methods: We recruited 40 females (20 - 40 years) with MS(EDSS: 3-5). Then, using simple randomization, the subjects were assigned to four groups including aerobic training (AT; n=9; 50%-75%, 20-40 min/day, 3 days/wk aerobic training), vitamin D supplementation (Vit D; n=9; 50,000 IU one day/week), aerobic training plus vitamin D supplementation (AT + Vit D; n=10), and sedentary control (C; n=10 placebo). The data were analyzed using paired t-test and one-way analysis of variance and Tukey’s post hoc test with SPSS21 at a significance level of P < 0.05.Results: After eight weeks of intervention, fatigue grade markedly reduced in the AT + Vit D, AT, and Vit D groups); However, fatigue increased in the control group. QoLincreased significantly in AT+Vit D, AT, and Vit D compared to C. Also, the results show that the AT+Vit D had significantly higherQoL compared to AT and Vit D. Conclusion:These findings suggest that therapeutic AT and VitD supplementation is very effective in reducing fatigue and consequently improves the QoLin female MS patients.

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Treatment of Multiple Sclerosis

10.1093/med/9780197512166.003.0066 ◽

2021 ◽

pp. 548-554

Author(s):

Orhun H. Kantarci

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Central Nervous System ◽

Complete Recovery ◽

Disease Course ◽

Progressive Neurodegeneration ◽

History Of ◽

Level 3 ◽

Active Disease

A comprehensive and ideal approach to treatment of multiple sclerosis (MS) has 5 levels of intervention. They are 1) prevention of active disease (clinical or subclinical relapses) in the first place, to prevent cumulative relapse-associated disability burden; 2) shortening the duration of active inflammatory demyelination associated with relapses, to limit the extent of irreversible central nervous system injury; 3) induction of more complete recovery after a relapse, to prevent or delay an ensuing chronic progressive neurodegeneration; 4) slowing the progressive phase of MS after progression ensues; and 5) treatment of symptoms and complications. The ultimate combined goal of these intervention levels is to alter the natural history of MS and prevent progression responsible for the main quantity of disability in MS, thereby improving the quality of life for patients with MS. Currently, treating physicians can accomplish levels 1, 2, and 5. Level 3 and level 4 interventions are yet to be developed sufficiently to affect the disease course meaningfully.

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Coping and quality of life in one hundred and thirty five subjects with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458506071170 ◽

2007 ◽

Vol 13 (3) ◽

pp. 393-401 ◽

Cited By ~ 76

Author(s):

S.R. Montel ◽

C. Bungener

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Multiple Sclerosis ◽

Coping Strategies ◽

Rating Scale ◽

Well Being ◽

Self Report ◽

Disease Course ◽

Depression And Anxiety

Introduction and objective The aim of this study was to compare coping strategies and quality of life (QoL) in multiple sclerosis (MS), as they relate to the course of the disease (relapsing-remitting (RR), secondary progressive (SP), primary progressive (PP)), while taking depression and anxiety into account. Methods A total of 135 MS subjects were seen for a semi-structured interview in order to collect socio-demographic and clinical information, after which there was an assessment of their mental and cognitive states (Mini International Neuropsychiatric Interview (MINI), Montgomery and Asberg Depression Rating Scale (MADRS), Depressive Mood Scale (EHD), Hamilton Anxiety (HAMA), Frontal Assessment Battery (FAB)). All subjects then completed three self-report questionnaires; two about coping strategies (Ways of Coping Checklist (WCC), Coping with Health, Injuries and Problems Scale (CHIP)) and one about QoL (SEP59). Results The mental health (depression and anxiety) and the psychological and social dimensions of QoL were relatively unaffected. However, after controlling for age and disability, the disease course had a strong effect on both mental health and QoL, with the poorest condition for SPMS and the best condition for PPMS. The SPMS patients tend to use emotional coping strategies extensively, while the PPMS patients use more instrumental strategies. Discussion Our study clearly demonstrated that psychological and social well-being were substantially affected by the disease course. These results encourage us to develop interventions focused on coping strategies and which are better adapted to individual patients. Multiple Sclerosis 2007; 13: 393- 401. http://msj.sagepub.com

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The effect of rhythmic-cued motor imagery on walking, fatigue and quality of life in people with multiple sclerosis: A randomised controlled trial

Multiple Sclerosis Journal ◽

10.1177/1352458516644058 ◽

2016 ◽

Vol 23 (2) ◽

pp. 286-296 ◽

Cited By ~ 14

Author(s):

Barbara Seebacher ◽

Raija Kuisma ◽

Angela Glynn ◽

Thomas Berger

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Motor Imagery ◽

Walking Speed ◽

Short Form ◽

Controlled Trial ◽

Impact Scale ◽

Scale Scores ◽

Randomised Controlled

Background: Motor imagery and rhythmic auditory stimulation are physiotherapy strategies for walking rehabilitation. Objectives: To investigate the effect of motor imagery combined with rhythmic cueing on walking, fatigue and quality of life (QoL) in people with multiple sclerosis (MS). Methods: Individuals with MS and Expanded Disability Status Scale scores of 1.5–4.5 were randomised into one of three groups: 17 minutes of motor imagery, six times per week, for 4 weeks, with music (A) or metronome cues (B), both with verbal cueing, and (C) controls. Primary outcomes were walking speed (Timed 25-Foot Walk) and distance (6-Minute Walk Test). Secondary outcomes were walking perception (Multiple Sclerosis Walking Scale-12), fatigue (Modified Fatigue Impact Scale) and QoL (Short Form-36 Health Survey, Multiple Sclerosis Impact Scale-29, Euroquol-5D-3L Questionnaire). Results: Of the 112 participants randomised, 101 completed the study. Compared to controls, both interventions significantly improved walking speed, distance and perception. Significant improvements in cognitive but not psychosocial fatigue were seen in the intervention groups, and physical fatigue improved only in the music-based group. Both interventions improved QoL; however, music-cued motor imagery was superior at improving health-related QoL. Conclusion: Rhythmic-cued motor imagery improves walking, fatigue and QoL in people with MS, with music-cued motor imagery being more effective.

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Comparing individual and group intervention for psychological adjustment in people with multiple sclerosis: a feasibility randomised controlled trial

Clinical Rehabilitation ◽

10.1177/0269215515616446 ◽

2016 ◽

Vol 30 (12) ◽

pp. 1156-1164 ◽

Cited By ~ 8

Author(s):

Roshan das Nair ◽

Eirini Kontou ◽

Kathryn Smale ◽

Alex Barker ◽

Nadina B Lincoln

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Randomised Controlled Trial ◽

Group Intervention ◽

Controlled Trial ◽

Depression Scale ◽

Individual Treatment ◽

Feasibility Randomised Controlled Trial ◽

Randomised Controlled

Objective: To modify a published group intervention for adjustment to multiple sclerosis (MS) to suit an individual format, and to assess the feasibility of a randomised controlled trial (RCT) to compare individual and group intervention for people with multiple sclerosis and low mood. Design: Feasibility randomised controlled trial. Setting: Participants were recruited through healthcare professionals at a hospital-based multiple sclerosis service and the MS Society. Subjects: People with multiple sclerosis. Interventions: Adjustment to multiple sclerosis in individual or group delivery format. Main measures: Participants completed mood and quality of life assessments at baseline and at four-month follow-up. Measures of feasibility included: recruitment rate, acceptability of randomisation and the intervention (content and format), and whether the intervention could be adapted for individual delivery. Participants were screened for inclusion using the General Health Questionnaire-12 and Hospital Anxiety and Depression Scale, and were randomly allocated to receive either individual or group intervention, with the same content. Results: Twenty-one participants were recruited (mean age 48.5 years, SD 10.5) and were randomly allocated to individual ( n=11) or group ( n=10) intervention. Of those offered individual treatment, nine (82%) completed all six sessions. Of those allocated to group intervention, two (20%) attended all six sessions and three (30%) attended five sessions. There were no statistically significant differences between the groups on the outcome measures of mood and quality of life. Conclusions: The intervention could be provided on an individual basis and the trial design was feasible. There were lower attendance rates at group sessions compared to individual sessions.

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