Review: Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training

2008 ◽  
Vol 14 (1) ◽  
pp. 35-53 ◽  
Author(s):  
U. Dalgas ◽  
E. Stenager ◽  
T. Ingemann-Hansen
Keyword(s):  
Multiple Sclerosis ◽  
Physical Exercise ◽  
Endurance Training ◽  
Exercise Prescription ◽  
Moderate Intensity ◽  
Physiological Profile ◽  
Combined Training ◽  
Beneficial Effects ◽  
Training Modality

This review summarizes the existing knowledge regarding the effects of physical exercise in patients suffering from multiple sclerosis (MS). Furthermore, recommendations are given regarding exercise prescription for MS patients and for future study directions. Previously, MS patients were advised not to participate in physical exercise. During recent years, it has been increasingly acknowledged that exercise benefits MS patients. The requirement for exercise in MS patients is emphasized by their physiological profile, which probably reflects both the effects of the disease per se and the reversible effects of an inactive lifestyle. To date the effects of exercise have only been studied in moderately impaired MS patients with an EDSS score of less than 7. Evidence exists for recommending participation in endurance training at low to moderate intensity, as the existing literature demonstrates that MS patients can both tolerate and benefit from this training modality. Also, resistance training of moderate intensity seems to be well tolerated and to have beneficial effects on MS patients, but the methodological quality of the existing evidence is in general low and the number of studies is limited. Only two studies have evaluated the effects of combined resistance- and endurance training, making solid conclusions regarding this training modality impossible. Multiple Sclerosis 2008; 14: 35—53. http://msj.sagepub.com

scholarly journals Exercise as Medicine in Multiple Sclerosis—Moving Beyond Compensatory Benefits

US Neurology ◽  
2017 ◽  
Vol 13 (02) ◽  
pp. 70 ◽  
Author(s):  
Kathleen M Zackowski ◽  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Nervous System ◽  
Physical Exercise ◽  
Exercise Prescription ◽  
Bladder Function ◽  
Evidence Based ◽  
Pathophysiologic Mechanisms

Many studies have shown that physical exercise improves multiple sclerosis (MS) symptoms, including cognition, fatigue, bowel and bladder function, depression, and overall quality of life. However, the pathophysiologic mechanisms responsible for these symptomatic changes remain elusive. Exercise offers a likely path for addressing progressive MS, nervous system repair, and as a wellness approach for people with MS. We as a community need to work toward gaining information to establish an evidence-based exercise prescription for people living with MS.

scholarly journals Exercise as Medicine in Multiple Sclerosis—Moving Beyond Compensatory Benefits

2017 ◽  
Vol 13 (02) ◽  
pp. 70
Author(s):  
Kathleen M Zackowski ◽  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Nervous System ◽  
Physical Exercise ◽  
Exercise Prescription ◽  
Bladder Function ◽  
Evidence Based ◽  
Pathophysiologic Mechanisms

Many studies have shown that physical exercise improves multiple sclerosis (MS) symptoms, including cognition, fatigue, bowel and bladder function, depression, and overall quality of life. However, the pathophysiologic mechanisms responsible for these symptomatic changes remain elusive. Exercise offers a likely path for addressing progressive MS, nervous system repair, and as a wellness approach for people with MS. We as a community need to work toward gaining information to establish an evidence-based exercise prescription for people living with MS.

scholarly journals Glatiramer Acetate Treatment in Multiple Sclerosis-Associated Fatigue—Beneficial Effects on Self-Assessment Scales But Not on Molecular Markers

Biomolecules ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 393
Author(s):  
Oliver Neuhaus ◽  
Wolfgang Köhler ◽  
Florian Then Bergh ◽  
Wolfgang Kristoferitsch ◽  
Jürgen Faiss ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Neurotrophic Factors ◽  
Common Symptom ◽  
Mrna Levels ◽  
Open Label ◽  
Immunological Parameters ◽  
Beneficial Effects

Although fatigue is a common symptom in multiple sclerosis (MS), its pathomechanisms are incompletely understood. Glatiramer acetate (GA), an immunomodulatory agent approved for treatment of relapsing-remitting MS (RRMS), possesses unique mechanisms of action and has been shown to exhibit beneficial effects on MS fatigue. The objective of this study was to correlate clinical, neuropsychological, and immunological parameters in RRMS patients with fatigue before and during treatment with GA. In a prospective, open-label, multicenter trial, 30 patients with RRMS and fatigue were treated with GA for 12 months. Inclusion criterion was the presence of fatigue as one of the most frequent and disabling symptoms. Before and during treatment, fatigue was assessed using the Fatigue Severity Scale (FSS), the MS-FSS, and the Modified Fatigue Impact Scale (MFIS). In addition, fatigue and quality of life were assessed using the Visual Analog Scales (VAS). Laboratory assessments included screening of 188 parameters using real-time PCR microarrays followed by further analysis of several cytokines, chemokines, and neurotrophic factors. Fatigue self-assessments were completed in 25 patients. After 12 months of treatment with GA, 13 of these patients improved in all three scales (with the most prominent effects on the MFIS), whereas 5 patients had deteriorated. The remaining 7 patients exhibited inconsistent effects within the three scales. Fatigue and overall quality of life had improved, as assessed via VAS. Laboratory assessments revealed heterogeneous mRNA levels of cytokines, chemokines, and neurotrophic factors. In conclusion, we were not able to correlate clinical and molecular effects of GA in patients with RRMS and fatigue.

scholarly journals Immunomodulatory and anti-inflammatory effects of probiotics in multiple sclerosis: a systematic review

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Mohammad Morshedi ◽  
Reza Hashemi ◽  
Sara Moazzen ◽  
Amirhossein Sahebkar ◽  
Elaheh-Sadat Hosseinifard
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Inflammatory Markers ◽  
Methodological Quality ◽  
Inflammatory Responses ◽  
Dynamic Balance ◽  
Favorable Effect ◽  
Beneficial Effects ◽  
Inflammatory Parameters

AbstractMultiple sclerosis (MS) is an inflammatory and autoimmune neurological disorder which leads to demyelination. Although the etiology of MS is yet to be known, it appears that regulating the immune system and suppressing inflammatory pathways may possibly have a favorable effect on the healing of this disease. Evidence suggests that probiotics consumption via gut microbiome alteration devises beneficial effects in improving immune and inflammatory responses in MS. All articles were systematically searched (in the main databases) for this paper. Two investigators independently scrutinized full texts of the potentially eligible articles. The quality of the study was evaluated using standardized tools. The methodological quality of seven studies included in this review ranged from fair to good. The findings illustrated that there were statistically significant improvements in the static and dynamic balance in patients and animals with MS. In the paper in hand, the effects of probiotics administration on immune and inflammatory markers in MS disease are evaluated. In addition, the limitations and knowledge gaps were reported while proposing a possible mechanism of probiotics therapy in modulating immune and inflammatory responses. This systematic review indicated that the probiotics could improve immune and inflammatory parameters, the cytokines and cells in MS disease. Probiotics may have efficient effects in management and treatment of MS. More studies are required to clarify the effect of supplementation with probiotics and their mechanisms in MS disease.

scholarly journals Impact of a Tailored Nutritional and Physical Exercise Programme on Efficacy and Functional Outcomes in Older Patients with Hematological Malignancies Classified By Frailty Profile

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3424-3424
Author(s):  
Maite Antonio ◽  
Montserrat Arnan Sangerman ◽  
Eva Domingo-Domenech ◽  
Eva González-Barca ◽  
Casimiro Javierre ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Exercise ◽  
Older Patients ◽  
Nutritional Support ◽  
Hematological Malignancies ◽  
Moderate Intensity ◽  
Control Group ◽  
Chi Square ◽  
Before And After

BACKGROUND As the result of population aging, hematologists increasingly face the challenge of effectively managing older adults with oncological diseases. The heterogeneity of the aging process means that chronological age does not serve as a pivotal variable on which the clinical or treatment decisions are based. To improve outcomes in older population it is critical to select treatment considering patients' frailty profile and patients' needs to ensure they complete the treatment proposedComprehensive geriatric assessment (CGA) is a gold-standard multidimensional tool to characterize older patients according to their biological frailty profile. CGA identifies patient- and condition-related factors that might be potentially reversible through subsequent clinical interventions Older patient may present some degree of physical decline during the treatment due to variables related to the disease itself and/or to the treatment. This can lead to an accelerated decline from aging, affect their functional independence, their quality of life, and their ability to complete the treatment There is evidence that nutritional support and physical exercise during and after oncological treatments provides benefits in muscular and aerobic condition, quality of life, fatigue and adherence to treatment. But data on hematological patient, usually treated with more intensive schemes associated with a higher incidence of cytopenia and fatigue is scarce ENDPOINT - PRIMARY To determine the impact of an individualized geriatric intervention program of physical exercise and nutritional support on adherence to planned oncological treatment in patients ≥ 70 years with hematological malignancies - SECONDARY Analyze the relation between CGA and aging biomarkersEvaluate adherence to the intervention programDetermine the rate of completion and causes for non-completion of treatmentMeasure at the beginning and end of intervention, and 6 months after treatment completion: The program's effect on physical condition parametersChanges in functional capacity: basic and instrumental activities of daily lifeLevels of fatigueQuality of lifeDetermine the incidence and degree of severity of toxicityDetermine treatment response parameters: time to treatment failure and to progression, disease-free, overall and cancer-specific survival METHODS DESIGN Prospective clinical trial, randomized, parallel and open groupsSETTING Comprehensive cancer centerINCLUSION CRITERIA Histopathological diagnosis of hematological malignancies: multiple myeloma, lymphoproliferative syndromes and myelodisplastic syndromesPatients who meet criteria for medical treatment: chemotherapy, radiotherapy, immunotherapy or targeted therapiesPatients in optimal conditions to perform moderate intensity physical exercise (responsible doctor's judgement)Signature of informed consentEXCLUSION CRITERIA Failure to meet any of the inclusion criteria.INTERVENTION All patients will be assessed through a CGA. The intervention group will received the standard treatment according to the clinical protocol of the institution and will participate in a program of personalized physical exercise and nutritional support. The control group will be treated in a standard manner according to the institution's clinical protocolRANDOMIZATION Subjects will be assigned a 1.1 ratio to one of the groups using a simple randomisation methodMAIN VARIABLE: rate of treatment compliance (relationship between the prescribed dose and the dose administered)SECONDARY VARIABLES: CGA scales, aging biomarkers, nutritional parameters and basal body composition before and after the intervention, quality of life before and after the intervention, toxicity and complications during treatment and response to treatment.STATISTICAL ANALYSIS The comparability of the components of the intervention and control group will be analyzed by Chi square test (qualitative variables) and Student's t test and Wilcoxson test (quantitative variables). The analysis of the intervention will be carried out according to the intention of treatment. The main variable will be analyzed by comparison test of chi-square proportions and confidence intervals will be calculated. The variable will be measured at the end of the intervention, according to the degree of compliance with the nutritional and physical exercise program. Disclosures Domingo-Domenech: Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel expenses; Seattle Genetics: Research Funding; Bristol-Myers Squibb: Other: Travel expenses; Roche: Other: Travel expenses. González-Barca:Kiowa: Consultancy; Roche: Consultancy, Honoraria; Celgene: Consultancy; Celtrion: Consultancy; AbbVie: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Takeda: Honoraria. Sureda:Roche: Honoraria; BMS: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Gilead: Consultancy; Sanofi: Consultancy, Honoraria; Takeda: Consultancy, Honoraria, Speakers Bureau.

scholarly journals Dietary Supplements on Controlling Multiple Sclerosis Symptoms and Relapses: Current Clinical Evidence and Future Perspectives

Medicines ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. 95 ◽  
Author(s):  
Christina Tryfonos ◽  
Maria Mantzorou ◽  
Dimitris Fotiou ◽  
Michael Vrizas ◽  
Konstantinos Vadikolias ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Life Expectancy ◽  
Dietary Supplements ◽  
Dietary Supplementation ◽  
Clinical Indication ◽  
Beneficial Effects ◽  
Pubmed Database

Background: Multiple sclerosis (MS) constitutes a chronic progressive demyelinating disease which negatively affects the central nervous system. MS symptoms detrimentally affect the quality of life, as well as the life expectancy of MS patients. In this aspect, the present study aims to critically summarize and evaluate the currently available clinical studies focusing on the potential beneficial effects of dietary supplements on controlling MS symptomatology and relapse. Methods: PubMed database was comprehensively searched, using relative keywords to identify clinical trials that investigated the beneficial effects of dietary supplementation against MS symptomatology and progression. 40 clinical trials were found, which were divided into categories. Results: Nutritional status of MS patients, as well as supplementation have been suggested as potential factors affecting progression. Several substantial studies have documented a systematically high prevalence of vitamin A, B12 and D3 deficiency amongst MS patients. At present, clinical data have suggested that most of the dietary supplements under study may exert antioxidant and anti-inflammatory properties, improving depression symptomatology and quality of life overall. However, malnutrition risk in MS patients has not been adequately explored in order for more precise conclusions to be drawn. The supplements that may have a positive effect on MS are vitamins, fatty acids, antioxidants, phytochemicals and melatonin. Conclusions: Several dietary supplements may decrease inflammation and fatigue, also increasing also autoimmunity tolerance in MS patients, and thus improving quality of life and life expectancy. Currently, there is no effective clinical indication for applying dietary supplementation as complementary treatment against MS symptomatology.

scholarly journals Fatigue, Physical Activity, Quality of Life, and Fall Risk in People with Multiple Sclerosis

2017 ◽  
Vol 19 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Eva Vister ◽  
Mylou E. Tijsma ◽  
Phu D. Hoang ◽  
Stephen R. Lord
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Risk Scores ◽  
Activity Levels ◽  
Physiological Profile ◽  
Walking Activity ◽  
Physiological Profile Assessment

Background: Fatigue, inactivity, and falls are major health issues for people with multiple sclerosis (MS). We examined the extent to which fatigue and low walking activity are associated with quality of life and increased fall risk in people with MS. Methods: People with MS (N = 210, aged 21–74 years) were categorized as having either high or low reported fatigue and walking activity levels and were then followed up for falls using monthly fall diaries for 6 months. Results: A high level of fatigue was significantly associated with higher MS Disease Steps scores, worse balance, high composite physiological (Physiological Profile Assessment) fall risk scores, greater fear of falling, lower World Health Organization Disability Assessment Schedule (WHODAS) quality of life scores, and more prospectively recorded falls. Low walking activity was significantly associated with higher MS Disease Steps scores, reduced proprioception, worse standing and leaning balance, slow stepping, slow gait speed, worse fine motor control, high Physiological Profile Assessment fall risk scores, more fear of falling, and lower WHODAS quality of life scores. Conclusions: Increased fatigue and low walking activity levels were significantly associated with increased fall risk and lower quality of life in people with MS. Interventions aimed at addressing fatigue and inactivity may have multiple benefits for this group.

scholarly journals Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults

2021 ◽  
Vol 13 ◽  
Author(s):  
Naina Yuki Vieira Jardim ◽  
Natáli Valim Oliver Bento-Torres ◽  
Victor Oliveira Costa ◽  
Josilayne Patricia Ramos Carvalho ◽  
Helen Tatiane Santos Pontes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Exercise Training ◽  
Physical Exercise ◽  
Dual Task ◽  
Cognitive Stimulation ◽  
Moderate Intensity ◽  
Healthy Older Adults ◽  
Physical Exercise Training

BackgroundIt has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults.MethodsThis clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures.ResultsControl (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance.ConclusionWe suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults.Clinical Trial RegistrationBrazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.

scholarly journals Effect of 8-Week Combined Training (Resistance and Proprioceptive Neuromuscular Facilitation) on Fatigue and Quality of Life in Multiple Sclerosis Patients

2016 ◽  
Vol 22 (1) ◽  
pp. 43-50
Author(s):  
آقاابراهیم Attar Sayyah A.E. ◽  
سید علیرضا Hoseini Kakhk S.A.R. ◽  
محمدرضا Hamedinia M.R. ◽  
مریم Mehrjoo M. ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Combined Training ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Multiple Sclerosis Patients

scholarly journals The benefits of exercise in cancer patients and the criteria for exercise prescription in cardio-oncology

2019 ◽  
pp. 204748731987490 ◽  
Author(s):  
Flavio D’Ascenzi ◽  
Francesca Anselmi ◽  
Caterina Fiorentini ◽  
Roberta Mannucci ◽  
Marco Bonifazi ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Cancer Patients ◽  
Exercise Prescription ◽  
Cardiovascular Complications ◽  
Individual Characteristics ◽  
Negative Effects ◽  
Cardiac Damage ◽  
Beneficial Effects ◽  
Tailored Approach ◽  
Response To Exercise

Cancer and cardiovascular diseases are the leading causes of death in high-income countries. Cardiovascular complications can be found in cancer patients, being the result of so-called ‘cardio-toxicity’. Therefore, it becomes essential to thoroughly investigate the origin of cardiac damage and the strategy to prevent it or to reverse the negative remodelling associated with cardiotoxicity. In this review the beneficial effects of physical exercise in cancer patients were analysed, particularly to prevent cardio-toxicity before its clinical manifestation. According to the relevance of exercise, we suggest strategies for exercise prescription with a tailored approach in these patients. In conclusion, physical exercise seems to be a promising and effective treatment for cancer patients during and after therapy and seems to counteract the negative effects induced by drugs on the cardiovascular system. Exercise prescription should be tailored according to patient’s individual characteristics, to the drugs administered, to the personal history, and to his/her response to exercise, taking into account that different types of training can be prescribed according also to the patient’s choice. A cardiological evaluation including exercise testing is essential for an appropriate prescription of exercise in these patients.

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