Exercise in the management of multiple sclerosis relapses: current evidence and future perspectives

Relapses are a common feature of multiple sclerosis; however, recovery from relapses is often incomplete, with up to half of people experiencing residual disabilities postrelapse. Therefore, treatments are required to promote recovery of function and reduce the extent of residual disabilities postrelapse. Accordingly, this Perspective article explores the role of exercise in relapse management. Current evidence from two studies suggests that exercise in combination with steroid therapy improves disability and quality of life postrelapse, and may be more beneficial in promoting relapse recovery than steroid therapy alone. However, given the small number of studies and methodological limitations, further studies are required to understand the effects of exercise in relapse management and the mechanism through which exercise influences relapse recovery.

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The Role of Disease Acceptance, Life Satisfaction, and Stress Perception on the Quality of Life Among Patients With Multiple Sclerosis

Rehabilitation Nursing ◽

10.1097/rnj.0000000000000288 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Aleksandra Kołtuniuk ◽

Aleksandra Pytel ◽

Anna Kulik ◽

Joanna Rosińczuk

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Life Satisfaction ◽

Stress Perception

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178Depression but not physical activity mediates the fatigue-mental quality of life relationship in multiple sclerosis

International Journal of Epidemiology ◽

10.1093/ije/dyab168.606 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Alexander Fidao ◽

Alysha De Livera ◽

Tracey Weiland ◽

George Jelinek ◽

Sandra Neate ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Multiple Sclerosis ◽

Indirect Effect ◽

Mediation Effect ◽

Study Cohort ◽

Wide Range ◽

Clinically Significant

Abstract Background Fatigue is among the most prevalent symptoms of multiple sclerosis (MS), and significantly detrimental to mental quality of life. We examined the role of depression and physical activity as mediators in the fatigue-QoL relationship in MS. Methods Using an international study cohort measuring a wide range of lifestyle and clinical factors, determinants of fatigue (Fatigue Severity Scale) and mental quality of life (MSQoL-54; QoL) were assessed in 2,104 participants using log-binomial and linear regression, respectively. Structural equation modelling (SEM) was used to assess the mediating role of depression and physical activity between fatigue and mental QoL. Results The median mental QoL score in the sample was 73.8/100. The mean fatigue score was 40.5/63, with 65.6% having clinically significant fatigue. In SEM analyses evaluating depression as a mediator of the fatigue-QoL relationship, mental QoL was 14.17-points lower in those with clinically significant fatigue, of which the indirect effect via depression accounted for over 30.8% (p < 0.001). This mediation effect was most pronounced for the Role Limitations from Emotional Issues (44.9%, p < 0.001) and Emotional Wellbeing (41.6%, p < 0.001) subdomains. Evaluating physical activity as a mediator of the fatigue-QoL relationship, mental QoL was 11.03-points lower in those with clinically significant fatigue, of which the indirect effect via physical activity accounted for only 1.0% (p = 0.001). Conclusions This study provides evidence that depression accounts for a majority of the fatigue-mental QoL relationship, while physical activity only plays a small role. While replication and longitudinal studies are required for validation, our findings may inform the development of treatments for reducing the impacts of fatigue and improving QoL in people with MS. Key messages Fatigue’s negative impact on emotional quality of life in multiple sclerosis is not a function of reduced ambulation but instead its impact on depression. Reducing depression may thus markedly improve quality of life in this population.

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Mediating Role of Resilience on Quality of Life in Individuals With Multiple Sclerosis: A Structural Equation Modeling Approach

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2020.02.010 ◽

2020 ◽

Vol 101 (7) ◽

pp. 1152-1161 ◽

Cited By ~ 5

Author(s):

Susan L. Kasser ◽

Asim Zia

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Structural Equation Modeling ◽

Structural Equation ◽

Equation Modeling ◽

Mediating Role ◽

Modeling Approach

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Physical Activity in Prevention of Risk and Disability in Some Neurological Diseases

Physiotherapy and Health Activity ◽

10.1515/pha-2015-0004 ◽

2014 ◽

Vol 22 (1) ◽

pp. 21-27

Author(s):

Józef Opara

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Multiple Sclerosis ◽

Physical Disability ◽

Neurological Diseases ◽

Review Of The Literature ◽

Disability Progression ◽

Multiple Sclerosis Patients

Abstract The question of the role of physical activity in preventing disability in neurological diseases is the issue which is not in doubt. There is well known that physical activity in Parkinson`s disease and in Multiple Sclerosis patients is less than is the case in the general population. Numerous scientific studies have confirmed the low physical activity of people with PD and MS. Improving physical activity delays the progress of physical disability and has the effect on increasing the quality of life in those two diseases. In this paper an descriptive review of the literature devoted to the effect of physical activity on risk of PD and its impact on disability progression in PD and MS has been presented. The different recommendations for physical activity and different methods of assessment have been described.

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Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

International Journal of MS Care ◽

10.7224/1537-2073.2014-031 ◽

2015 ◽

Vol 17 (4) ◽

pp. 172-180 ◽

Cited By ~ 3

Author(s):

Valerie Block ◽

Monica Rivera ◽

Marsha Melnick ◽

Diane D. Allen

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Urinary Incontinence ◽

Physical Therapy ◽

Bladder Dysfunction ◽

Meta Analysis ◽

Group Analysis ◽

Current Evidence ◽

Level Of Evidence

Background: Multiple sclerosis (MS) presents with many debilitating symptoms, including urinary incontinence (UI), that physical therapy (PT) may address; UI is widely prevalent, but PT management of symptoms lacks consensus. A meta-analysis of long-term nonsurgical and nonpharmaceutical treatment options may supply this deficiency. We analyzed the current evidence for effectiveness of PT to decrease UI and improve quality of life (QOL) in people with MS. Methods: An electronic search conducted through November 26, 2013, included the following search terms: incontinence, bladder dysfunction, urinary incontinence, multiple sclerosis, MS, physical therapy, physiotherapy, therapy, and rehabilitation. Criteria for inclusion were as follows: MS diagnosis, intervention involved PT for UI or bladder dysfunction, outcomes assessed QOL or UI, and at least a 4 of 10 on the Physiotherapy Evidence Database scale or a 2b level of evidence. Outcomes were combined across studies, and effect sizes are depicted in forest plots. Results: Six studies met the inclusion criteria. Between-group analysis revealed statistically significant differences in incontinence episodes and QOL, but did not reach significance for functional control mechanisms (eg, electromyography data on strength of contraction, relaxation, and endurance). Incontinence leakage episodes and QOL participation improved within groups. Conclusions: Meta-analysis indicates support for PT for minimizing incontinence compared with pretreatment and affecting incontinence and QOL more than control in people with MS. Protocols were heterogeneous regarding duration and type of PT intervention and were applied in different types of MS. Further research may reveal the most effective combination and variety of PT interventions for people with MS.

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