scholarly journals Evaluation of Power Production Asymmetry during Cycling in Persons with Multiple Sclerosis

Author(s):  
John W. Farrell ◽  
Debra A. Bemben ◽  
Christopher D. Black ◽  
Daniel J. Larson ◽  
Gabriel Pardo ◽  
...  

Lower limb asymmetries have been observed in persons with multiple sclerosis (PwMS), and have been associated with mobility impairment. An incremental cycling test was performed on a cycle ergometer to determine peak power output (PPO) and peak oxygen consumption (VO2peak). Then, participants cycled at 50%, 60%, and 70% of their PPO to assess the contribution of each lower limb to power production. Two-way repeated measures ANOVA was used to detect group × intensity differences in power production asymmetry. Eight PwMS and six healthy individuals (Non-MS) completed the study. No statistically significant (p > 0.05) group × intensity interactions or main effects were present when examining between-limb differences in power production. The current data do not indicate a statistically significant difference in power production asymmetry between groups and exercise intensities. Previous research has established a 10% difference between contralateral limbs as a threshold for asymmetry. The average asymmetry in power production in PwMS exceeded the 10% threshold at all measured outputs, suggesting the presence of asymmetry in power production.

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Daniela Bassi ◽  
Vivian M Arakelian ◽  
Renata G Mendes ◽  
Flavia C Caruso ◽  
José C Bonjorno Júnior ◽  
...  

Background: The prevalence of diabetes have increased globally to epidemic proportions; glycemic control and treatment remains a challenge. Concurrent aerobic and resistance training programs (CART) have been widely recommended as an important strategy to improve physiologic and functional performance. Objective: The impact of CART programs on metabolic profile, glycemic control and exercise capacity status in patients with diabetes requires additional study, which is the primary aim of the current study. Materials and Methods: We evaluated 41 patients (15 female and 19 male, 50.8±7 years) with a confirmed diagnosis of diabetes. The subjects were randomized in two groups: sedentary group (SG) and CART group (CART-G). CART was performed 12 weeks, 3 times a week for approximately 1 hour per session (30 minutes aerobic and 30 minutes resistance). Body habitus was assessed by body mass index, waist circumference, and skinfolds. Peripheral muscular strength was evaluated by an isokinetic dynamometer and pulmonary gas exchange was measured breath-by-breath, using a portable telemetric system during maximal incremental exercise testing on a cycle ergometer. Statistical analysis included Shapiro-Wilk test follow by ANOVA two way repeated measures. Results: We observed a decrease in HbA1c (8.1±1.6 to 7.3±1.2%), cholesterol (198.38.1±50.3 to 186.8±35.1 mg/dL) and HOMA IR (6.4±6.8 to 5.0±1.4) in the CART-G compared to the SG. There was no significant difference in fasting plasma glucose. Although body weight did not significantly change after training, skinfold measurements indicated decreased body fat in the CART-G only. CART significantly enhanced muscle strength (p<0.05) (peak torque: 135.5±4 to 159.7±47.7 N.m) compared to the SG (Peak torque: 145.3±47.9 to 143±42.2 N.m). CART was also associated with a significant increase in peak oxygen consumption, from 22.9±6.1 to 27.2±4.7 ml•kg –1 •min –1 compared to the SG, from 21.7±4.5 to 21±3.3 ml•kg –1 •min –1 as well as the maximal workload (124.6±29.1 to 149.9±29 watts) compared to the SG (123.6±36.9 to 122.1±32.9 watts). Conclusion: We concluded that CART is an important intervention strategy, producing both physiologic and functional improvements, in patients with diabetes.


2021 ◽  
Vol 26 (1) ◽  
pp. 163-168
Author(s):  
Maedeh Pourhossein Alamdari ◽  
Fazlollah Ahmadi ◽  
Mahmoud Abedini

Multiple sclerosis is a chronic and unpredictable disease and is a growing trend and, like other chronic diseases, affects one's quality of life and since sleep quality is one of the dimensions of quality of life, this study aimed to investigate the effect of applying continuous care model on sleep quality of patients with MS in 2013. This clinical trial study was performed on 80 patients with multiple sclerosis who were randomly assigned to experimental and control groups. Data collection tools included demographic information questionnaire, PSQI questionnaire and model implementation in four stages (familiarization, sensitization, control, evaluation). Model stages were performed individually and in groups for three weeks according to patients' educational needs (sleep, activity, medication and nutrition) and after two months follow up, control and evaluation were performed. Data were analyzed using Chi-square test, independent t-test and repeated measures ANOVA and spss16 software. Statistical analysis of variance (ANOVA) with repeated measures showed a significant difference between the mean of total score and the scores of sleep quality dimensions in three times between the two groups (p<0.05). It can be concluded that the implementation of continuous care model causes a significant difference in the sleep quality of patients with MS.


2021 ◽  
Vol 17 ◽  
Author(s):  
Negin Sayari ◽  
Katayon Vakilian ◽  
Zohre Khalajinia ◽  
Seyyed Amir Hejazi ◽  
Mostafa Vahedian

Aims: Improving sexual function in women with disability such as multiple sclerosis was aimed. Background: Sexual dysfunction and the consequent low satisfaction is very common in females with Multiple Sclerosis (MS). Objectives: This study aimed to investigate the effectiveness of Relationship Enhancement Therapy (REP) on sexual function and satisfaction of females with MS. Methods: the present study was an educational design with two groups, in which 44 females with MS participated and their spouses (N= 88) participated and randomly divided in two groups of intervention (N= 22 couples) and control (N= 22 couples). They signed written consent forms and were included in the project. The intervention group received the REP in six 90-minute sessions. The groups completed standard questionnaires of sexual dysfunction and sexual satisfaction in three stages of pretest-posttest and 3 months later. The Descriptive and inferential statistics (Two- way repeated measures ANOVA, chi-square, t-test and Mann-Whitney U test) were used to analyze data. Results: The results of analysis showed that there was a clinically significant difference between the scores of sexual dysfunction in different phases of the assessment between two groups (p <0.05). Also sexual satisfaction was higher in the intervention group vs. in the control (p <0.05). Conclusion: according to the findings, marital enrichment program was effective in improvement of sexual function and sexual satisfaction of females with multiple sclerosis. It is recommended to healthcare providers to use enrichment alongside medical services to improve patients' sexual life.


2018 ◽  
Vol 43 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Thomas Edwards ◽  
Robert W. Motl ◽  
Lara A. Pilutti

Exercise training is one strategy for improving cardiorespiratory fitness (CRF) in multiple sclerosis (MS); however, few modalities are accessible for those with severe mobility impairment. Functional electrical stimulation (FES) cycling is an adapted exercise modality with the potential for improving CRF in people with severe MS. The objective of this study was to characterize the cardiorespiratory response of acute voluntary cycling with FES in people with MS with severe mobility impairment, and to compare this response to passive leg cycling. Eleven participants with MS that required assistance for ambulation completed a single bout of voluntary cycling with FES or passive leg cycling. Oxygen consumption, heart rate (HR), work rate (WR), and ratings of perceived exertion (RPE) were recorded throughout the session. For the FES group, mean exercising oxygen consumption was 8.7 ± 1.8 mL/(kg·min)−1, or 63.5% of peak oxygen consumption. Mean HR was 102 ± 9.7 bpm, approximately 76.4% of peak HR. Mean WR was 27.0 ± 9.2 W, or 57.3% of peak WR, and median RPE was 13.5 (interquartile range = 5.5). Active cycling with FES was significantly (p < 0.05) more intense than passive leg cycling based on oxygen consumption, HR, WR, and RPE during exercise. In conclusion, voluntary cycling with FES elicited an acute response that corresponded with moderate-to vigorous-intensity activity, suggesting that active cycling with FES can elicit a sufficient stimulus for improving CRF.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lulu Yin ◽  
Kun Liu ◽  
Chengmei Liu ◽  
Xiaodong Feng ◽  
Lin Wang

Background: The purpose of the study was to determine the effect of kinesiology tape (KT) on lower limb muscle activation during computerized dynamic posturography (CDP) tasks and ankle kinesthesia in individuals with chronic ankle instability (CAI).Methods: Thirty-five men with CAI participated in this study. The experimental procedure followed a repeated measures design. Muscle activation of lower extremity and ankle kinesthesia of participants were measured using four taping treatments, namely, KT, athletic tape (AT), sham tape (ST), and no tape (NT) in a randomized order. Muscle activation was assessed using surface electromyography (sEMG) synchronized with CDP tests from seven lower extremity muscles of the unstable limb. Ankle kinesthesia was measured by using a threshold to detect the passive motion direction of the unstable ankle. Parameters were analyzed by using a one-way repeated measures ANOVA and followed by pairwise comparisons with a Bonferroni correction.Results: No significant difference was observed among different taping treatments for the majority of parameters during CDP. Except for condition 4 with open eyes, sway-referenced surface, and fixed surround in the sensory organization test (SOT), gastrocnemius medialis root mean square (RMS) was 28.19% lower in AT compared with NT (p = 0.021, 95% CI = 0.002–0.039), while gastrocnemius lateralis RMS was 20.25% lower in AT compared with KT (p = 0.038, 95% CI = 0.000–0.021). In forward-small sudden translation from motor control test (MCT), for peroneal longus (PL), RMS was 24.04% lower in KT compared with ST (p = 0.036, 95% CI = 0.000–0.018). In toes-down sudden rotation from adaption test (ADT), for PL, RMS was 23.41% lower in AT compared with ST (p = 0.015, 95% CI = 0.002–0.027). In addition, no significant difference was observed for a threshold to the detection of passive motion direction among different taping treatments.Conclusion: This study indicated that KT had minimal effect on the muscle activation of the unstable lower limb during static stance, self-initiated, and externally triggered perturbation tasks from CDP and ankle kinesthesia among individuals with CAI, suggesting that the benefit of KT was too small to be clinically worthwhile during application for CAI.


Author(s):  
Mojtaba Dehestani Ardakani

Introduction: The purpose of this study was to determine the effect of aerobic exercise program on quality of life in multiple sclerosis men as a complementary therapeutic approach to multiple sclerosis. Methods: This was a semi-experimental study. The statistical sample consisted of 60 people was selected by the available sampling method from Kahrizak Nursing Home where was also a member of the Iranian MS society. They were randomly divided into control and test groups. After an introductory session of the patients with the aims and intervention method in the experimental group, 27 sessions of 60 minutes of aerobic exercise program were performed in 9 weeks. Data collection tools consisted of a demographic questionnaire, a short quality of life (SF-8) questionnaire, and self-report checklist with a significant level of p≤0.05. Descriptive statistical tests, independent t-test and repeated measures analysis of variance were used for analysis using SPSS version 16 statistical software with a significance level of p≤0.05. Results: The results showed that there was no significant different between the two groups in terms of the total score (df = 48 = T 21.1, p = 0.23) and dimensions of quality of life (Physical: df = 48, T = 1.31, p = 0.19; mental: df = 48, t = 0.96, p = 0.31) There was no significant difference between the control and experimental groups. The results of repeated measures analysis of variance showed that there was a significant difference between the experimental and control groups in terms of quality of life dimensions. Conclusion: In general, aerobic exercise, which was chosen as an exercise program in this study, improves the quality of life of multiple sclerosis patients. Therefore, this complementary therapeutic approach is recommended as an effective and cost-effective method in cost and time, as well as the ability to learn and easy to administer to multiple sclerosis patients.


Author(s):  
Fatemeh Nazari ◽  
Mozhgan Soheili ◽  
SayedMohsen Hosseini ◽  
Vahid Shaygannejad

Abstract: Pain is a common and significant symptom in many individuals with multiple sclerosis (MS). The presence and severity of pain in individuals with MS has also been shown to be associated with higher levels of depression, functional impairment, and fatigue. It is common for MS patients and their caregivers to worry about narcotic addiction in the management of chronic pain. Therefore, this study aimed to determine and compare the effects of reflexology and relaxation on pain in women suffering from MS.: This study was a single-blind randomized clinical trial performed on 75 patients with MS referred to the MS Clinic of Ayatollah Kashani Hospital (Isfahan, Iran). After simple non-random sampling, using the minimization method, participants were randomly assigned to the three groups of reflexology, relaxation, and control. In the experimental groups, foot reflexology and relaxation interventions (Jacobson and Benson) were performed within 4 weeks, twice a week for 40 min. The control group received routine care and medical treatment as directed by a doctor. Data were collected using the Numerical Rating Scale before, immediately after, and 2 months after interventions in all three groups. Data analysis was performed using SPSS version 18 and descriptive and inferential statistical tests.: Findings obtained from analysis of variance (ANOVA) showed no significant differences between mean pain intensity scores in the three groups preintervention and 2 months after interventions (p > 0.05). However, this difference was statistically significant immediately after the study (p < 0.05). Findings obtained from repeated measures ANOVA showed that the severity of pain significantly differed during different times in reflexology and relaxation (p < 0.05); however, this difference was not significant in the control group (p > 0.05). Furthermore, Fisher’s least significant difference (LSD) revealed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention, compared with the two other groups, but showed no significant differences between relaxation and control groups. There were no significant differences between the three groups 2 months after the interventions (p > 0.05).: The results showed that both interventions are effective on relieving pain in women with MS; however, it appears that the effect of reflexology on pain reduction is greater than that of relaxation. Hence, these two methods can be recommended as effective techniques.


Author(s):  
John W. Farrell ◽  
Thomas Edwards ◽  
Robert W. Motl ◽  
Lara A. Pilutti

Abstract Background: Lower limb strength asymmetry (ie, significant difference between contralateral limbs) has been associated with mobility impairment in persons with multiple sclerosis (MS). However, whether an adaptive exercise modality can be used to modify lower limb strength and potentially improve mobility is unclear. The effect of functional electrical stimulation (FES) cycling on lower limb strength asymmetry in persons with MS with mobility impairment was assessed, and the association between change in lower limb strength asymmetries and changes in functional and self-reported mobility outcomes was explored. Methods: Eight adults with MS (Expanded Disability Status Scale scores, 5.5–6.5) were included. Outcomes included knee extensor and knee flexor strength asymmetry, Timed 25-Foot Walk (T25FW) test, 2-Minute Walk Test (2MWT), Timed Up and Go (TUG) test, and 12-item Multiple Sclerosis Walking Scale (MSWS-12). Participants received 24 weeks (three times per week) of FES cycling or passive leg cycling. Results: The FES condition demonstrated a small decrease in knee extensor (d = −0.33) and knee flexor (d = −0.23) strength asymmetry compared with passive leg cycling. With both groups combined, moderate-to-strong associations were observed between change in knee extensor asymmetry and change in T25FW test time (rs = −0.43), 2MWT time (rs = −0.24), TUG test time (rs = 0.55), and MSWS-12 score (rs = 0.43). Moderate correlations were observed between change in knee flexor asymmetry and change in T25FW test time (rs = −0.31), TUG test time (rs = 0.33), and MSWS-12 score (rs = 0.35). Conclusions: FES cycling may be an efficacious exercise modality for reducing lower limb strength asymmetry and improving mobility in persons with MS.


2019 ◽  
Author(s):  
James Graeme Wrightson ◽  
Louis Passfield

Objectives: To examine the effect of exercise at and slightly above the maximal lactate steady state (MLSS) on self-efficacy, affect and effort, and their associations with exercise tolerance.Design: Counterbalanced, repeated measures designMethod: Participants performed two 30‐minute constant‐load cycling exercise at a power output equal to that at MLSS and 10 W above MLSS, immediately followed by a time‐to‐exhaustion test at 80% of their peak power output. Self-efficacy, affect and effort were measured before and after 30 minutes of cycling at and above MLSS.Results: Negative affect and effort higher, and self-efficacy and time to exhaustion were reduced, following cycling at MLSS + 10 W compared to cycling at the MLSS. Following exercise at the MLSS self-efficacy, affect and effort were all associated with subsequent time-to exhaustion. However, following exercise at MLSS + 10 W, only affect was associated with time-to exhaustion. Conclusions: Self efficacy, affect and effort are profoundly affected by physiological state, highlighting the influence of somatic states on perceptions and emotions during exercise. The affective response to exercise appears to be associated with exercise tolerance, indicating that the emotional, as well as physiological, responses should be considered when prescribing exercise training.


2020 ◽  
Vol 132 (5) ◽  
pp. 1405-1413 ◽  
Author(s):  
Michael D. Staudt ◽  
Holger Joswig ◽  
Gwynedd E. Pickett ◽  
Keith W. MacDougall ◽  
Andrew G. Parrent

OBJECTIVEThe prevalence of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS-TN) is higher than in the general population (idiopathic TN [ITN]). Glycerol rhizotomy (GR) is a percutaneous lesioning surgery commonly performed for the treatment of medically refractory TN. While treatment for acute pain relief is excellent, long-term pain relief is poorer. The object of this study was to assess the efficacy of percutaneous retrogasserian GR for the treatment of MS-TN versus ITN.METHODSA retrospective chart review was performed, identifying 219 patients who had undergone 401 GR procedures from 1983 to 2018 at a single academic institution. All patients were diagnosed with medically refractory MS-TN (182 procedures) or ITN (219 procedures). The primary outcome measures of interest were immediate pain relief and time to pain recurrence following initial and repeat GR procedures. Secondary outcomes included medication usage and presence of periprocedural hypesthesia.RESULTSThe initial pain-free response rate was similar between groups (p = 0.726): MS-TN initial GR 89.6%; MS-TN repeat GR 91.9%; ITN initial GR 89.6%; ITN repeat GR 87.0%. The median time to recurrence after initial GR was similar between MS-TN (2.7 ± 1.3 years) and ITN (2.1 ± 0.6 years) patients (p = 0.87). However, there was a statistically significant difference in the time to recurrence after repeat GR between MS-TN (2.3 ± 0.5 years) and ITN patients (1.2 ± 0.2 years; p < 0.05). The presence of periprocedural hypesthesia was highly predictive of pain-free survival (p < 0.01).CONCLUSIONSPatients with MS-TN achieve meaningful pain relief following GR, with an efficacy comparable to that following GR in patients with ITN. Initial and subsequent GR procedures are equally efficacious.


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