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Does mindfulness, meditation and progressive muscle relaxation reduce stress in people with multiple sclerosis?
Agland, S., Shaw, S., Lea, R., Mortimer-Jones, S. and Lechner-Scott, J. (2017)
Multiple Sclerosis Journal, 23 (Suppl. 3). pp. 680-975.
Link to Published Version: https://doi.org/10.1177/1352458517731285
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Abstract
Background and aim: The National Institute for Health and Care Excellence clinical guidelines, together with the global consensus document ‘Brain Health’, acknowledge that modification of lifestyle factors contribute to the holistic care of people with Multiple Sclerosis (MS). While people with MS often report stressful life events as a precursor to developing MS, and despite increasing evidence of perceived stress as a risk factor for disease activity, the evidence for effectively managing stress in this population is limited. This study examined the effect of an educational program that incorporates progressive muscle relaxation (PMR), meditation and mindfulness exercises (ME), on a population of people with MS over a six month period.
Method: 100 people with relapsing remitting MS were randomly assigned to receive:
1) stress management education (SME) or
2) wait list (WL).
The SME group received four one-on-one sessions learning PMR, meditation and ME and asked to perform PMR, meditation and ME for 5-7 days of the week for six months, which was monitored by diary. The primary outcome was change in perceived stress as measured by: the stress Visual Acuity Scale (sVAS), the stress component of the Depression, Anxiety and Stress Score (DASS21), and cortisol levels collected at baseline and four weeks. Cortisol levels were ascertained by saliva samples collected at three time points over a 24-hour period and then averaged. The secondary outcome measure was change in quality of life as measured by the Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL).
Results: None of the parameters evaluated changed between pre and post SME (p≤ 0.05). Mean scores for sVAS at baseline and follow up 1 (4 weeks) were 4.8 and 4.5 for SME and 3.7 and 4.1 for WL. Mean scores for stress component of the DASS21 were 15.3 and 13.7 for SME and 13.8 and 12.6 for WL. Mean cortisol levels changed were 7.3 nmol/L to 7.6 nmol/L for SME and 5.1 nmol/L to 7.6 nmol/L for WL. Mean MusiQoL scores were 65.2% and 67.3% for SME and 66.9% and 70.8% for WL. Study outcome was potentially limited by intervention adherence; good adherence (5-7 days per week), reasonable adherence (2-4 days per week) and poor adherence (0-1 day per week) to SME was undertaken by 24%, 19% and 45% respectively.
Conclusions: Results indicate that SME does not significantly improve levels of stress or quality of life in people with MS. Future studies could include barriers to adherence.
Agland, S., Shaw, S., Lea, R., Mortimer-Jones, S. and Lechner-Scott, J. (2017)
Multiple Sclerosis Journal, 23 (Suppl. 3). pp. 680-975.
Link to Published Version: https://doi.org/10.1177/1352458517731285
*Subscription may be required
Abstract
Background and aim: The National Institute for Health and Care Excellence clinical guidelines, together with the global consensus document ‘Brain Health’, acknowledge that modification of lifestyle factors contribute to the holistic care of people with Multiple Sclerosis (MS). While people with MS often report stressful life events as a precursor to developing MS, and despite increasing evidence of perceived stress as a risk factor for disease activity, the evidence for effectively managing stress in this population is limited. This study examined the effect of an educational program that incorporates progressive muscle relaxation (PMR), meditation and mindfulness exercises (ME), on a population of people with MS over a six month period.
Method: 100 people with relapsing remitting MS were randomly assigned to receive:
1) stress management education (SME) or
2) wait list (WL).
The SME group received four one-on-one sessions learning PMR, meditation and ME and asked to perform PMR, meditation and ME for 5-7 days of the week for six months, which was monitored by diary. The primary outcome was change in perceived stress as measured by: the stress Visual Acuity Scale (sVAS), the stress component of the Depression, Anxiety and Stress Score (DASS21), and cortisol levels collected at baseline and four weeks. Cortisol levels were ascertained by saliva samples collected at three time points over a 24-hour period and then averaged. The secondary outcome measure was change in quality of life as measured by the Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL).
Results: None of the parameters evaluated changed between pre and post SME (p≤ 0.05). Mean scores for sVAS at baseline and follow up 1 (4 weeks) were 4.8 and 4.5 for SME and 3.7 and 4.1 for WL. Mean scores for stress component of the DASS21 were 15.3 and 13.7 for SME and 13.8 and 12.6 for WL. Mean cortisol levels changed were 7.3 nmol/L to 7.6 nmol/L for SME and 5.1 nmol/L to 7.6 nmol/L for WL. Mean MusiQoL scores were 65.2% and 67.3% for SME and 66.9% and 70.8% for WL. Study outcome was potentially limited by intervention adherence; good adherence (5-7 days per week), reasonable adherence (2-4 days per week) and poor adherence (0-1 day per week) to SME was undertaken by 24%, 19% and 45% respectively.
Conclusions: Results indicate that SME does not significantly improve levels of stress or quality of life in people with MS. Future studies could include barriers to adherence.