STUDY: Does exercise improve cognitive functions in multiple sclerosis? (2 Findings)

[ActiveMSers]

Does exercise improve cognitive functions in multiple sclerosis? Report of a pilot study

B. Sangelaji, S.M. Nabavi, S. Hozhabri Fouladizadeh, M. Moghaddam Nia, D. Morsali (Tehran, IR; Huston, US)

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Multiple sclerosis, has a significant effect on cognition and its dysfunction is evident in about 40 to 60 percent of the patients due to the different surveys.Various interventions including medications had no significant effect in improving this problem , so finding the new more efficient and available methods to overcome this problem may help the patients and enhance the quality of their lives..According to the several studies one of these methods could be exercise therapy, so we designed a pilot study in MS patients to evaluate the effect of it on cognitive functions.

Method and material: 17 (3 male and 14 female) defenite MS patients with mean disease duration of 3 y and mead EDSS of 2.35, have been enrolled and started the selected designed physical exercises, assessed as a before and after semi-experimental intervention. All of them did balance and aerobic exercises 3 times per week for 8 weeks. This physical activity planed for each patient personally by a professional physiotherapist. Before and after of aforementioned exercises, Screening cognition test (Rao etal) in 6 domains , were obtained.

Results: All of the patients did 22.5 sessions of exercises .Changes in all part of Selective reminding test (SRT), Symbol digit modalities test (SDMT) and one part of Paced auditory serial addition test(PASAT) were significant ( p<0.05). Although, the result of (10/36) Spatial recall test, word generation list test and second part of PASAT were not significant.

Conclusion: The results of this study as compare with other limited researchs showed that physical exercises could make significant changes in different aspects of cognitive tests in the patients with MS. However, more investigation and RCTs need to improve this fact more precisely.

[ActiveMSers]

Impact of exercise on cognition in multiple sclerosis
N. Hartoonian, M. Beier, C. Bombardier (Seattle, US)

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Introduction: Cognitive impairment is one of the most prevalent and disabling features of multiple sclerosis (MS) and is present in 22%-60% of individuals. Medical and rehabilitation approaches to improving cognition have not shown encouraging results. Based on studies in older adults, exercise represents a promising approach to improve cognitive functioning in MS.

Methods: Data from a previously published randomized controlled trial on the effects of telephone counselling on health promotion was used. A subgroup from this study indicated interest in exercise and was measured for strength (Cybex 6000 isokinetic dynamometer), aerobic fitness (bicycle ergometer) and cognition (Paced Auditory Serial Addition Test, PASAT; Trail Making Test, TMT) at baseline and 12 weeks later. Change in fitness was calculated by subtracting each participant’s baseline score from the outcome score, and then transformed to z-scores. Individuals with a z-score >= 1 on any fitness measure was placed in the Physically improved (PI) group (N = 25). All others were in the Physically not-improved (PNI) group (N = 57). We compared changes in cognition between these two groups.

Results: Repeated-measures analysis of covariance was used to assess if improved fitness was associated with improved cognition over time. Age, gender, ethnicity, education, and MS type were chosen as covariates because previous research has shown that they can have a relationship with cognition. After controlling for demographic variables there was a significant group (PI vs. PNI) x time (Baseline to 12-weeks) interaction, F (4, 72) = 2.58, p = .04. More specifically, there was a significant within-subjects main effect of group by time for TMT – Form B minus Form A, F (1, 75) = 5.4, p = .02, r = 0.26. The PI group demonstrated greater improvement in performance at follow-up compared to the PNI group. There was also a significant within-subjects main effect of group by time for TMT – Form A, F (1, 75) = 4.27, p = .04, r = 0.23. Contrary to expectations, planned contrasts revealed that the PI group demonstrated significantly slowed performance from baseline (M = 27.59, SD = 3.03) to follow-up (M = 29.41, SD = 2.16). The PNI group demonstrated improved performance from baseline (M = 32.08, SD = 1.98) to follow-up (M = 26.68, SD = 1.41). There were no significant findings for the PASAT.

Conclusion: The results of this study lend support to the hypothesis that fitness is associated with improved executive functioning in people with MS.