STUDY ANALYSIS: The benefits of exercise in progressive MS—some cautious optimism

[ActiveMSers]

The benefits of exercise in progressive MS: some cautious optimism

Anthony Feinstein1,2
Ulrik Dalgas3
1Department of Psychiatry, Sunnybrook Health Sciences Centre, Canada
2University of Toronto, Canada
3Department of Public Health, Section of Sport Science, Aarhus University, Denmark
•Anthony Feinstein, Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada.

The therapeutic landscape in progressive multiple sclerosis (MS) is bleak. The promise of disease-modifying drugs has not extended to this subgroup of patients, which has meant that treatment is confined to symptom management. Here too the challenges are considerable given the greater all-around morbidity that accompanies the transition to a progressive disease course coupled with a dearth of clinical trials focusing specifically on this subgroup of patients. Cognizant of these challenges, researchers and clinicians from seven countries have recently joined forces to form a Progressive MS Alliance with a multiplicity of aims, one of which is to advance treatment options for patients left behind by the disease-modifying bandwagon. All of which makes the study by Briken et al. timely and important. (Abstract: http://activemsers.wssnoc.net/showthread.php?t=1437) The authors have shown that three different aerobic exercise modalities tailored according to a patient’s physical condition at baseline and undertaken two to three times a week over an eight- to 10-week period produced an array of benefits, including improved walking and cognition plus a reduction in fatigue and depression. Furthermore, a low drop-out rate suggests that patients were comfortable with the exercise intervention.

FULL ARTICLE (Read It!): http://msj.sagepub.com/content/20/3/269.full

[ActiveMSers]

I was especially encouraged by this:

"Cognitive dysfunction can affect up to three-quarters of patients with secondary progressive MS and half of all patients with primary progressive MS.... There are as yet no effective pharmacological treatments.... Enter exercise, an intervention that is both complied with and relatively free of side effects, and the data indicate some notable gains in memory and attention."

And it was interesting that an arm ergometer improved walking. Who would have thunk?

[Veronica]

Well, when I read this just now, I see that they felt that the arm ergometer was similar to practiced arm swinging when walking, which is something that my PT has encouraged me to do....as he explained to me the arm movement controls the leg movement.( Not explaining it quite right!) Makes sense to me as when I do dedicated walking in this fashion, my legs do develop a rhythm and it is easier for me to keep my strides more even. Maybe the arm ergometer would promote muscle memory for people who would have too difficult a time doing dedicated walking for muscle memory?

[LivWell]

It is just encouraging to me, plain and simple, that exercise can be so beneficial. I like this statement:

The authors have shown that three different aerobic exercise modalities tailored according to a patient’s physical condition at baseline and undertaken two to three times a week over an eight- to 10-week period produced an array of benefits, including improved walking and cognition plus a reduction in fatigue and depression. Furthermore, a low drop-out rate suggests that patients were comfortable with the exercise intervention.

If you have done a bit of searching on the NMSS website you may have already come across this brochure but I thought I'd include the link. I think it is an excellent summary of basics for exercise. (Includes tips on staying cool also.)

http://www.nationalmssociety.org/Nat...e_Exercise.pdf

[teena marie]

Hi all,

We've had a bit of a discussion on walking in the MS'ers in training thread. I've always maintained that for my nervous system, front crawl when swimming promotes that left right pendulum movement. In my pool, I practise walking with exaggerated arm swinging. I see how it also helps with balance. Crawling is another way. That's where I discovered that that circuit was miswired. Instead of moving left knee forward at the same time as the right arm, I was moving both left knee and left arm. I now try to incorporate a walking visualization at the same time as moving my hips and swinging my arms while seated. All in the name of developing new pathways and neural regeneration.

Take care all,

Teena Marie