Wednesday, 26 September 2012

Research: pre-MS physical activity predicts disease progression

EpubMotl et al. Premorbid physical activity predicts disability progression in relapsing-remitting multiple sclerosis. J Neurol Sci. 2012 Sep 15. pii: S0022-510X(12)00485-6. doi: 10.1016/j.jns.2012.08.033

BACKGROUND: Disability progression is a hallmark feature of MS that has been predicted by a variety of demographic and clinical variables and treatment with disease modifying therapies. This study examined premorbid physical activity as a predictor of change in disability over 24months in RRMSers

METHODS: 269 RRMSers completed baseline measures of demographic and clinical variables, premorbid and current physical activity, and disability status. The measure of disability was further completed every 6 months over the subsequent 24-month period.

RESULTS: There was a significant, linear increase in disability scores over time (p=.0015). Physical activity before disease onset significantly predicted the linear change in disability scores (standardized β=-.23, p<.005); current physical activity (standardized β=-.02, p=.81), gender (standardized β=-.06, p=.54), age (standardized β=.05, p=.56), duration of MS (standardized β=.11, p=.15), and treatment with disease modifying therapies (standardized β=-.03, p=.77) did not predict change in disability scores.


CONCLUSIONS: The current research highlights the possible role of physical activity before MS onset for lessening disability progression over time in persons with RRMS. Additional research is necessary on physical activity initiated after the diagnosis of RRMS as a lifestyle approach for bolstering physiological reserve and preventing disability progression.


"This study indicates that physical exercise prior to MS-onset is a predictor of slower disease progression once you have the disease. Chicken or egg? Physical activity is associated with a lot of other factors that could explain this result, apart from exercise itself. For example, exercise may be a marker of outdoor activity and greater sunlight exposure and therefore higher vD levels. vD may be the factor that is influencing disease course. People who exercise are less likely to smoke, we know that smokers have a worse disease course. People who exercise tend to have better diets and weigh less....., etc.  I could go on but I won't. This study needs to be repeated and we need to try and identify the confounders. This would be important for MSers as they may support lifestyle changes that could modify the course of MS."

Other posts of interest:

04 Sep 2012
BACKGROUND: The influences of exercising on cytokine response, fatigue and cardiorespiratory values are important aspects of rehabilitation in MSers. Exercise performed within these programs is often practised in water ...
07 Jun 2012
Purpose: The evidence base to support therapeutic exercise for MSers is improving; however few studies have considered the MSers' perspective. This study aimed to explore the experiences and views of people moderately ...
15 Jun 2012
Objective: Our aim was to evaluate the effects of a Nintendo Wii Fit® balance exercise programme on balance function and walking ability in people with multiple sclerosis (MS). Methods: A multi-centre, randomised, controlled ...
01 Jun 2012
RESULTS: Findings are based on 21 patients (10 from exercise and 11 controls) who had data available on outcomes. There was no significant difference between the two groups at the baseline. MSers in the aquatic exercise ...

14 Jul 2011
Exercise also release endorphins within the brain that are part of the brain's reward system and make you feel pleasant. Interestingly, this is one of the ways low dose naltrexone is meant to work. Do any of you exercise and ...
11 Apr 2011
The effect of exercise therapy on fatigue in multiple sclerosis. Exercise therapy may have a positive effect on MS-related fatigue, however, the findings of a systematic review show the impact of exercise can be highly variable.
20 Jul 2012
"This is good news; MSers behave in the same way as normal subjects when it comes to energy expenditure from exercise or physical activity. This is not surprising as there is no evidence that MSers peripheral energy usage ...
28 Dec 2011
CONCLUSION: Group kickboxing appears to be a feasible exercise activity for individuals with MS and may lead to improvement in select measures of balance. Further investigation is warranted. "The creativity of the research ...

22 Dec 2010
Walking impairment in patients with multiple sclerosis: exercise training as a treatment option; "exercise training and physical activity might hold significant potential for the management of progressive mobility disability in MS.

5 comments:

  1. One of the frustrating aspects of MS is that as a person who used to exercise a lot, it has now become more difficult (although still possible!). Very irritating when you try to keep yourself in good shape, but are confounded :-(
    But it woukd be good to know the true benefits, or otherwise, of exercise to (slowing) disease progression. My experience is that it can help with symptom relief, eg swimming helps make muscles less stiff, leading to easier movement after a short period of recovery from exercise.

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  2. I think this is interesting. There is research to support the application of cognitive reserve theory in MS cognitive impact (i.e. premorbid 'intelligence' mitigates impact of MS on cognitive effects and not just relatively). I've often wondered whether there is a physical element - eg I have no balance issues right now; would working on my balance and developing exceptional balance skills protect me from the impact of a balance-related relapse? I don't know the answer to that - Prof G? Would a world class gymnast suffer less with balance issues than your average joe bloggs because they had superlative balance pre-MS?

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  3. Question for Dr. G:

    For those with MS, is hard or intense exercise, like running, ok if one is able? Is it possible for intense exercise to bring on a relapse, or cause other damage?

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  4. Re: "Would a world class gymnast suffer less with balance issues than your average joe bloggs because they had superlative balance pre-MS?"

    I suspect they would as they have increased reserve in that system. This has not formally been studied in MS, but similar work has be done in Alzhiemer's disease. Educational and cognitive exercises protects you from MS.

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  5. Re: "For those with MS, is hard or intense exercise, like running, ok if one is able? Is it possible for intense exercise to bring on a relapse, or cause other damage?"

    Again we have no data, but we think this is unlikely. The one situation I advise against intense exercise is during a clinical relapse. It doesn't make sense overworking vulnerable axons.

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