Exercise is the old chestnut on MS forums: how do we get MSers to exercise? #MSBlog #MSResearch
"The following study suggests, and only suggests, that physical activity is associated with better outcomes in MS. We have no idea based on the trial design if this is cause or association; i.e. does exercise improve MS outcomes or are MSers with better outcomes likely to partake in exercise? This is why we need randomised double-blind placebo-controlled trials to answer the question whether any health intervention is effective, or not. Exercise is also likely to be associated with many confounding variables that may affect the results. For example, people who exercise are less likely to smoke. Smoking has been shown to be associated with a poor outcome in MS. People who exercise are less likely to be obese; obesity is a risk factor for MS and may be linked to hormonal changes that affect disease outcome. Exercise is a natural anti-depressant; if you are less depressed you may respond to the questionnaires of these sorts of studies differently. MSers who exercise are less likely to have comorbidities of diabetes and hypertension and therefore less likely to suffer from small vessel, or cardiovascular, disease, which have been linked to a poorer MS outcome."
"Taking my cynical hat off; it is quite clear that MSers have an enormous amount to gain from being physically active and I recommend to all my patients regardless of levels of disability that they need to exercise. However, I am fully aware that clinical advice is not often taken and we need better systems to get MSers exercising. Some MSers benefit from a formal training programme designed by a physiotherapist and other not."
"Exercise is the old chestnut; how do you change population behaviour for the good. Is there something we can use to nudge people in the right direction? Would mass exercise monitoring with rewards for those adhering to their exercise programme work? Any ideas? Crack this problem and we will solve a lot of the health problems of the general population."
|Exercise is the old chestnut! How do we crack it?|
BACKGROUND: MS is a common neurodegenerative disease, which often has a devastating effect on physical and emotional wellbeing of MSers. Several studies have shown positive effects of physical activity (PA) on disability, health related quality of life (HRQOL), and other outcomes. However, many studies include only MSers with mild disability making it difficult to generalize findings to those with moderate or severe disability. This study investigated the associations between PA and HRQOL, relapse rate (RR), disability, and demographic variables in MSers with varying disability.
METHODS: Through online platforms this large international survey recruited 2232 MSers who completed items regarding PA, MS and other health characteristics.
RESULTS: MSers who were younger (p < .001), male (p = 0.006), and with lower body mass index (BMI) (p < .001) undertook more PA, which was associated with decreased disability (p < 0.001) and increased HRQOL measures (all p < 0.001). For the subsample of RRMSers, PA was associated with a decreased RR (p = 0.009). Regression analyses showed that increased PA predicted clinically significant improvements in HRQOL while controlling for level of disability, age and gender. More specifically, increasing from low to moderate and to high PA increased estimated mean physical health composite from 47.7 to 56.0 to 59.9 respectively (25.6% change), mental health composite from 60.6 to 67.0 to 68.8 (13.5% change), energy subscale from 35.9 to 44.5 to 49.8 (38.7% change), social function subscale from 57.8 to 66.1 to 68.4 (18.3% change), and overall QOL subscale from 58.5 to 64.5 to 67.7 (15.7% change).
CONCLUSIONS: For MSers, regardless of disability level, increased PA is related to better HRQOL in terms of energy, social functioning, mental and physical health. These are important findings that should be taken into consideration by clinicians treating MSers.