ClinicSpeak: aquatic training

Brain health through an holistic approach: exercise is a must #ClinicSpeak #MSBlog #MSResearch

"Brain health has become my new mantra in MS. How do we protect the brain and spinal cord from damage so as to maintain reserve capacity for old age. Yes, MSers will get old and there is no reason why they will not be subject to the same age-related diseases the general population will suffer from. Interestingly, one the best neuroprotectants in the general population is exercise. How does exercise work? It seems to change the microenvironment within the brain and does this by promoting growth factors that favour repair; for example IGF-1 (insulin-like growth factor 1). Exercise also stimulates the productions of endorphins, which are natural neuromodulators that have anti-depressant effects. This is why the results of this randomised aquatic exercise study below are not surprising. I can only assume that this exercise programme helped these woman recondition, lose weight, protect their brains and elevate their mood. Exercise also promotes good quality sleep. The message is simple if you can manage to get enrolled into an exercise programme please do; you will feel the effects within weeks. If you are disabled and not sure about what you can do ask your physiotherapist for help. If you don't have a physiotherapist ask your team to refer you."

"Why only woman? In Iran the female to male ratio with regard to MS is 5:1. Iran is also an Islamic state so I can only assume mixed sex aquatic classes are no-no. Another interesting observation about Iran is that about 20-25 years after the Islamic Revolution there was a massive uptick in the incidence of MS, particularly in woman. This surge in incidence happened to coincide with a significant fall in blood vitamin D levels in woman, compared to men. Vitamin D levels in serum banks collected before the revolution showed similar vD levels in Iranian men and woman. The million dollar question is it vD levels or lack of sun exposure that is the real risk factor for MS?  

"Exercise, exercise, exercise....."

Epub: Kooshiar et al. Aquatic exercise effect on fatigue and quality of life of women with multiple sclerosis: a randomized controlled clinical trial. J Sports Med Phys Fitness. 2014 Oct 10. 

AIM: The aim of this study was to determine the effects of aquatic exercise on fatigue and the quality of life in women with multiple sclerosis (MS).

METHODS: This randomized controlled clinical trial was carried out in a multiple sclerosis clinic in Iran, where 37 outpatient women with MS were randomized into an exercise group (n = 18) and a control group (n = 19). In the exercise group, aquatic exercise was performed for 45 minutes, 3 times per week for 8 weeks. The control group did not receive any interventions (aquatic exercise) and were asked to maintain their normal treatments. The severity and perception of fatigue and quality of life (QoL) were measured using the Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), and Multicultural Quality of Life Index questionnaires.

RESULTS: The repeated measure ANOVA demonstrated significant effects of aquatic exercise on the changes in the scores of physical and psychosocial fatigue perception, QoL, and fatigue severity (p = 0.001). However, its effect was not significant for cognitive fatigue perception (p > 0.05). General linear models show that the percentages of variation, as explained by the aquatic exercises, were highest in the QoL and the physical and psychosocial fatigue perceptions.

CONCLUSION: Aquatic exercise can improve the QoL and decrease fatigue severity and fatigue perception, specifically in the physical and psychosocial domain for MS patients. However, it was not effective in improving cognitive fatigue perception.

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