ClinicSpeak: exercise the next big thing in neurodegenerative disease

Exercise therapy; will it work in MS? #MSBlog #MSResearch #ClinicSpeak

"Exercise is the next big thing in neurodegenerative diseases. It looks as if exercise delays the onset of age-related neurodegenerative diseases. It may have a similar effect in MS. Hence the interest in using exercise as a treatment for MS; to improve symptoms and possibly as a disease-modifying therapy to delay the onset of clinically-apparent progressive MS and to slow the rate of progression. The abstract below describes a randomised controlled trial that has started in Ireland to assess the impact of exercise on MS."

"How does exercise work? Firstly, it conditions you and as a result improves your overall health. As a result you feel better. Exercise also stimulates the production of endorphins in the brain that act as anti-depressants. In addition, it causes the production of growth factors, in particular IGF-1 (insulin-like growth factor-1) that may be neuroprotective. People who exercise regularly sleep better and generally not improved quality of life."

"We recommend to all our patients to try and engage in an active exercise programme. Even patients who are disabled can do exercise; physiotherapists are very good at designing exercise programmes if have a disability. Exercise is a core component of the brain health initiative that many public health doctors are beginning to promote at a National level to deal with the incipient dementia epidemic in developed countries."

If you live in Ireland you may be eligible for this study; please checkout the eligibility criteria here. You can also contact the PIs who are running the trial:

Contacts: Susan Coote, PhD, +35361234278,   
Contact: Sara Hayes, PhD, +35361234861,   

Epub: Coote et al. A randomised controlled trial of an exercise plus behaviour change intervention in people with multiple sclerosis: the step it up study protocol. BMC Neurol. 2014 Dec 21;14(1):241.

Background: Exercise has consistently yielded short-term, positive effects on health outcomes in people with multiple sclerosis (MS). However, these effects have not been maintained in the long-term. Behaviour change interventions aim to promote long-term positive lifestyle change. 

Aims: This study, namely, "Step it Up" will compare the effect of an exercise plus Social Cognitive Theory (SCT)-based behaviour change intervention with an exercise plus control education intervention on walking mobility among people with MS.

Methods/design: People with a diagnosis of MS who walk independently, score of 0-3 on the Patient Determined Disease Steps, who have not experienced an MS relapse or change in their MS medication in the last 12 weeks and who are physically inactive will be randomised to one of two study conditions. The experimental group will undergo a 10-week exercise plus SCT-based behavioural change intervention. The control group will undergo a 10-week exercise plus education intervention to control for contact. Participants will be assessed at weeks 1, 12, 24 and 36. The primary outcome will be walking mobility. Secondary outcomes will include: aerobic capacity, lower extremity muscle strength, participant adherence to the exercise programme, self-report exercise intensity, self-report enjoyment of exercise, exercise self-efficacy, outcome expectations for exercise, goal-setting for exercise, perceived benefits and barriers to exercise, perceptions of social support, physical and psychological impact of MS and fatigue. A qualitative evaluation of Step it Up will be completed among participants post-intervention.

Discussion: This randomised controlled trial will examine the effectiveness of an exercise plus SCT-based behaviour change intervention on walking mobility among people with MS. To this end, Step it Up will serve to inform future directions of research and clinical practice with regard to sustainable exercise interventions for people with MS. 

Trial registration NCT02301442.

Labels: ,