ClinicSpeak & BrainHealth: Is sedentary behaviour a silent killer?

Are you a MS Sedent? Time to change your behaviour. #ClinicSpeak #MSBlog #BrainHealth

"Sedentary behaviour is well described in MS (see review below). Is sedentary behaviour a consequence of you having MS or does MS cause sedentary behaviour? It is obvious that if you are disabled it is more difficult to exercise. Similarly, if you suffer from exercise induced fatigue you may be reluctant to exercise, or exert yourself unnecessarily, so as not exacerbate your fatigue. Then there is the issue of low mood and poor motivation. MSers have a high prevalence of comorbid depression and this is associated with reduced motivation and drive; people who are depressed simply don't want to exercise. Then there is deconditioning; the less you exercise the less you are able to exercise because any exertion is tiring. All these factors create a downward spiral that leads to you becoming a sedent. It is often difficult to break the cycle unless you want to break it. What is clear that if you are a sedent you may need help to break the cycle. I suggest asking your neurologists or MS clinical nurse specialist to refer you to a physiotherapist for help. Once you start reconditioning yourself you will be surprised how good it makes you feel. Exercise is one of the most effective treatments we have for a whole range of issues MSers suffer from; low mood, obesity, poor sleep, fatigue, etc. The problem I have is how do I successfully prescribe exercise to my patients in a way that they take me seriously and adhere to the prescription? One thing I am trying to do is to practice what I preach; I personally try to get in 4-5 exercise sessions in a week. It is difficult to tell your patients to exercise if you don't exercise yourself. Exercise is one component of the Barts-MS Brain Health Challenge; have you signed-up to the challenge?"

Epub: Veldhuijzen van Zanten et al. Sedentary behaviour in people with multiple sclerosis: Is it time to stand up against MS? Mult Scler. 2016 Apr 12. pii: 1352458516644340.

Historically, people with multiple sclerosis (MS) have been considered sedentary, although the actual scientific study of sedentary behaviour in MS did not originate until 2011. Sedentary behaviour, which is conceptually distinct from physical inactivity, is defined as any waking activity characterised by an energy expenditure ⩽ 1.5 metabolic equivalents and in a sitting or reclining posture. In the general population, the volume of sitting time is associated with increased risks of morbidity and mortality, independent of physical activity, and has been suggested to carry a greater risk of mortality than smoking behaviour. There are many symptoms of MS (e.g. mobility disability and fatigue) that could increase the prevalence of sedentary behaviour, and sedentary behaviour may have considerable implications for the development of comorbid conditions prevalent in MS. This review provides a summary of the rates, correlates, consequences and interventions attempting to reduce sedentary behaviour in MS. We provide a research agenda that guides future research on sedentary behaviour in MS. This paper provides a clarion call that it is time to 'stand up against MS'.

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