Wednesday, 21 June 2017

#NeuroSpeak & #BrainHealth: walking the talk

How competitive is your group when it comes to the health of your brain? #BrainHealth #NeuroSpeak

We have been promoting 'the holistic management of MS' and 'brain health' for sometime now, hoping that the wider MS community will take the message seriously. If you repeat things enough people may start to notice and say, yes I should do this.

Interestingly, I was made aware yesterday of a Novartis funded site ( to educate pwMS about brain health. Has anyone used the site? If yes, how did you find it? 

People with MS who exercise more and have higher self-rated health had lower levels of functional limitations 11 years later. Is this chicken or egg? Did the exercise result in better outcomes or did those pwMS who were doing well simply able to exercise more? Is this observation an association or is it causal? For this we need to do randomised trials or look to animal models and other data to make the case that exercise is actually good for you. It is clear that exercise is more than just a manifestation of being physically able; exercise has biological effects that change the way the brain functions. 

Based on these and other observations exercise should be classified as a DMT (disease-modifying treatment) for MS and that everyone with MS should be enrolled on an ongoing exercise programme of some description. It doesn't matter how disabled you are there is always a form of exercise that you will be able to perform. 

If you don't have MS and are reading this post, for example you may be a HCP, Scientist or Pharma Executive, you should also be doing regular exercise. The data linking regular exercise to a reduced risk of developing dementia, or age-related cognitive impairment, is overwhelming. The problem we face is that as our society gets more sedentary how do we get people to do more exercise? This is a big public health challenge. It is time to formalise our Barts-MS Brain Health Challenge into something more concrete? 

Jodi Haartsen, a MS Nurse Practitioner, from Australia contacted me over 2 years ago about setting up a platform so that Australian MS Healthcare professionals could compete against UK MS HCPs & pwMS. We can now make this happen. How?

Virgin Pulse an organisation that is trying to transform the cultures of the world's leading organisations and improve the health and performance of employees, launched the Global Challenge (formerly known as GCC). Virgin Pulse provides a technology solutions that promote employee engagement and well-being. The next Global Challenge starts 6th September 2017.

I am going to suggest that as many MS Units and Pharma teams take-up the challenge and compete with each other. We are prepared to curate a list of competing centres and groups. If you are prepared to join please register via the Google form below and register at Virgin Pulse.

When we surveyed readers when we raised the challenge, most of you were up to doing it. I hope nothing has changed.

Stuifbergen et al. Selected health behaviors moderate the progression of functional limitations in persons withmultiple sclerosis: Eleven years of annual follow-up. Disabil Health J. 2016 Jan 28. pii: S1936-6574(16)00008-X.

BACKGROUND: Multiple sclerosis (MS), a chronic neurological disease typically diagnosed in young adulthood, presents with a wide variety of symptoms, impairments and functional limitations. Given the chronic, unpredictable and long-term nature of this disease, preserving function is essential.

OBJECTIVE: The purpose of this study was to identify psychosocial and behavioral factors that might influence the trajectory of functional limitation through eleven years of longitudinal follow-up of a sample of persons with MS.

METHODS: Participants (N = 606) completed measures of health behaviors, related constructs and functional limitations annually over eleven years. Longitudinal measures of functional limitations were analyzed using random-effects regression that allows for study of individual differences in the trajectories of a measure. Using the best fitting quadratic growth model, we tested the within and between-person effects of Nutrition, Interpersonal Relationships, Exercise, Stress Management, Health Responsibilities, Spiritual Growth, Self-rated Health and Barriers, controlling for Age, Year since Diagnosis and Year of Dropout, on Functional Limitations in the 11th year.

RESULTS: After adjusting for covariates, higher mean scores for Exercise and Self-rated Health were related to lower levels of Functional Limitations in Year 11. Higher mean scores for Stress Management, Health Responsibilities and Barriers were related to higher levels of Functional Limitations in Year 11. Higher mean Exercise scores and lower mean Health Responsibilities scores were related to slower rates of progression of functional limitations in Year 11.

CONCLUSION: Findings suggest that the highly variable trajectory of functional limitations in MS may be extended and shaped through health behavior strategies.


  1. I think those home pedal exercisers would be good for pwMS and for those without MS. They cost from ten pounds upwards and people can sit in a chair to use it. Good for the legs and can also use it for exercising arms too. Might help with leg tightness?
    Less need to pay for a gym membership.

  2. > exercise has biological effects that change the way the brain functions.

    Yep, we know that professional soccer players develop ALS four times more often than controls, and effect is dose dependent, etc, so one could easily imagine that this neurodegeneration is not caused by excessive physical overload, but any physical activity consumes your irreplaceable resource to some degree instead. Is it biological effects we are looking for?..

  3. I think the point is oxygenation of the body/brain. I feel 10x better after exercising outdoors, particularly in cool weather. Household chores like vacuuming, on the other hand, does me no good at all. I think exercise outdoors slows my PPMS.

  4. I highly recommend considering Brazilian jiu jitsu for those who are able. Jiu jitsu combines flexibility, functional strength, and cardiovascular fitness and can be started at any age regardless of past athletic history. Typical jiu jitsu gyms are very supportive of all demographics and fitness levels. Thanks for bringing up the benefits of exercise and good luck with the Brain Health challenge!


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