Exploring the role of physical activity and exercise for managing vascular comorbidities in people with multiple sclerosis: A scoping review

Ewanchuk, Benjamin W.; Gharagozloo, Marjan; Peelen, Evelyn; Pilutti, Lara A.

doi:10.1016/j.msard.2018.08.022

Cited by 26 publications

(22 citation statements)

References 71 publications

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“…Our outcome is in agreement with previous studies that did not demonstrate a relationship between PA with being overweight or obese, based on BMI [14][15][16]. Furthermore, the recent review of Ewanchuk et al strengthens this line of evidence [17]. The authors…”

Section: Discussionsupporting

confidence: 93%

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Kalron

2020

IJERPH

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(1) Purpose: Conflicting information exists regarding the relationship between obesity, leisure-time physical activity (PA), and disability in people with multiple sclerosis (PwMS). We aimed to investigate the association between leisure-time PA and weight status in a relatively large cohort of PwMS. Furthermore, we examined this relationship according to the level of neurological disability. (2) Methods: The study included 238 PwMS (138 women) with a mean Expanded Disability Status Scale (EDSS) score of 2.5 (standard deviation [SD] = 1.7), mean disease duration of 6.4 (SD = 8.2) years, and mean age of 40.5 (SD = 12.9) years. Obesity was defined using two different metrics, each based on body mass index (BMI). Leisure-time PA was determined by the Godin–Shephard leisure-time PA questionnaire. Statistical analyses included multivariate logistic regression, the chi-square test, and Pearson coefficient correlations. (3) Results: The unadjusted odds ratio (OR) between leisure-time PA and BMI based on the World Health Organization’s (WHO) definition was 1.070 (p = 0.844) for overweight and 1.648 (p = 0.254) for obesity. The adjusted OR was 1.126 (p = 0.763) for overweight and 1.093 (p = 0.847) for obesity after adjustment for age, gender, and disability status. Chi-square analysis revealed no significant correlation between leisure-time PA and obesity (p = 0.564) according to the BMI threshold for PwMS. The unadjusted OR (95% confidence interval [CI]) between disability level and BMI based on the WHO definition was 1.674 (p = 0.220) for overweight and 0.618 (p = 0.460) for obesity. The adjusted OR was 1.130 (p = 0.787) for overweight and 0.447 (p = 0.234) for obesity after adjustment for age, gender, and leisure-time PA. Similarly, chi-square analysis revealed no significant correlation between disability level and obesity (p = 0.701) per the BMI threshold for PwMS. (4) Conclusions: No association was found between leisure-time PA and BMI in PwMS. An additional finding was the absence of any association between obesity and neurological disability level in the multiple sclerosis cohort.

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Section: Discussionsupporting

confidence: 93%

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Kalron

2020

IJERPH

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“…A 12-weeks course of high-intensity aerobic exercise, in combination with resistance training, was found to improve glucose tolerance in persons with MS (96). According to a systematic review, physical training interventions in persons with MS improve the vascular risk factors and may be considered as a therapeutic strategy for managing vascular comorbidities (97). There is strong evidence that smoking-apart from being a strong risk factor for vascular and pulmonary diseases-increases the EDSS score (98), so smoking cessation is strongly recommended.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity in Multiple Sclerosis

2020

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Comorbidities in patients with multiple sclerosis (MS) has become an area of increasing interest in the recent years. A comorbidity is defined as any additional disease that coexists in an individual with a given index disease and that is not an obvious complication of the index disease. The aim of this review is to describe the current evidence regarding the range of comorbidities in the population with MS reported in different countries and the current knowledge about the influence of comorbidities on the clinical features and therapeutic challenges in MS. Certain comorbidities are more prevalent in people with MS such as depression, anxiety, cerebro-and cardiovascular diseases, and certain autoimmune disorders such as diabetes, thyroid disease, and inflammatory bowel disease. A previous perception of a trend toward a lower overall risk of cancer in patients with MS appears to be challenged, but there is no evidence on any higher occurrence of malignancies in the population with MS. Comorbidities may modify the clinical presentation of MS, and have implications for treatment choice, adherence, and outcome. Several comorbid conditions are associated with increased disability progression, including diabetes, hypertension, and chronic obstructive pulmonary disease. Comorbidities are common in MS from the time of diagnosis and may account for some of the heterogeneity observed in MS, including diagnostic delay, clinical presentation, degree of disability progression, rate of health care utilization, working ability, employment status, and quality of life. Coexisting diseases and polypharmacy increase the complexity of patient management and poses major challenges, particularly with the increasing number of immunosuppressive disease-modifying therapies.

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“…Although the effectiveness of rehabilitation and pharmacological interventions for MS has improved substantially in the recent decades, these interventions are only aimed at delaying the progress of the disease [ 4 ]. Physical exercise has been consistently demonstrated to have therapeutic effects in MS subjects, as it improves MS-associated motor and cognitive symptoms, including muscle weakness [ 5 , 6 ], balance and coordination [ 7 , 8 ], muscle fatigue [ 9 , 10 ], vascular and metabolic comorbidities [ 11 , 12 ], cognitive/motor dysfunction [ 13 , 14 ], and more recently the pathophysiology of the disease [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of a Combined Program of Strength and Dual Cognitive-Motor Tasks in Multiple Sclerosis Subjects

Gutiérrez-Cruz

Rojas-Ruiz

Márquez

et al. 2020

IJERPH

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This study investigated the effects of a 24-week combined training program (CTP) based on strength exercises and cognitive–motor tasks performed concurrently in participants with multiple sclerosis. A randomized, controlled intervention study was carried out. In total, 31 subjects with a confirmed diagnosis of multiple sclerosis (14 men and 17 women) were stratified and randomized into an intervention group (17 subjects) and a control group (14 subjects). The intervention group completed three weekly training sessions for 24 weeks, while the control group pursued their normal daily activities. In this program, cognitive–motor tasks were completed at once (dual tasking). A 3D photogrammetry connected to a selective attention system designed for dual tasking while walking was used. Ground reaction forces were measured using two force plates, one for sit-to-stand testing, while the other was used for static force measurement. Postural equilibrium was examined using a stabilometric plate based for Romberg test assessment. The 24-week training program for multiple sclerosis patients improved their static peak force by 11% (p < 0 .05), their rate of force development by 36% (p < 0.05), and their balance (p < 0.05). Performance in daily activities such as walking or sitting-to-standing improved significantly in multiple sclerosis participants. CTP training was effective in reducing the dual-task costs of step length (48%) and walking velocity (54%), as compared to a matched control group.

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Exploring the role of physical activity and exercise for managing vascular comorbidities in people with multiple sclerosis: A scoping review

Cited by 26 publications

References 71 publications

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Comorbidity in Multiple Sclerosis

Effect of a Combined Program of Strength and Dual Cognitive-Motor Tasks in Multiple Sclerosis Subjects

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