Use of Physical Therapy Services Among Middle-Aged and Older Adults With Multiple Sclerosis

Finlayson, Marcia; Plow, Matthew; Cho, Chi

doi:10.2522/ptj.20100072

Cited by 33 publications

(20 citation statements)

References 49 publications

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“…In 1,065 middle‐aged and older adults living with multiple sclerosis (MS), 88% experienced impaired balance (Finlayson, Plow, & Cho, ). It has been reported that 52% of people with MS sustain at least one fall to the ground within a 6‐month time frame (M. L. Finlayson, Peterson, & Cho, ).…”

Section: Introductionmentioning

confidence: 99%

Relationship between subjective visual vertical and balance in individuals with multiple sclerosis

Klatt

Sparto

Terhorst

et al. 2018

Physiotherapy Res Intl

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Subjective Visual Vertical (SVV) deviations have been correlated to abnormal cerebellar function in individuals diagnosed with Multiple Sclerosis (MS). It has been shown that individuals with MS have increased incidence of SVV abnormalities, yet this is not routinely tested in this population during physical therapy evaluation. Objective: To determine if there is a relationship between SVV and balance performance in people with MS who have cerebellar involvement. We hypothesize that individuals with greater SVV deviations will have worse balance performance. Methods: Fifteen females and 5 males [mean age 54.5 years old (± 7.03 SD)] with the diagnosis of MS and cerebellar involvement participated. Computerized SVV testing included rod and rod-and-frame conditions. None of the balance outcomes were correlated with the rod only condition. Because there was a difference in magnitude of results within the rod-and-frame condition, based on whether the frame was rotated clockwise (CW) or counter clockwise (CCW), they were analyzed independently. Results: For all 6 of the balance outcomes there was a statistically significant moderate correlation with SVV deviations when the frame was tilted CCW: Barthel Index (r=−.47, p=.018); Berg Balance Score (r=−.59, p=.003); gait velocity (r=−.52, p=.010); International Cooperative Ataxia Rating Scale (r=.56, p=.006); Scale for the Assessment and Rating of Ataxia (r=.62, p=.002); and Timed Up and Go (r=.58, p=.003). Interestingly, the Barthel Index was the only outcome that had statistical significance with a moderate correlation (r=−.66, p=.001) when the frame was rotated CW. In this cohort greater deviations during the rod-and-frame condition of SVV testing correlated with worse functional outcomes, especially when the frame was tilted CCW. Conclusion: Individuals with MS who demonstrate decreased balance performance may rely more heavily on visual backgrounds. Implementation of SVV assessment for individuals with MS may provide clinicians with valuable information to identify clinical interventions.

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Section: Introductionmentioning

confidence: 99%

Relationship between subjective visual vertical and balance in individuals with multiple sclerosis

Klatt

Sparto

Terhorst

et al. 2018

Physiotherapy Res Intl

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“…Some of those factors have been shown to negatively influence the walking speed of PwMS: muscle performance [9], sensorial function [10], habitual activity level [11], and disability [4]. Disability-related factors of PwMS were the primary indicators of use of physical therapy services [12]. …”

Section: Introductionmentioning

confidence: 99%

Factors for Lower Walking Speed in Persons with Multiple Sclerosis

Nogueira

Santos

Sabino

et al. 2013

Multiple Sclerosis International

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Objective. The purpose of this study was to analyze factors related to lower walking speed in persons with multiple sclerosis (PwMS). Methods. A cross-sectional survey was conducted. The study participants were 120 consecutive PwMS, who were able to walk, even with device assistance. Demographic and clinical data were collected. Walking speed was measured in 10 m walk test. Possible factors were assessed: disability, fatigue, visual functioning, balance confidence, physical activity level, walking impact, cognitive interference, and motor planning. A forward linear multiple regression analysis examined the correlation with lower speed. Results. Lower walking speed was observed in 85% of the patients. Fatigue (41%), recurrent falls (30%), and balance problems were also present, even with mild disability (average EDSS = 2.68). A good level of physical activity was noted in most of the subjects. Dual-task procedure revealed 11.58% of walking speed reduction. Many participants (69.57%) imagined greater walking speed than motor execution (mean ≥ 28.42%). Physical activity level was the only characteristic that demonstrated no significant difference between the groups (lower versus normal walking speed). Many mobility measures were correlated with walking speed; however, disability, balance confidence, and motor planning were the most significant. Conclusions. Disability, balance confidence, and motor planning were correlated with lower walking speed.

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“…No study to date has systematically explored the combined benefits of teaching fatigue management strategies and promoting physical activity. We also note that the population with MS may have limited access to health professionals who can adequately address problems related to fatigue and inactivity, particularly for those who reside in rural communities [23,24]. Therefore, using a telehealth approach to address the reciprocal relationship between MS fatigue and inactivity could increase the intervention’s accessibility and dissemination.…”

Section: Introductionmentioning

confidence: 99%

Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: rationale and research protocol

et al. 2012

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BackgroundChronic fatigue and inactivity are prevalent problems among individuals with multiple sclerosis (MS) and may independently or interactively have detrimental effects on quality of life and ability to participate in life roles. However, no studies to date have systematically evaluated the benefits of an intervention for both managing fatigue and promoting physical activity in individuals with MS. This study involves a randomized controlled trial to examine the effectiveness of a telehealth intervention that supports individuals with MS in managing fatigue and increasing physical activity levels.Methods/DesignA randomly-allocated, three-parallel group, time-series design with a social support program serving as the control group will be used to accomplish the purpose of the study. Our goal is to recruit 189 ambulatory individuals with MS who will be randomized into one of three telehealth interventions: (1) a contact-control social support intervention, (2) a physical activity-only intervention, and (3) a physical activity plus fatigue management intervention. All interventions will last 12 weeks and will be delivered entirely over the phone. Our hypothesis is that, in comparison to the contact-control condition, both the physical activity-only intervention and the physical activity plus fatigue management intervention will yield significant increases in physical activity levels as well as improve fatigue and health and function, with the physical activity plus fatigue management intervention yielding significantly larger improvements. To test this hypothesis, outcome measures will be administered at Weeks 1, 12, and 24. Primary outcomes will be the Fatigue Impact Scale, the Godin Leisure-Time Exercise Questionnaire (GLTEQ), and Actigraph accelerometers. Secondary outcomes will include the SF-12 Survey, Mental Health Inventory, Multiple Sclerosis Impact Scale, the Community Participation Indicator, and psychosocial constructs (e.g., self-efficacy).DiscussionThe proposed study is novel, in that it represents a multi-disciplinary effort to merge two promising lines of research on MS: fatigue management and physical activity promotion. Collectively, the proposed study will be the largest randomized controlled trial to examine the effects of a lifestyle physical activity intervention in people with MS.Trial registrationNCT01572714

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Use of Physical Therapy Services Among Middle-Aged and Older Adults With Multiple Sclerosis

Abstract: Factors associated with use of and need for physical therapy services reflect issues of access (geographical, referrals), MS status, and mobility difficulties.

Cited by 33 publications

References 49 publications

Relationship between subjective visual vertical and balance in individuals with multiple sclerosis

Relationship between subjective visual vertical and balance in individuals with multiple sclerosis

Factors for Lower Walking Speed in Persons with Multiple Sclerosis

Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: rationale and research protocol

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