Worsening of symptoms is associated with lower physical activity levels in individuals with multiple sclerosis

Motl, Robert W.; Arnett, Peter A.; Smith, Megan M.; Barwick, Fiona H.; Ahlstrom, Brian P.; Stover, Elaina

doi:10.1177/1352458507079126

Cited by 102 publications

(61 citation statements)

References 10 publications

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“…The attitudes of people with MS toward the benefits of PA can be influenced by patterns of disease progression. 11,50 Thus, participants may have experienced an increase in symptoms or a disease exacerbation, and then concluded that Wii Fit was not effective and stopped playing it.…”

Section: Discussionmentioning

confidence: 99%

Potential Benefits of Nintendo Wii Fit Among People with Multiple Sclerosis

Plow

Finlayson

2011

International Journal of MS Care

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We examined the potential of Nintendo Wii Fit (Nintendo Co, Ltd, Kyoto, Japan) to increase physical activity (PA) behavior and health among people with multiple sclerosis (MS). The study consisted of a repeated-measures design with a baseline control period and involved 30 people with MS who had the ability to walk 25 feet with or without a cane (26 individuals were included in the analyses). Nintendo Wii was set up in the homes of participants, who were prescribed a Wii Fit exercise program lasting 14 weeks, 3 days a week. The Physical Activity and Disability Survey, Modified Fatigue Impact Scale, and 36-item Short Form Health Status Survey were administered three times before participants gained access to Wii Fit (control period, at 2-week intervals), and three times after they received Wii Fit (posttest 1: immediately after; posttest 2: 7 weeks after; posttest 3: 14 weeks after). Mobility, balance, strength, and weight were assessed at the first pretest, immediately prior to obtaining access to Wii Fit, and 7 weeks after obtaining access to Wii Fit. Results from the questionnaires indicated that PA significantly improved at week 7, but at week 14, PA levels declined relative to week 7 and the difference was no longer significant compared with the control period. Physical assessments indicated that balance and strength significantly improved at week 7. One adverse event was reported (repetitive knee injury). Physical assessments indicated that people with MS may be able to improve their fitness levels by using Wii Fit. Future studies should incorporate behavior change strategies to promote long-term use of Wii Fit, and explore whether individuals with more severe symptoms of MS can safely use Wii Fit. Int J MS Care. 2011;13:21-30.

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Section: Discussionmentioning

confidence: 99%

Potential Benefits of Nintendo Wii Fit Among People with Multiple Sclerosis

Plow

Finlayson

2011

International Journal of MS Care

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“…2,3 In HC, physical inactivity is associated with an increased risk of the metabolic syndrome, 4-10 a term describing the combined presence of the cardiovascular risk factors hypertension, dyslipidemia, elevated glucose concentrations and obesity. 11 Many metabolic syndrome patients also suffer from insulin resistance, which confers an increased risk of developing type II diabetes, which in turn increases the cardiovascular disease (CVD) risk markedly.…”

Section: Introductionmentioning

confidence: 99%

Risk factors related to cardiovascular diseases and the metabolic syndrome in multiple sclerosis – a systematic review

et al. 2013

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Despite many epidemiological studies examining comorbidity in people with multiple sclerosis (pMS), there are conflicting opinions on whether pMS are at more or less risk of cardiovascular disease (CVD) and the metabolic syndrome compared with the general population. As pMS can now expect longer survival, this as an important question both at an individual and public health level. This study aimed to systematically review the literature linking MS to CVD risks and to the risk factors constituting the metabolic syndrome. This systematic review is based on a comprehensive literature search of six databases (Swemed+, Pubmed, Embase, Cochrane, PEDro and CINAHL). In total 34 studies were identified. Despite the high number of identified papers, only limited and inconsistent data exist on the risk factors of the metabolic syndrome and MS. Overall, the data suggest an increased CVD risk in pMS. From the existing studies it is not clear whether the increased risk of CVD is related to an increased risk of obesity or changes in body composition, hypertension, dyslipidemia or type II diabetes in pMS, indicating the need for future research in the field, if we are to advise pMS adequately in avoiding preventable comorbidity.

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“…A growing body of research has identified symptoms as a correlate of physical activity in MS. [9][10][11][12] Those studies have reported a moderate inverse association whereby the number, frequency, intensity, and worsening of symptoms are associated with reduced physical activity. Only one of the studies accounted for the possible confounding influence of neurological impairment, and controlling for neurological impairment based on EDSS scores did not weaken the relationship between the dichotomous worsening of symptoms and selfreported physical activity in the small sample (N = 51) of individuals with MS. 10 By comparison, the current study included a much larger sample (N = 292) and indicated that controlling for neurological impairment based on PDDS scores attenuated the association between symptoms and physical activity.…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms are perceived indicators of change in normal functioning, sensation, or appearance 8 and have been identified as a correlate of physical activity in people with MS. [9][10][11][12] For example, one study reported that worsening of overall symptoms across a 3-to 5-year period was independently and negatively associated with self-reported levels of physical activity. 10 Other studies indicated that a higher number, frequency, or intensity of overall symptoms was directly and indirectly associated with lower levels of physical activity and with indirect-pathway-involved mediator variables such as difficulty walking 11 or self-efficacy for physical activity.…”

mentioning

confidence: 99%

“…10 Other studies indicated that a higher number, frequency, or intensity of overall symptoms was directly and indirectly associated with lower levels of physical activity and with indirect-pathway-involved mediator variables such as difficulty walking 11 or self-efficacy for physical activity. 9,12 Neurological impairment defined by Expanded Disability Status Scale (EDSS) 13 or Patient-Determined Disease Step (PDDS) 14,15 scores may play a role in the relationship between symptoms and physical activity by acting as either a confounder or a moderator variable. Confounders change the relationship between two variables because the confounder is jointly related to both variables and may falsely obscure or accentuate the relationship.…”

mentioning

confidence: 99%

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