Effects of an individual 12-week community-located “start-to-run” program on physical capacity,walking,fatigue,cognitive function,brain volumes,and structures in persons with multiple sclerosis

Abstract

Background:

Exercise therapy studies in persons with multiple sclerosis (pwMS) primarily focused on motor outcomes in mid disease stage, while cognitive function and neural correlates were only limitedly addressed.

Objectives:

This pragmatic randomized controlled study investigated the effects of a remotely supervised community-located “start-to-run” program on physical and cognitive function, fatigue, quality of life, brain volume, and connectivity.

Method:

In all, 42 pwMS were randomized to either experimental (EXP) or waiting list control (WLC) group. The EXP group received individualized training instructions during 12 weeks (3×/week), to be performed in their community aiming to participate in a running event. Measures were physical (VO_2max, sit-to-stand test, Six-Minute Walk Test (6MWT), Multiple Sclerosis Walking Scale-12 (MSWS-12)) and cognitive function (Rao’s Brief Repeatable Battery (BRB), Paced Auditory Serial Attention Test (PASAT)), fatigue (Fatigue Scale for Motor and Cognitive Function (FSMC)), quality of life (Multiple Sclerosis Impact Scale-29 (MSIS-29)), and imaging. Brain volumes and diffusion tensor imaging (DTI) were quantified using FSL-SIENA/FIRST and FSL-TBSS.

Results:

In all, 35 pwMS completed the trial. Interaction effects in favor of the EXP group were found for VO_2max, sit-to-stand test, MSWS-12, Spatial Recall Test, FSMC, MSIS-29, and pallidum volume. VO_2max improved by 1.5 mL/kg/min, MSWS-12 by 4, FSMC by 11, and MSIS-29 by 14 points. The Spatial Recall Test improved by more than 10%.

Conclusion:

Community-located run training improved aerobic capacity, functional mobility, visuospatial memory, fatigue, and quality of life and pallidum volume in pwMS.

Keywords

Multiple sclerosis running community walking cognitive function exercise neuroplasticity

Get full access to this article

View all access options for this article.

References

Veldhuijzen van Zanten

Pilutti

Duda

et al . Sedentary behaviour in people with multiple sclerosis: Is it time to stand up against MS? Mult Scler 2016; 22(10): 1250–1256.

Wens

Dalgas

Stenager

et al . Risk factors related to cardiovascular diseases and the metabolic syndrome in multiple sclerosis: A systematic review. Mult Scler 2013; 19: 1556–1564.

Pilutti

Platta

Motl

et al . The safety of exercise training in multiple sclerosis: A systematic review. J Neurol Sci 2014; 343: 3–7.

Latimer-Cheung

Pilutti

Hicks

et al . Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: A systematic review to inform guideline development. Arch Phys Med Rehabil 2013; 94: 1800–1828.

Pearson

Dieberg

Smart

Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: A meta-analysis. Arch Phys Med Rehabil 2015; 96: 1339–1348.e7.

Snook

Motl

RW.

Effect of exercise training on walking mobility in multiple sclerosis: A meta-analysis. Neurorehabil Neural Repair 2009; 23: 108–116.

Dalgas

Stenager

Exercise and disease progression in multiple sclerosis: Can exercise slow down the progression of multiple sclerosis?

Ther Adv Neurol Disord 2012; 5: 81–95.

Prosperini

Piattella

Gianni

et al . Functional and structural brain plasticity enhanced by motor and cognitive rehabilitation in multiple sclerosis. Neural Plast 2015; 2015: 481574.

Sandroff

Johnson

Motl

RW.

Exercise training effects on memory and hippocampal viscoelasticity in multiple sclerosis: A novel application of magnetic resonance elastography. Neuroradiology 2017; 59: 61–67.

10.

Leavitt

Cirnigliaro

Cohen

et al . Aerobic exercise increases hippocampal volume and improves memory in multiple sclerosis: Preliminary findings. Neurocase 2014; 20: 695–697.

11.

Kalron

Achiron

Dvir

Muscular and gait abnormalities in persons with early onset multiple sclerosis. J Neurol Phys Ther 2011; 35: 164–169.

12.

Kalron

Dvir

Givon

et al . Gait and jogging parameters in people with minimally impaired multiple sclerosis. Gait Posture 2013; 39(1): 297–302.

13.

Neven

Vanderstraeten

Janssens

et al . Understanding walking activity in multiple sclerosis: Step count, walking intensity and uninterrupted walking activity duration related to degree of disability. Neurol Sci 2016; 37(9): 1483–1490.

14.

Langeskov-Christensen

Heine

Kwakkel

et al . Aerobic capacity in persons with multiple sclerosis: A systematic review and meta-analysis. Sports Med 2015; 45: 905–923.

15.

Kos

Kerckhofs

Nagels

et al . Origin of fatigue in multiple sclerosis: Review of the literature. Neurorehabil Neural Repair 2007; 22(1): 91–100.

16.

Amato

Ponziani

Pracucci

et al . Cognitive impairment in early-onset multiple sclerosis. Pattern, predictors, and impact on everyday life in a 4-year follow-up. Arch Neurol 1995; 52: 168–172.

17.

Heine

van de Port

Rietberg

et al . Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev 2015; 9: CD009956.

18.

Briken

Gold

Patra

et al . Effects of exercise on fitness and cognition in progressive MS: A randomized, controlled pilot trial. Mult Scler 2014; 20: 382–390.

19.

Kalron

Zeilig

Efficacy of exercise intervention programs on cognition in people suffering from multiple sclerosis, stroke and Parkinson’s disease: A systematic review and meta-analysis of current evidence. Neurorehabilitation 2015; 37(2): 273–289.

20.

Sandroff

Motl

Scudder

et al . Systematic, evidence-based review of exercise, physical activity, and physical fitness effects on cognition in persons with multiple sclerosis. Neuropsychol Rev 2016; 26(3): 271–294.

21.

Prakash

Snook

Motl

et al . Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis. Brain Res 2010; 1341: 41–51.

22.

Motl

Pilutti

Hubbard

et al . Cardiorespiratory fitness and its association with thalamic, hippocampal, and basal ganglia volumes in multiple sclerosis. Neuroimage Clin 2015; 7: 661–666.

23.

Bansi

Bloch

Gamper

et al . Training in MS: Influence of two different endurance training protocols (aquatic versus overland) on cytokine and neurotrophin concentrations during three week randomized controlled trial. Mult Scler 2013; 19: 613–621.

24.

Rampello

Franceschini

Piepoli

et al . Effect of aerobic training on walking capacity and maximal exercise tolerance in patients with multiple sclerosis: A randomized crossover controlled study. Phys Ther 2007; 87: 545–555.

25.

Motl

Sandroff

BM.

Benefits of exercise training in multiple sclerosis. Curr Neurol Neurosci Rep 2015; 15: 62.

26.

Motl

Sandroff

DeLuca

Exercise training and cognitive rehabilitation: A symbiotic approach for rehabilitating walking and cognitive functions in multiple sclerosis?

Neurorehabil Neural Repair 2016; 30: 499–511.

27.

Hillman

Erickson

Kramer

AF.

Be smart, exercise your heart: Exercise effects on brain and cognition. Nat Rev Neurosci 2008; 9: 58–65.

28.

Hotting

Roder

Beneficial effects of physical exercise on neuroplasticity and cognition. Neurosci Biobehav Rev 2013; 37: 2243–2257.

29.

van den Berg

Dawes

Wade

et al . Treadmill training for individuals with multiple sclerosis: A pilot randomised trial. J Neurol Neurosurg Psychiatry 2006; 77: 531–533.

30.

Newman

Dawes

van den Berg

et al . Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: A pilot study. Mult Scler 2007; 13: 113–119.

31.

Schmidt

Wonneberger

Long-term endurance exercise improves aerobic capacity in patients with relapsing-remitting multiple sclerosis: Impact of baseline fatigue. J Neurol Sci 2014; 336: 29–35.

32.

Riazi

Thompson

Hobart

JC.

Self-efficacy predicts self-reported health status in multiple sclerosis. Mult Scler 2004; 10: 61–66.

33.

Goldman

Marrie

Cohen

JA.

Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls. Mult Scler 2008; 14: 383–390.

34.

Hobart

Riazi

Lamping

et al . Measuring the impact of MS on walking ability: The 12-item MS Walking Scale (MSWS-12). Neurology 2003; 60: 31–36.

35.

Moller

Bibby

Skjerbaek

et al . Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disabilrehabil 2012; 34: 2251–2258.

36.

Hobart

Lamping

Fitzpatrick

et al . The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain 2001; 124: 962–973.

37.

Penner

Raselli

Stocklin

et al . The Fatigue Scale for Motor and Cognitive Functions (FSMC): Validation of a new instrument to assess multiple sclerosis-related fatigue. Multscler 2009; 15: 1509–1517.

38.

Strober

Englert

Munschauer

et al . Sensitivity of conventional memory tests in multiple sclerosis: Comparing the Rao Brief Repeatable Neuropsychological Battery and the Minimal Assessment of Cognitive Function in MS. Mult Scler 2009; 15: 1077–1084.

39.

Boringa

Lazeron

Reuling

et al . The brief repeatable battery of neuropsychological tests: Normative values allow application in multiple sclerosis clinical practice. Mult Scler 2001; 7: 263–267.

40.

Gontkovsky

Vickery

Beatty

WW.

Construct validity of the 7/24 spatial recall test. Appl Neuropsychol 2004; 11: 75–84.

41.

Patenaude

Smith

Kennedy

et al . A Bayesian model of shape and appearance for subcortical brain segmentation. Neuroimage 2011; 56: 907–922.

42.

Smith

Jenkinson

Johansen-Berg

et al . Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion data. Neuroimage 2006; 31: 1487–1505.

43.

Geddes

Costello

Raivel

et al . The effects of a twelve-week home walking program on cardiovascular parameters and fatigue perception of individuals with multiple sclerosis: A pilot study. Cardiopulm Phys Ther J 2009; 20: 5–12.

44.

Romberg

Virtanen

Ruutiainen

et al . Effects of a 6-month exercise program on patients with multiple sclerosis: A randomized study. Neurology 2004; 63: 2034–2038.

45.

Katch

Sady

Freedson

Biological variability in maximum aerobic power. Med Sci Sports Exerc 1982; 14: 21–25.

46.

Petajan

Gappmaier

White

et al . Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39: 432–441.

47.

Schulz

Gold

Witte

et al . Impact of aerobic training on immune-endocrine parameters, neurotrophic factors, quality of life and coordinative function in multiple sclerosis. J Neurol Sci 2004; 225: 11–18.

48.

Platta

Ensari

Motl

et al . Effect of exercise training on fitness in multiple sclerosis: A meta-analysis. Arch Phys Med Rehabil 2016; 97: 1564–1572.

49.

Heine

Wens

Langeskov-Christensen

et al . Cardiopulmonary fitness is related to disease severity in multiple sclerosis. Mult Scler. 2016; 22: 231–238.

50.

Kileff

Ashburn

A pilot study of the effect of aerobic exercise on people with moderate disability multiple sclerosis. Clin Rehabil 2005; 19: 165–169.

51.

Ruano

Portaccio

Goretti

et al . Age and disability drive cognitive impairment in multiple sclerosis across disease subtypes. Mult Scler 2016; 23(9): 1258–1267.

52.

Sandroff

Pilutti

Benedict

et al . Association between physical fitness and cognitive function in multiple sclerosis: Does disability status matter? Neurorehabil Neural Repair 2015; 29: 214–223.

53.

Sandroff

Klaren

Pilutti

et al . Randomized controlled trial of physical activity, cognition, and walking in multiple sclerosis. J Neurol 2014; 261: 363–372.

54.

Langeskov-Christensen

Bisson

Finlayson

et al . Potential pathophysiological pathways that can explain the positive effects of exercise on fatigue in multiple sclerosis: A scoping review. J Neurol Sci 2017; 373: 307–320.

55.

Sebastiao

Hubbard

Klaren

et al . Fitness and its association with fatigue in persons with multiple sclerosis. Scand J Med Sci Sports 2016. Epub ahead of print 17 October 2017. DOI: 10.1111/sms.12752.

56.

Motl

Hubbard

Sreekumar

et al . Pallidal and caudate volumes correlate with walking function in multiple sclerosis. J Neurol Sci 2015; 354: 33–36.

57.

Motl

Zivadinov

Bergsland

et al . Thalamus volume and ambulation in multiple sclerosis: A cross-sectional study. Neurodegener Dis Manag 2016; 6: 23–29.

58.

Dalgas

Kjolhede

Gijbels

et al . Aerobic intensity and pacing pattern during the six-minute walk test in patients with multiple sclerosis. J Rehabil Med 2014; 46: 59–66.

59.

Learmonth

Motl

Sandroff

et al . Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurol 2013; 13: 37.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.10 MB

0.08 MB