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Physical fitness associated with improved cognition in multiple sclerosis

The benefits of exercise and being physically fit is what many people strive for.  However, a recent study added a new dimension to what exercise can do to enhance health.  In other words, exercise did more than keep a body fit.  It also made study participants think better.  You may ask, why is this new information important?  

 
Cognitive impairment is one of multiple scleroris (MS) ’s most disabling features and it can affect between 22% to 60% of people living with the disease.  Cognitive deficits may include problems with: slower information processing speed; memory impairment; difficulty with new learning and executive functioning.  Historically, medical and rehabilitation approaches to the problem have been inconsistent in improving cognition.
 
The new frontier of exercise for improved cognition provides hope. This study’s objective was to determine if there was an association between improvements in objective measures of physical fitness and performance on cognitive tests.
 
Participants were people with MS who participated in a telephone based health promotion intervention, chose to work on exercise, and who completed pre and post intervention assessments. Participants were then measured for strength, aerobic fitness, and cognition at baseline and 12 weeks later.
 
After controlling for variables such as age, gender, MS disease activity, MS type, etc. there was evidence suggesting that cognitive functioning changed over time based on level of fitness. Participants in the physically improved group showed improved performance on measures of executive functioning after 12 weeks of exercise.  The results of this study add support to the hypothesis that change in fitness is associated with improved executive functioning in people with MS. The desired outcomes are that improved cognition correlates with better quality of life, activities of daily living, vocational endeavors, and rehabilitation measures.
 
Where do we go from here? Since less is known about exercise training and cognition in MS (compared to studies demonstrating aerobic and strength training significantly improving cognitive functioning in older adults and people with mild cognitive impairment), we need more studies to examine this relationship in the MS population. 

MS Research Update: How reliable are biomarkers measured by multiple providers?

Mobility issues secondary to strength, balance, and walking problems affect up to 80 percent of people with multiple sclerosis (MS). Providers and therapists use a variety of scales and tools to measure the extent of these issues such as:

 

  • The Berg Balance Scale (BBS) is a measure of balance that uses a 14-item scale and is scored based upon the results 0-56.
  • The 6-minute walk (6MW) is a measure of walking endurance.
  • Handheld Dynamometry (HHD) is a way to quantify manual muscle strength testing.

 

There is a lot of emerging research about “MS biomarkers,” which are values that look for ways to predict how patients will do in the future. The above tests are “physical biomarkers” of patient performance that may be able to be used as measures of disease state and change over time.

 

Often patients and clinicians are left wondering how accurate the results of these tests are. For instance, if provider A performs a functional test on a patient, will provider B get the same results if administering the same test to the same patient?

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