NeuroRehabilitation - Volume 45, issue 1

Authors: Keytsman, Charly | Hansen, Dominique | Wens, Inez | Eijnde, Bert O.

Article Type: Research Article

Abstract: BACKGROUND: Persons with Multiple Sclerosis have elevated resting serum lactate concentrations compared to healthy controls (HC). OBJECTIVE: To evaluate lactate concentrations during acute exercise and/or following training in MS compared to HC. METHODS: In this retrospective study, blood lactate concentrations (mmol/l) originating from two previous studies were analyzed. Lactate concentrations originated from acute submaximal (MSsubmax ; HC, n  = 11; MS, n  = 32) or maximal (MSmax ; HC, n  = 20; MS, n  = 24) exercise tests and following a 24-week mild to moderate intensity (MSsubmax , n  = 12) or 12-week high intensity interval (MSmax , n  = 13) exercise …intervention. RESULTS: Under submaximal conditions in MS and compared to HC, lactaterest (MS: 2.7±0.6 vs HC: 2.3±0.7 was significantly (p  < 0.05) elevated. After 24 weeks of mild-to-moderate-intensity exercise training and compared to PRE-values, lactatebout2 (2.5±0.7 vs 3.4±1.1) significantly (p  < 0.05) decreased during submaximal testing in MSsubmax . Under maximal conditions, lactatestart (2.3±1.0 vs 1.7±0.9) was significantly (p  > 0.05) elevated in MS. Twelve weeks of high intensity interval training did not improve this (p  > 0.05). CONCLUSIONS: Under the conditions of this retrospective analysis we conclude that lactate concentrations during acute submaximal and maximal exercise in persons with MS are similar compared to healthy controls. Moderate intensity exercise therapy appeared to improve lactate accumulation but high intensity exercise therapy did not. Show more

Keywords: Multiple sclerosis, rehabilitation, lactate, endurance training, interval training

DOI: 10.3233/NRE-192740

Citation: NeuroRehabilitation, vol. 45, no. 1, pp. 99-106, 2019

Authors: Al-Sharman, Alham | Khalil, Hanan | El-Salem, Khalid | Aldughmi, Mayis | Aburub, Aseel

Article Type: Research Article

Abstract: BACKGROUND: Sleep disturbances are highly prevalent in people with multiple sclerosis(MS), and are associated with pain, fatigue, depression, and reduced quality of life (QoL). Importantly, sleep has been considered a critical brain state for motor learning and memory consolidation. Therefore, interventions that target sleep managementin people with MS are needed. OBJECTIVES: To explore the effects of a six weeks moderate-intensity aerobic exercise intervention on sleep characteristics and sleep-related biomarkers specifically serotonin, melatoninand cortisol in people with MS using a pilot randomized controlled trial. METHODS: Participants were randomly allocated to either a moderate-intensity aerobic exercise program (MAE, …n  = 20) or a home exercise program (HEP, n  = 20). Participants were assessed at baseline and follow-up. Subjective and objective measures were used to assess sleep quality. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to subjectively assess sleep. While Actigraphy was used to objectivelyassess sleep. Blood samples were collected for measurement of cortisol, melatonin and serotonin from MS participants in both groups at 8:00 am±1 hour. RESULTS: Seventeen participants in the MAE and 13 in the HEP group completed the study. Compared to the HEP group, people with MS who participated in a moderate-intensity aerobic exercise experienced significant improvements (P  < 0.05) on the PSQI, ISI, and several objective sleep parameters measured using actigraphy. Only the serotonin levels increased significantly over the six-week period in the MAE group compared to the HEP group. The change score in serotonin (from baseline to follow up assessment) was significantly correlatedwith the change score in PSQI (r  = –0.97, p  < 001) and the change score in ISI (r  = –0. 56, p  = 0.015) only in the MAE group but not the HEP group. CONCLUSIONS: Exercise may be a non-pharmacological, inexpensive, safe method to improve sleep quality in people with MS. The improvement in the serotonin level due to aerobic exercisemight explain one of the physiologic mechanisms driving these improvements. Show more

Keywords: Multiple sclerosis, sleep, motor training, rehabilitation

DOI: 10.3233/NRE-192748

Citation: NeuroRehabilitation, vol. 45, no. 1, pp. 107-115, 2019

Authors: Donia, Scott A. | Allison, David J. | Gammage, Kimberley L. | Ditor, David S.

Article Type: Research Article

Abstract: BACKGROUND: Spinal cord injury (SCI) and multiple sclerosis (MS) are associated with increased risks of depression. Acute exercise may improve mood in these populations via its affect on inflammation. OBJECTIVE: To determine if acute exercise can positively affect mood in individuals with SCI and MS, and whether exercise-induced changes in inflammation contribute to such improvements. METHODS: Thirteen participants completed 30 minutes of moderate-intensity exercise. Mood data (POMS questionnaire) and blood samples were taken before and after exercise, and blood was analyzed for inflammatory mediators and kynurenine pathway metabolites. RESULTS: There was a significant reduction …in total mood disturbance (TMD) pre to post-exercise, and pre to one-hour post-exercise. There was a significant decrease in TNF-α from pre to post-exercise, with further reductions one-hour post-exercise. There were no correlations between changes in TMD and changes in inflammation. However, changes in certain cytokines showed significant or trending correlations with changes in subsets of the POMS. Likewise, there was a trend for a correlation between exercise-induced changes in KYN/TRP and depression (p  = 0.096). CONCLUSIONS: Acute exercise can positively affect mood after SCI and MS, and this change may be partially accounted for by exercise-induced changes in inflammation. This relationship may be, in part, kynurenine pathway-dependent. Show more

Keywords: Exercise, mood, inflammation, spinal cord injury, multiple sclerosis, kynurenine pathway

DOI: 10.3233/NRE-192773

Citation: NeuroRehabilitation, vol. 45, no. 1, pp. 117-124, 2019

Authors: Olivares, Adriana | Comini, Laura | Orfano, Jacopo | Froldi, Marcello | Vezzadini, Giuliana

Article Type: Research Article

Abstract: BACKGROUND: Physical exercise combined with occupational therapy (OT) can lead to a global improvement in personal well-being. OBJECTIVE: To assess in PD patients: 1) if a rehabilitation program involving OT, Nordic walking (NW) and therapeutic touch (TT) yields motor/non-motor benefits; 2) if the time collocation of OT within the program influences results. METHODS: This is a pilot study on 17 PD patients undergoing a 10-week rehabilitation program consisting of OT, NW and TT. Patients were randomized to receive OT in the first [Group 1, n  = 8] vs. last five weeks [Group 2, n  = 9] of the …program. Scales (MMSE, FAB, BDI, UPDRS II and III, PDQ39 and AES-S) and 6MWT, Gait speed and length were assessed at three time-points. RESULTS: Thirteen out of 17 patients were analyzed. 6MWT, Gait speed and length improved in time without between-group differences (p  < 0.05) as did UPDRII, UPDRSIII, FAB and PDQ39 (p  < 0.05). Baseline UPDRS II and III significantly determined Δ 6MWT (adjusted R2  = 0.6738) and Δ GAIT speed (R2  = 0.6746) at multiple regression, while Δ GAIT length showed the best regression (adjusted R2  = 0.8247) with impact of age, gender and baseline PDQ39 (ADL and cognition dimensions). CONCLUSIONS: Multidisciplinary rehabilitation including OT can improve motor and non-motor conditions in PD patients. The OT time-collocation at beginning or end of the rehabilitation program does not significantly affect results. Show more

Keywords: Parkinson’s disease, occupational therapy, Nordic walking, multidisciplinary rehabilitation, outcome

DOI: 10.3233/NRE-192772

Citation: NeuroRehabilitation, vol. 45, no. 1, pp. 125-134, 2019

Authors: Engkasan, Julia Patrick

Article Type: Other

Abstract: The aim of this commentary is to discuss in a rehabilitation perspective the recently published Cochrane Review “Vitamin D for the management of multiple sclerosis” by Jagannath et al. (2018) 1 under the direct supervision of Cochrane Multiple Sclerosis and rare diseases of the CNS Group. This Cochrane Corner is produced in agreement with NeuroRehabilitation by Cochrane Rehabilitation.

DOI: 10.3233/NRE-189008

Citation: NeuroRehabilitation, vol. 45, no. 1, pp. 135-136, 2019