Bennett_Cardiology_book_temp 15/02/2010 13:24 Page 70
Multiple Sclerosis
In the same year, Motl and Gosney
28
published a meta-analysis on the “rehabilitation is one of the treatments of MS patients and should be
effects of exercise training on quality of life. The cumulative evidence viewed as an ongoing process to maintain and restore maximum
supported that exercise training is associated with a small improvement function and quality of life.”
31
in quality of life among individuals with MS.
Conclusion
Most recently, in 2009 Asano et al.
29
identified 11 RCTs that were It is a well recognized fact that exercise is an important component in
acceptable to their methodological investigation and concluded that promoting health and wellness in the general population. For individuals
there was insufficient research in this area, making it difficult to guide living with MS, exercise and rehabilitative interventions play an
regular exercise prescription. Furthermore, the authors emphasized the important role in symptom management, enhancing cardiovascular
methodological challenges in these RCTs and the need for high-quality function and promoting motor recovery. RCTs are needed to
research to establish evidence for regular exercise and physical activity demonstrate specific neuro-rehabilitative techniques and exercise
prescription for persons with MS. interventions that result in improved function and motor recovery. n
Health and Wellness
Susan E Bennett, PT, DPT, EdD, NCS, MSCS, is a Clinical
“People with multiple sclerosis have a lifelong need for physiotherapy
Associate Professor in the Department of Rehabilitation
and exercise interventions due to the progressive nature of the Science and the Department of Neurology at the
disease and their greater risk of the complications of inactivity.”
30
A
University at Buffalo, State University of New York (SUNY),
where she also serves as Director of the Multiple Sclerosis
study has been initiated by Coote and colleagues in conjunction with
(MS) Comprehensive Care Center within the Jacobs
the Multiple Sclerosis Society of Ireland to examine which form of Neurological Institute. She has long been active in various
physical activity might optimize physical and quality of life outcomes
professional societies related to physical therapy and MS,
and chairs the Rehabilitation Research Interest Group of
for people living with MS. The study will examine the benefits of
the Consortium of MS Centers (CMSC) and is the Treasurer of the CMSC. Dr Bennett
physiotherapy, yoga, and exercise classes for their members. As received her BS in physical therapy from Daemen College (Buffalo), followed by an MS in
stated in the introduction, physical inactivity in itself may contribute to
health-science education and an EdD in health behavioral sciences, both from SUNY in
Buffalo. She recently completed her DPT from the University of Marymount Loyola. She
a worsening of symptoms in this population. If we can identify exercise
is a board- certified neurorehabilitation specialist through the American Board of
programs that optimize health and wellness, we can have a more Physical Therapy Specialists and is certified as an MS specialist by the CMSC.
positive impact on overall quality of life. As reported by Donze,
1. National MSS, Multiple Sclerosis Information Sourcebook, 12. Benedetti MG, et al., Treadmill exercise in early mutiple 23. Goodman AD, et al., Sustained-release oral fampridine in
Information Resource Center and Library of the National sclerosis: a case series study, Eur J Phys Rehabil Med, multiple sclerosis: a randomised, double-blind, controlled
Multiple Sclerosis Society, 2005. 2009;45(1):53–9. trial, Lancet, 2009;373(9665):732–8.
2. Motl RW, et al., Worsening of symptoms is associated with 13. Crayton H, et al., A multimodal approach to managing 24. Gold SM, et al., Basal serum levels and reactivity of nerve
lower physical activity levels in individuals with multiple symptoms of multiple sclerosis, Neurology, 2004;63(11): growth factor and brain-derived neurotrophic factor to
sclerosis, Mult Scler, 2008;14(1):140–42. S12–S18. standardized acute exercise in multiple sclerosis and
3. Rietberg MB, et al., Exercise therapy for multiple sclerosis, 14. Mathiowetz VG, et al., One-year follow-up to a randomized controls, J Neuroimmunol, 2003;138(1–2):99–105.
Cochrane Database Syst Rev, 2005(1). controlled trial of an energy conservation course for persons 25. White LJ, Castellano V, Exercise and brain health –
4. Gehlsen GM, et al., Effects of an aquatic fitness program on with multiple sclerosis, Int J Rehabil Res, 2007;30(4):305–13. Implications for multiple sclerosis – Part II – Immune factors
the muscular strength and endurance of patients with 15. Gentry T, PDAs as cognitive aids for people with multiple and stress hormones, J Sports Med, 2008;38(3):179–86.
multiple sclerosis, Phys Ther, 1984;64(5):653–7. sclerosis, Am J Occup Ther, 2008;62(1):18–27. 26. Baker NA,Tickle-Degnen L, The effectiveness of physical,
5. Chen WY, et al., Force–time measurements of knee muscle 16. Bovend’Eerdt TJ, et al., The effects of stretching in psychological, and functional interventions in treating
functions of subjects with multiple sclerosis, Phys Ther, spasticity: A systematic review, Arch Phys Med Rehabil, clients with multiple sclerosis: A meta-analysis, Am J Occup
1987;67(6):934–40. 2008;89(7):1395–1406. Ther, 2001;55(3):324–31.
6. Brar SP, et al., Evaluation of treatment protocols on minimal 17. Motl RW, et al., Effect of acute leg cycling on the soleus 27. Dalgas U, et al., Multiple sclerosis and physical exercise:
to moderate spasticity in multiple-sclerosis, Arch Phys Med H-reflex and modified Ashworth scale scores in individuals recommendations for the application of resistance-,
Rehabil, 1991;72(3):186–9. with multiple sclerosis, Neurosci Lett, 2006;406(3):289–92. endurance- and combined training, Mult Scler, 2008;14(1):
7. Petajan JH, et al., Impact of aerobic training on fitness and 18. Craig J, et al., A randomised controlled trial comparing 35–53.
quality of life in multiple sclerosis, Ann Neurol, 1996;39(4): rehabilitation against standard therapy in multiple sclerosis 28. Motl RW, Gosney JL, Effect of exercise training on quality
432–41. patients receiving intravenous steroid treatment, J Neurol of life in multiple sclerosis: a meta-analysis, Mult Scler,
8. White LJ, et al., Resistance training improves strength and Neurosurg Psychiatry, 2003;74(9):1225–30. 2008;14(1):129–35.
functional capacity in persons with multiple sclerosis, Mult 19. www.drugs.com/nda/fampridine_sr_090202.html (accessed 29. Asano M, et al., What does a structured review of the
Scler, 2004;10(6):668–74. November 29, 2009). effectiveness of exercise interventions for persons with
9. Gutierrez GM, et al. Resistance training improves gait 20. www.medscape.com/viewarticle/588839 (accessed multiple sclerosis tell us about the challenges of designing
kinematics in persons with multiple sclerosis, Arch Phys Med November 29, 2009). trials?, Mult Scler, 2009;15(4):412–21.
Rehabil, 2005;86(9):1824–9. 21. Goodman AD, et al., Fampridine-SR in multiple sclerosis: a 30. Coote S, et al., Getting the Balance Right: A randomised
10. Bjarnadottir OH, et al., Multiple sclerosis and brief moderate randomized, double-blind, placebo-controlled, dose-ranging controlled trial of physiotherapy and Exercise Interventions
exercise. A randomised study, Mult Scler, 2007;13(6):776–82. study, Mult Scler, 2007;13(3):357–68. for ambulatory people with multiple sclerosis, BMC Neurol,
11. van den Berg M, et al., Treadmill training for individuals with 22. Goodman AD, et al., Dose comparison trial of sustained- 2009;9.
multiple sclerosis: a pilot randomised trial, J Neurol Neurosurg release fampridine in multiple sclerosis, Neurology, 31. Donze C, Neurorehabilitation in multiple sclerosis: an
Psychiatry, 2006;77(4):531–3. 2008;71(15):1134–41. overview, Rev Neurol (Paris), 2007;163(6–7):711–19.
70 US NEUROLOGY
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100