BackgroundMultiple sclerosis (MS) can result in significant mental and physical symptoms, specially muscle weakness, abnormal walking mechanics, balance problems, spasticity, fatigue, cognitive impairment and depression. Patients with MS frequently decrease physical activity due to the fear from worsening the symptoms and this can result in reconditioning.Physicians now believe that regular exercise training is a potential solution for limiting the reconditioning process and achieving an optimal level of patient activities, functions and many physical and mental symptoms without any concern about triggering the onset or exacerbation of disease symptoms or relapse.Main bodyAppropriate exercise can cause noteworthy and important improvements in different areas of cardio respiratory fitness (Aerobic fitness), muscle strength, flexibility, balance, fatigue, cognition, quality of life and respiratory function in MS patients.Aerobic exercise training with low to moderate intensity can result in the improvement of aerobic fitness and reduction of fatigue in MS patients affected by mild or moderate disability.MS patients can positively adapt to resistance training which may result in improved fatigue and ambulation.Flexibility exercises such as stretching the muscles may diminish spasticity and prevent future painful contractions. Balance exercises have beneficial effects on fall rates and better balance.Some general guidelines exist for exercise recommendation in the MS population.The individualized exercise program should be designed to address a patient’s chief complaint, improve strength, endurance, balance, coordination, fatigue and so on.An exercise staircase model has been proposed for exercise prescription and progression for a broad spectrum of MS patients.ConclusionExercise should be considered as a safe and effective means of rehabilitation in MS patients. Existing evidence shows that a supervised and individualized exercise program may improve fitness, functional capacity and quality of life as well as modifiable impairments in MS patients.

ContextToday, different kinds of non-invasive body contouring modalities, including cryolipolysis, radiofrequency (RF), low-level laser therapy (LLLT), and high-intensity focused ultrasound (HIFU) are available for reducing the volume of subcutaneous adipose tissue or cellulite. Each procedure has distinct mechanisms for stimulating apoptosis or necrosis adipose tissue. In addition to the mentioned techniques, some investigations are underway for analyzing the efficacy of other techniques such as whole body vibration (WBV) and extracorporeal shockwave therapy (ESWT). In the present review the mechanisms, effects and side effects of the mentioned methods have been discussed. The effect of these devices on cellulite or subcutaneous fat reduction has been assessed.Evidence AcquisitionWe searched pubmed, google scholar and the cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to February 2015. The keywords were subcutaneous fat, cellulite, obesity, noninvasive body contouring, cryolipolysis, RF, LLLT, HIFU, ESWT and WBV with full names and abbreviations.ResultsWe included seven reviews and 66 original articles in the present narrative review. Most of them were applied on normal weight or overweight participants (body mass index < 30 kg/m2) in both genders with broad range of ages (18 to 50 years on average). In the original articles, the numbers of included methods were: 10 HIFU, 13 RF, 22 cryolipolysis, 11 LLLT, 5 ESWT and 4 WBV therapies. Six of the articles evaluated combination therapies and seven compared the effects of different devices.ConclusionsSome of the noninvasive body contouring devices in animal and human studies such as cryolipolysis, RF, LLLT and HIFU showed statistical significant effects on body contouring, removing unwanted fat and cellulite in some body areas. However, the clinical effects are mild to moderate, for example 2 - 4 cm circumference reduction as a sign of subcutaneous fat reduction during total treatment sessions. Overall, there is no definitive noninvasive treatment method for cellulite. Additionally, due to the methodological differences in the existing evidence, comparing the techniques is difficult.

On base of our results, it can be found that in short term lumbopelvic belt and information in treatment of pregnant women with pelvic girdle pain is superior to exercise plus information or information alone.

Background:Muscle weakness and fatigue contribute to the reduction of daily activity in multiple sclerosis (MS) patients. Therapeutic strategies to promote improvements in muscle strength and endurance are limited in individuals with MS. Some evidence showed that exercise may improve and affect different aspects of the disease including quality of life, fatigue, motor and cognitive functions.Objectives:To investigate the value of resistance training of moderate to high intensity on motor function, muscle strength, balance and perceived disability in male patients with multiple sclerosis compared to a control group.Patients and Methods:20 male patients with MS (mean ± SD, age: 34.05 ± 7.8 y; Expanded Disability Status Scale (EDSS): 2.94 ± 1.5) were recruited and randomized either to the exercise (E) or control group (C). Group E participated in a three-time weekly individualized progressive resistance-training program (both upper and lower extremities) for eight weeks, while group C was advised not to change their physical activity habits. All initial measures (including EDSS, balance, muscle strength, and functional mobility) were re-evaluated at the end of the program.Results:Two patients of group E left the program. The other eight subjects completed the program with no MS-related exacerbations/complications. There was a significant change in 2 of 3 aspects of ambulatory function [Three minutes step test (P = 0.001), Timed Up and Go test (P = 0.009)], muscle strength (P = 0.000), and EDSS (P = 0.014). Comparing the two groups, we did not observe any significant change in “Balance” (P = 0.407).Conclusions:The resistance training of moderate to high intensity was well-tolerated in MS patients and may be an effective intervention for improving muscle strength, functional ability and EDSS-based disease severity.