Current perspectives on exercise training in the management of multiple sclerosis

Motl, Robert W.; Sandroff, Brian M.

doi:10.1080/14737175.2020.1796640

Cited by 14 publications

(5 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nonetheless, the present pilot RCT provides proof-of-concept data supporting REAER for improving functional mobility and CPS in PwMS, perhaps based on adaptive neuroplasticity. Subsequent exercise trials using REAER should pre-screen participants for impairments in both domains of functioning (Motl and Sandroff, 2020).…”

Section: Discussionmentioning

confidence: 99%

A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis

Androwis

Sandroff

Niewrzol

et al. 2021

Multiple Sclerosis and Related Disorders

Self Cite

View full text Add to dashboard Cite

Background: Co-occurring mobility and cognitive impairments are common, debilitating, and poorly-managed with pharmacological therapies in persons with multiple sclerosis (MS). Exercise rehabilitation (ER), particularly walking ER, has been suggested as one of the best approaches for managing these manifestations of MS. However, there is a focal lack of efficacy of ER on mobility and cognitive outcomes in persons with MS who present with substantial neurological disability. Such severe neurological disability oftentimes precludes the ability for participation in highly-intensive and repetitive ER that is necessary for eliciting adaptations in mobility and cognition. To address such a concern, robotic exoskeleton-assisted ER (REAER) might represent a promising intervention approach for managing co-occurring mobility and cognitive impairments in those with substantial MS disability who might not benefit from traditional ER. Methods: The current pilot single-blind, randomized controlled trial (RCT) compared the effects of 4-weeks of REAER with 4-weeks of conventional gait training (CGT) as a standard-of-care control condition on functional mobility (timed up-and-go; TUG), walking endurance (six-minute walk test; 6MWT), cognitive processing speed (CPS; Symbol Digit Modalities Test; SDMT), and brain connectivity (thalamocortical resting-state functional connectivity (RSFC) based on fMRI) outcomes in 10 persons with substantial MS-related neurological disability. Results: Overall, compared with CGT, 4-weeks of REAER was associated with large improvements in functional mobility (η p 2 =.38), CPS (η p 2 =.53), and RSFC between the thalamus and ventromedial prefrontal cortex (η p 2 =.72),but not walking endurance (η p 2 =.01). Further, changes in RSFC were moderately associated with changes in TUG, 6MWT, and SDMT performance, respectively, whereby increased thalamocortical RSFC was associated with improved functional mobility, walking endurance, and CPS (|ρ|>.36). Conclusion:The current pilot RCT provides initial support for REAER as an approach for improving functional mobility and CPS, perhaps based on adaptive and integrative central nervous system plasticity, namely increases in RSFC between the thalamus and ventromedial prefrontal cortex, in a small sample of persons with substantial MS disability. Such a pilot trial provides proof-of-concept data for the design and implementation of an appropriately-powered RCT of REAER in a larger sample of persons with MS who present with co-occurring impairments in both mobility and cognitive functioning.

show abstract

Section: Discussionmentioning

confidence: 99%

A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis

Androwis

Sandroff

Niewrzol

et al. 2021

Multiple Sclerosis and Related Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

“…Such research might further determine prognostic values of neuroimaging outcomes for predicting functional status in MS [17,18]. Using such observational evidence for hypothesis development and subsequent RCT design might be advantageous for steering clear of a generalized search for neural signals within exercise training research that involves neuroimaging in MS [19].…”

Section: Neural Correlates Of Functions Targeted In Exercise Training...mentioning

confidence: 99%

Neuroimaging Technology in Exercise Neurorehabilitation Research in Persons with MS: A Scoping Review

Sandroff

Rafizadeh

Motl

2023

Sensors

Self Cite

View full text Add to dashboard Cite

There is increasing interest in the application of neuroimaging technology in exercise neurorehabilitation research among persons with multiple sclerosis (MS). The inclusion and focus on neuroimaging outcomes in MS exercise training research is critical for establishing a biological basis for improvements in functioning and elevating exercise within the neurologist’s clinical armamentarium alongside disease modifying therapies as an approach for treating the disease and its consequences. Indeed, the inclusion of selective neuroimaging approaches and sensor-based technology among physical activity, mobility, and balance outcomes in such MS research might further allow for detecting specific links between the brain and real-world behavior. This paper provided a scoping review on the application of neuroimaging in exercise training research among persons with MS based on searches conducted in PubMed, Web of Science, and Scopus. We identified 60 studies on neuroimaging-technology-based (primarily MRI, which involved a variety of sequences and approaches) correlates of functions, based on multiple sensor-based measures, which are typically targets for exercise training trials in MS. We further identified 12 randomized controlled trials of exercise training effects on neuroimaging outcomes in MS. Overall, there was a large degree of heterogeneity whereby we could not identify definitive conclusions regarding a consistent neuroimaging biomarker of MS-related dysfunction or singular sensor-based measure, or consistent neural adaptation for exercise training in MS. Nevertheless, the present review provides a first step for better linking correlational and randomized controlled trial research for the development of high-quality exercise training studies on the brain in persons with MS, and this is timely given the substantial interest in exercise as a potential disease-modifying and/or neuroplasticity-inducing behavior in this population.

show abstract

“…Exercise and physical rehabilitation are the most prominent therapeutic approaches to promote synaptic plasticity and improve clinical recovery in patients with neurological deficits. Physical exercise has been suggested as an effective treatment strategy for people with MS [11][12][13], indeed studies in animal models of MS have demonstrated that different exercise paradigms, such as environmental enrichment-mimicking lifestyle interventions, voluntary and forced exercise, both preventive and therapeutic, can restore LTP expression and improve functional outcomes [14,15].…”

Section: Introductionmentioning

confidence: 99%

Preventive exercise and physical rehabilitation promote long‐term potentiation‐like plasticity expression in patients with multiple sclerosis

Stampanoni Bassi,

Gilio,

Buttari

et al. 2023

Euro J of Neurology

View full text Add to dashboard Cite

Background and purposeLoss of long‐term potentiation (LTP) expression has been associated with a worse disease course in relapsing–remitting multiple sclerosis (RR‐MS) and represents a pathophysiological hallmark of progressive multiple sclerosis (PMS). Exercise and physical rehabilitation are the most prominent therapeutic approaches to promote synaptic plasticity. We aimed to explore whether physical exercise is able to improve the expression of LTP‐like plasticity in patients with multiple sclerosis (MS).MethodsIn 46 newly diagnosed RR‐MS patients, we explored the impact of preventive exercise on LTP‐like plasticity as assessed by intermittent theta‐burst stimulation. Patients were divided into sedentary or active, based on physical activity performed during the 6 months prior to diagnosis. Furthermore, in 18 patients with PMS, we evaluated the impact of an 8‐week inpatient neurorehabilitation program on clinical scores and LTP‐like plasticity explored using paired associative stimulation (PAS). Synaptic plasticity expression was compared in patients and healthy subjects.ResultsReduced LTP expression was found in RR‐MS patients compared with controls. Exercising RR‐MS patients showed a greater amount of LTP expression compared with sedentary patients. In PMS patients, LTP expression was reduced compared with controls and increased after 8 weeks of rehabilitation. In this group of patients, LTP magnitude at baseline predicted the improvement in hand dexterity.ConclusionsBoth preventive exercise and physical rehabilitation may enhance the expression of LTP‐like synaptic plasticity in MS, with potential beneficial effects on disability accumulation.

show abstract

Current perspectives on exercise training in the management of multiple sclerosis

Cited by 14 publications

References 79 publications

A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis

A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis

Neuroimaging Technology in Exercise Neurorehabilitation Research in Persons with MS: A Scoping Review

Preventive exercise and physical rehabilitation promote long‐term potentiation‐like plasticity expression in patients with multiple sclerosis

Contact Info

Product

Resources

About