Effects of a cooling vest with sham condition on walking capacity in heat-sensitive people with Multiple Sclerosis

Abstract

Purpose Heat sensitivity is a common contraindication in people with Multiple Sclerosis (pwMS), and physical fatigue is one of the most frequently reported symptoms that can affect quality of life. Increases in body temperature may exacerbate fatigue and heat-related symptoms. Decreasing body temperature via cooling devices may mitigate disease symptoms and improve physical abilities and quality of life. This study evaluates the effects of a cooling vest with sham condition on walking capacity using a commercially-available cooling vest specifically designed for pwMS. Methods A counter-balanced, cross-over design was used to assess the effects of a cooling vest (CryoVest Comfort, Cryo-Innov, France) (COLD) from a menthol-induced sham condition (CON) on ground walking time to exhaustion (T ex , s) and distance at exhaustion (D ex , m) in ambulatory pwMS. Secondary outcomes were heart rate (HR, bpm), thermal sensation (Tsens), skin chest (Tchest) and back (Tback) temperature. Results Ten females with Multiple Sclerosis (59 ± 9 years, EDSS 3.0-5.5) participated to the study. During COLD, pwMS walked significantly longer (1896 ± 602 vs. 1399 ± 404 s, p < 0.001) and farther (1879 ± 539 vs. 1302 ± 318 m, p < 0.001) than CON. Importantly, Tsens and HR at exhaustion were not significantly different between conditions, although Tchest (− 2.7 ± 1.8 °C, p < 0.01) and Tback (− 3.9 ± 1.8 °C, p < 0.001) were lower at volitional fatigue during COLD. Conclusion The lightweight cooling vest improved total walking time and distance in heat-sensitive pwMS. These physiological improvements were likely due to feeling perceptually cooler in the COLD trial, compared to the corresponding point of fatigue in the CON condition.

Effects of Tele-Pilates and Tele-Yoga on Biochemicals, Physical, and Psychological Parameters of Females with Multiple Sclerosis

“…In our study, a possible explanation for the improvements in physical activity and walking speed might be that tele-yoga may help by altering various factors such as reducing stress or tension in muscles, improving mobility, blood circulation, and flexibility in joints and tendons in female patients with MS, and also that the tele-Pilates exercise protocol improves functional factors such as balance, strength, and stability to enhance muscle capability and tolerability. In addition, improving muscle control through appropriate intra- and intermuscular contractions appears to be one of the major determinants of reduced walking speed in PwMS [ 73 ].…”

Thoughts on Fatigue in Multiple Sclerosis Patients

“…Regarding the management of fatigue symptomatology in PwMS, common pharmacological interventions include amantadine, modafinil (a wake-promoting agent that selectively works in the hypothalamic pathways), armodafinil, pemoline, and aspirin (reduction of inflammation and thermoregulation); however, a more recent systematic review of pharmacological interventions suggest the lack of strong evidence in the reduction of fatigue symptomatology (with the exception of modafinil) [21,22]. Additionally, fluoxetine is commonly prescribed for the management of MS fatigue-related symptomatology due to its neuroprotective action, even though its mechanism of action is not fully understood, and there is no strong evidence supporting its "anti-fatigue" action [23]. In contrast, educational and exercise interventions, energy conservation, and alternative forms of exercise such as yoga present supporting and strong evidence in reducing fatigue-related symptomatology [22].…”

“…In contrast, educational and exercise interventions, energy conservation, and alternative forms of exercise such as yoga present supporting and strong evidence in reducing fatigue-related symptomatology [22]. New technological advances like the cooling suit can help PwMS not only avoid any type of symptom exacerbation due to high ambient and core body temperatures but also exercise and stay active [23].…”