Exercise as Medicine in Multiple Sclerosis—Time for a Paradigm Shift: Preventive, Symptomatic, and Disease-Modifying Aspects and Perspectives

Dalgas, Ulrik; Langeskov‐Christensen, Martin; Stenager, Egon; Riemenschneider, Morten; Hvid, Lars G.

doi:10.1007/s11910-019-1002-3

Cited by 194 publications

(170 citation statements)

References 127 publications

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“…Regardless of our results, we find it important to notice that the benefits of PA in PwMS have been well documented [23]. PA beneficially affects a variety of MS symptoms (i.e., fatigue, mobility, depressive symptoms, muscle strength, and quality of life).…”

Section: Discussioncontrasting

confidence: 52%

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Kalron

2020

IJERPH

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(1) Purpose: Conflicting information exists regarding the relationship between obesity, leisure-time physical activity (PA), and disability in people with multiple sclerosis (PwMS). We aimed to investigate the association between leisure-time PA and weight status in a relatively large cohort of PwMS. Furthermore, we examined this relationship according to the level of neurological disability. (2) Methods: The study included 238 PwMS (138 women) with a mean Expanded Disability Status Scale (EDSS) score of 2.5 (standard deviation [SD] = 1.7), mean disease duration of 6.4 (SD = 8.2) years, and mean age of 40.5 (SD = 12.9) years. Obesity was defined using two different metrics, each based on body mass index (BMI). Leisure-time PA was determined by the Godin–Shephard leisure-time PA questionnaire. Statistical analyses included multivariate logistic regression, the chi-square test, and Pearson coefficient correlations. (3) Results: The unadjusted odds ratio (OR) between leisure-time PA and BMI based on the World Health Organization’s (WHO) definition was 1.070 (p = 0.844) for overweight and 1.648 (p = 0.254) for obesity. The adjusted OR was 1.126 (p = 0.763) for overweight and 1.093 (p = 0.847) for obesity after adjustment for age, gender, and disability status. Chi-square analysis revealed no significant correlation between leisure-time PA and obesity (p = 0.564) according to the BMI threshold for PwMS. The unadjusted OR (95% confidence interval [CI]) between disability level and BMI based on the WHO definition was 1.674 (p = 0.220) for overweight and 0.618 (p = 0.460) for obesity. The adjusted OR was 1.130 (p = 0.787) for overweight and 0.447 (p = 0.234) for obesity after adjustment for age, gender, and leisure-time PA. Similarly, chi-square analysis revealed no significant correlation between disability level and obesity (p = 0.701) per the BMI threshold for PwMS. (4) Conclusions: No association was found between leisure-time PA and BMI in PwMS. An additional finding was the absence of any association between obesity and neurological disability level in the multiple sclerosis cohort.

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Section: Discussioncontrasting

confidence: 52%

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Kalron

2020

IJERPH

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“…Therefore, we raise several speculations. Firstly, during the past two decades an increasing amount of scientific data has emphasized the benefits of PA in PwMS [10]. Benefits of PA have shown not only symptomatic relief but also disease-modifying effects [11].…”

Section: Discussionmentioning

confidence: 99%

Physical activity behavior in people with multiple sclerosis during the COVID-19 pandemic in Israel: Results of an online survey

Kalron

Dolev

Greenberg-Abrahami

et al. 2021

Multiple Sclerosis and Related Disorders

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“…Meta-analyses and systematic reviews of randomized controlled trials have demonstrated that people with MS who engage in exercise and lifestyle physical activity experience benefits from immune cell through quality-of-life outcomes. 8 , 9 Furthermore, exercise and lifestyle physical activity are safe for people with MS. 10 While initial studies established exercise as an effective symptomatic treatment (tertiary prevention), more recent studies have evaluated the disease-modifying effects (secondary prevention) as well as the impact on the risk of developing MS (primary prevention)—explaining why exercise and physical activity have been suggested as “medicine in MS.” 11 …”

Section: Introductionmentioning

confidence: 99%

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

et al. 2020

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Objectives: To provide clinicians who treat multiple sclerosis (MS) patients with evidence-based or expert opinion–based recommendations for promoting exercise and lifestyle physical activity across disability levels. Methods: The National MS Society (“Society”) convened clinical and research experts in the fields of MS, exercise, rehabilitation, and physical activity to (1) reach consensus on optimal exercise and lifestyle physical activity recommendations for individuals with MS at disability levels 0–9.0 on the Expanded Disability Status Scale (EDSS) and (2) identify and address barriers/facilitators for participation. Recommendations: Based on current evidence and expert opinion, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers: Healthcare providers should endorse and promote the benefits/safety of exercise and lifestyle physical activity for every person with MS. Early evaluation by a physical or occupational therapist or exercise or sport scientist, experienced in MS (hereafter referred to as “specialists”), is recommended to establish an individualized exercise and/or lifestyle physical activity plan. Taking into account comorbidities and symptom fluctuations, healthcare providers should encourage ⩾150 min/week of exercise and/or ⩾150 min/week of lifestyle physical activity. Progress toward these targets should be gradual, based on the person’s abilities, preferences, and safety. If disability increases and exercise/physical activity becomes more challenging, referrals to specialists are essential to ensure safe and appropriate prescriptions. When physical mobility is very limited, exercise should be facilitated by a trained assistant.

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Exercise as Medicine in Multiple Sclerosis—Time for a Paradigm Shift: Preventive, Symptomatic, and Disease-Modifying Aspects and Perspectives

Cited by 194 publications

References 127 publications

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Physical activity behavior in people with multiple sclerosis during the COVID-19 pandemic in Israel: Results of an online survey

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

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