Home-Based Exercise Training in Multiple Sclerosis: A Systematic Review with Implications for Future Research

Ghahfarrokhi, Majid Mardaniyan; Banitalebi, Ebrahim; Negaresh, Raoof; Motl, Robert W.

doi:10.1016/j.msard.2021.103177

Cited by 27 publications

(44 citation statements)

References 64 publications

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“…Participation in wellness activities was associated with physical, mental, and social QoL only for people with RRMS. Mind-body activities, encompassing yoga, Tai Chi, Qigong, and exercise therapy, were associated with positive affect, emotional dyscontrol, and social participation, consistent with past reports of favourable effects of exercise therapy and Tai Chi on mental QoL [12,14]. The non-significant and negative associations observed with mind and other wellness activities with QoL subdomains, some contrary to previously reported [27], may be attributable to category inclusions, adherence to behavior, and/or non-specific symptom assessment.…”

Section: Discussionsupporting

confidence: 85%

“…Less is known about the effects of omega-3 supplement use, though in an international cohort of over 2500 pwMS, those self-reporting frequent fish consumption and taking omega-3 supplements had better QoL [10]. Research on wellness activity participation, ranging from Tai Chi and exercise therapy to mindfulness, relaxation, and imagery has mixed evidence of associations with QoL, though participation is generally reported to be beneficial for physical and mental QoL [11][12][13][14]. The benefits of physical activity for wellbeing are well established, with primarily aerobic forms benefiting social, physical, and mental QoL in pwMS [15].…”

Section: Introductionmentioning

confidence: 99%

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Associations between Lifestyle Behaviors and Quality of Life Differ Based on Multiple Sclerosis Phenotype

Nag

Jelinek

et al. 2021

JPM

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Multiple sclerosis (MS), a neuroinflammatory disorder, occurs as non-progressive or progressive phenotypes; both forms present with diverse symptoms that may reduce quality of life (QoL). Adherence to healthy lifestyle behaviors has been associated with higher QoL in people with MS; whether these associations differ based on MS phenotype is unknown. Cross-sectional self-reported observational data from 1108 iConquerMS participants were analysed. Associations between lifestyle behaviors and QoL were assessed by linear regression, and phenotype differences via moderation analyses. Diet, wellness, and physical activity, but not vitamin D or omega-3 supplement use, were associated with QoL. Specifically, certain diet types were negatively associated with QoL in relapsing-remitting MS (RRMS), and positively associated in progressive MS (ProgMS). Participation in wellness activities had mixed associations with QoL in RRMS but was not associated in ProgMS. Physical activity was positively associated with QoL in RRMS and ProgMS. Phenotype differences were observed in diet and wellness with physical QoL, and physical activity with most QoL subdomains. Our findings show lifestyle behaviors are associated with QoL and appear to differ based on MS phenotype. Future studies assessing timing, duration, and adherence of adopting lifestyle behaviors may better inform their role in MS management.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Associations between Lifestyle Behaviors and Quality of Life Differ Based on Multiple Sclerosis Phenotype

Nag

Jelinek

et al. 2021

JPM

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“…At baseline, training time was dedicated to cognitive functions, suggesting that the observed improvements in attention, visual/spatial memory, auditory/verbal learning, and executive function could be explained by the program’s assigning a relatively integrated cognitive training component. Interestingly, Shatil et al [ 26 ] agreed about the effect of training time on memory and attention in MS patients, whereas home-based integrated cognitive rehabilitation 2–7 times a week could improve executive function and improve cognitive outcomes in people with MS [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…Campbell et al [ 49 ] supported the hypothesis that integrated home-based cognitive rehabilitation is a practical and effective approach to improving auditory/verbal learning and visual/spatial memory in people with MS and may reflect fundamental changes in brain activation. In particular, Ghahfarrokhi et al [ 45 ] found that home-based rehabilitation, 2–7 times per week, is beneficial, feasible, and safe for people with MS. Finally, Centonze et al [ 42 ] showed that physical exercise rehabilitation is more effective in improving patients’ cognitive functions and even their performance in cognitive tasks of training protocols.…”

Section: Discussionmentioning

confidence: 99%

Integrated Cognitive Rehabilitation Home-Based Protocol to Improve Cognitive Functions in Multiple Sclerosis Patients: A Randomized Controlled Study

Sharbafshaaer

Trojsi

Bonavita

et al. 2022

JCM

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Cognitive impairment (CI) occurs in about 40–65% of people with multiple sclerosis (MS) during the disease course. Cognitive rehabilitation has produced non-univocal results in MS patients. Objective: The present study aimed to evaluate whether an Integrated Cognitive Rehabilitation Program (ICRP) in MS patients might significantly improve CI. Methods: Forty patients with three phenotypes of MS were randomly assigned into two groups: the experimental group (EG, n = 20), which participated in the ICRP for 10 weeks of training; and the control group (CG, n = 20). All participants’ cognitive functions were assessed at three timepoints (baseline, post-treatment, and 3-month follow-up) with the California Verbal Learning (CVLT), Brief Visuospatial Memory (BVMTR), Numerical Stroop, and Wisconsin tests. Results: When compared to CG patients, EG patients showed significant improvements in several measures of cognitive performance after ICRP, including verbal learning, visuospatial memory, attention, and executive functions. Conclusions: Home-based ICRP can improve cognitive functions and prevent the deterioration of patients’ cognitive deficits. As an integrated cognitive rehabilitation program aimed at potentiation of restorative and compensatory mechanisms, this approach might suggest an effective role in preserving neuronal flexibility as well as limiting the progression of cognitive dysfunction in MS.

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“…In addition, they emerged as successful strategies for rehabilitation and physical exercise maintenance even during the COVID-19 outbreak, being substantially appreciated by patients with movement disorders such as Parkinson’s disease [ 22 ]. Moreover, a previous systematic review reported a significant beneficial effect for patients with multiple sclerosis [ 23 ]. Indeed, HBE (supervised or non-supervised) training represents promising strategies in the therapeutic scenario of neurological diseases [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Home-Based Exercise to Improve Motor Functions, Cognitive Functions, and Quality of Life in People with Huntington’s Disease: A Systematic Review and Meta-Analysis

Alwardat

Schirinzi

Hadoush

et al. 2022

IJERPH

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Exercise in different settings has become a fundamental part of Huntington’s disease (HD) management. The aim of this systematic review and meta-analysis was to investigate the effectiveness of home-based exercises (HBE) in HD. Randomized controlled trials (RCTs) investigating the effect of HBE on motor, cognitive, or health-related quality of life (QoL) outcomes in HD were included. Standardized mean difference (SMD), the 95% confidence interval, and p-values were calculated by comparing the outcomes change between HBE and control groups. Seven RCTs met the inclusion criteria. The included RCTs prescribed different types of HBEs, i.e., aerobic strengthening, walking, balance, and fine motor exercises. The HBE protocol length was between 6 and 36 weeks. The meta-analyses showed a significant effect of HBE intervention on motor function measure by Unified Huntington Disease Rating and overall QoL measure by Short Form−36 post-treatment respectively, [SMD = 0.481, p = 0.048], [SMD = 0.378, p = 0.003]. The pooled analysis did not detect significant changes in cognition, gait characteristics, or functional balance scales. The current study shows the positive effect of HBE in HD, especially on motor function and QoL. No significant adverse events were reported. The current results support the clinical effect of HBE intervention on motor function and QoL in HD patients. However, these results should be taken with caution due to the limited available evidence. Well-designed clinical studies that consider the disease severity and stages are required in the future.

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Home-Based Exercise Training in Multiple Sclerosis: A Systematic Review with Implications for Future Research

Cited by 27 publications

References 64 publications

Associations between Lifestyle Behaviors and Quality of Life Differ Based on Multiple Sclerosis Phenotype

Associations between Lifestyle Behaviors and Quality of Life Differ Based on Multiple Sclerosis Phenotype

Integrated Cognitive Rehabilitation Home-Based Protocol to Improve Cognitive Functions in Multiple Sclerosis Patients: A Randomized Controlled Study

Home-Based Exercise to Improve Motor Functions, Cognitive Functions, and Quality of Life in People with Huntington’s Disease: A Systematic Review and Meta-Analysis

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