The Prevalence of Overweight and Obesity in Veterans with Multiple Sclerosis

Khurana, Seema R.; Bamer, Alyssa M.; Turner, Aaron P.; Wadhwani, Rohini; Bowen, James D.; Leipertz, Steve L.; Haselkorn, Jodie K.

doi:10.1097/phm.0b013e318194f8b5

Cited by 75 publications

(74 citation statements)

References 31 publications

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“…Hewson et al showed high incidence of overweight in MS patients (40% in women and 44% in men) (39). In a recently preformed cross-sectional study on the prevalence of obesity in veterans with MS (n=4703) slightly higher adjusted prevalence of overweight comparing to veterans in general was found (42.3% vs. 39.6%, respectively) but prevalence of obesity was lower (20.1% vs. 33.1%) (40).…”

Section: Nutritional Status In Patients With Msmentioning

confidence: 90%

Nutrition in multiple sclerosis

Habek

Hojsak

Brinar

2010

Clinical Neurology and Neurosurgery

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Section: Nutritional Status In Patients With Msmentioning

confidence: 90%

Nutrition in multiple sclerosis

Habek

Hojsak

Brinar

2010

Clinical Neurology and Neurosurgery

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“…Indeed, persons with MS have similar rates of overweight and obesity as the general population [24,25], and this is problematic given the rates in the general population of adults [26]. For example, one study reported an average BMI of 27.0 kg/ m 2 in a large sample of persons with MS (n=8983); this average BMI value is comparable with the general population, but suggests that many persons with MS are overweight [25].…”

Section: Evidence For Physiological Deconditioning In Msmentioning

confidence: 98%

The Importance of Physical Fitness in Multiple Sclerosis

Motl¹

2013

J Nov Physiother

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Multiple Sclerosis (MS) is a common and life-altering neurological disease among adults in the United States and worldwide. This disease has an estimated prevalence of 1 per 1,000 adults in the United States [1] with the majority of cases occurring in women of European descent. The MS pathophysiology initially involves episodic periods of immune-mediated demyelination and transection of axons within the Central Nervous System (CNS). This results in the disruption of saltatory conduction of action potentials along myelinated axonal pathways in the brain, spinal cord, and optic nerves. The MS pathophysiology later transitions into a neurodegenerative disease process, presumably associated with insufficient neurotrophic support, and results in the accumulation of irreversible neurologic disability. The degree and location of axonal and neuronal damage within the CNS result in the heterogeneous expression of symptomatic, functional, and participatory consequences among persons with MS [2]. Such manifestations might be initiated or worsened by physical inactivity and resulting physiological deconditioning.We have previously described a model of physical inactivity, deconditioning, and worsening MS [3,4], and this was based on a similar framework for persons with chronic disease conditions [5] including MS [6]. The model is displayed in figure 1 and indicates that MS onset results in physical inactivity [7,8] that initiates physiological deconditioning (i.e., compromised or reduced physical fitness). This physiological deconditioning, in turn, results in worsening of MS, as indicated by loss of brain structure and function as well as symptomatic (e.g., fatigue) and functional (e.g., walking impairment) manifestations. The worsening of MS results in further physical inactivity and subsequent physiological deconditioning thereby yields a cycle of associations among physical inactivity, deconditioning, and worsening MS that develops over time. This model is important as it conceptualizes the importance of maintaining and improving physical fitness levels in persons with MS. Physical fitness might provide a form of "physiological reserve" that is protective of disease consequences and worsening of MS and this is consistent with other literatures such as cancer [9].To that end, this paper provides a comprehensive review of research on physical fitness in persons with MS. We begin by defining physical fitness and its domains as well as differentiating it from physical activity. We then present research on physiological deconditioning (i.e., detraining that manifests as a reduction in domains of physical work capacity or fitness) in persons with MS as well as evidence on the association between markers of physical fitness and consequences of MS. We lastly review research regarding the effects of exercise training on physical fitness and consequences of MS, and conclude with recently developed exercise recommendations for improving physical fitness. Our goal is the provision of a paper that underscores the (a) importance of p...

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“…Although our findings identified only one individual who was gaining weight such as to need a wider than normal wheelchair, this issue should be considered within the overall assessment. It is recommended that investigations into weight and MS are needed to elucidate the relationship with disability [39]. Users gaining weight who need wider chairs maybe unable to go through some doors at home without further house adaptations.…”

Section: Features Of Disabilitymentioning

confidence: 99%

“…Users gaining weight who need wider chairs maybe unable to go through some doors at home without further house adaptations. Wheelchair services could offer regular weighing; and measurement of abdominal girth may be taught as a self-management technique as routine screening for being overweight is recommended [39].…”

Section: Features Of Disabilitymentioning

confidence: 99%

Problematic clinical features of powered wheelchair users with severely disabling multiple sclerosis

Souza

Frank

2014

Disability and Rehabilitation

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Purpose: The aim of this study is to describe the clinical features of powered wheelchair users with severely disabling multiple sclerosis (MS) and explore the problematic clinical features influencing prescription. Method: Retrospective review of electronic and case note records of recipients of electric-powered indoor/outdoor powered wheelchairs (EPIOCs) attending a specialist wheelchair service between June 2007 and September 2008. Records were reviewed by a consultant in rehabilitation medicine, data systematically extracted and entered into a computer database. Further data were entered from clinical records. Data were extracted under three themes; demographic, diagnostic, clinical and wheelchair factors. Results: Records of 28 men mean age 57 (range 37-78, SD 12) years and 63 women mean age 57 (range 35-81, SD 11) years with MS were reviewed a mean of 64 (range 0-131) months after receiving their wheelchair. Twenty two comorbidities, 11 features of MS and 8 features of disability were thought to influence wheelchair prescription. Fifteen users were provided with specialised seating and 46 with tilt-in-space seats. Conclusions: Our findings suggest that people with severe MS requiring an EPIOC benefit from a holistic assessment to identify problematic clinical features that influence the prescription of the EPIOC and further medical and therapeutic interventions. ä Implications for RehabilitationPeople with multiple sclerosis (MS), referred for an EPIOC, require a full clinical assessment to identify problematic clinical features that are potentially treatable and/or can be accommodated through specialised seating and tilt. The beneficial effects of TIS should be considered for all EPIOC users with MS and particularly for those with comorbidity Poorly controlled spasticity, when identified in people with MS, should be managed through positioning in the chair, pressure-relieving cushion and referral for medical management.

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The Prevalence of Overweight and Obesity in Veterans with Multiple Sclerosis

Abstract: Overweight and obesity are a problem for more than 60% of veterans with MS in the VA. Screening for overweight and obesity should be done routinely. Interventions to prevent and manage excessive weight in individuals with MS should be developed and evaluated.

Cited by 75 publications

References 31 publications

Nutrition in multiple sclerosis

Nutrition in multiple sclerosis

The Importance of Physical Fitness in Multiple Sclerosis

Problematic clinical features of powered wheelchair users with severely disabling multiple sclerosis

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