The Effect of Combining Transcranial Direct Current Stimulation Treatment and an Exercise Program on Fragility in a Population with Multiple Sclerosis: Cross-Over Design Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Interventions
2.3. Procedure
2.4. Outcome Measures
2.5. Statistical Analysis
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
MS | Multiple sclerosis |
tDCS | Transcranial direct current stimulation |
NIBS | Non-invasive stimulation techniques |
DLPFC | Left dorsolateral prefrontal cortex |
MFIS | Modified fatigue impact scale |
IPAQ-SF | International physical activity questionnaire short form |
EDSS | Expanded disability status scale |
BDI-II | Beck depression inventory-II |
TUG | Timed Up and Go test |
References
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Week 1 | Week 2 | Week 3 | Week 4 | |
---|---|---|---|---|
Strength | 2 Sessions (A,B) | 2 Sessions (A,B) | 3 Sessions (A,B, A/B to choose) | 3 Sessions (A,B, A/B to choose) |
6 Exercise/circuit | 6 Exercise/circuit | 6 Exercise/circuit | 6 Exercise/circuit | |
15 Repetitions (2 min rest) | 15 Repetitions (2 min rest) | 10 Repetitions (3 min rest) | 10 Repetitions (3 min rest) | |
2 Circuits (3 min rest) | 2 Circuits (3 min rest) | 3 Circuits (5 min rest) | 3 Circuits (5 min rest) | |
Endurance | 1 Session | 2 Sessions | 2 Sessions | 2–3 Sessions |
10 min | 15 min | 10 + 10 min (5 min of rest | 15 + 15 min (5 min of rest | |
RPE 3–5 | RPE 3–5 | RPE 3–5 | RPE 3–5 | |
Static bike/MOTOmed | Static bike/MOTOmed | Static bike/MOTOmed | Static bike/MOTOmed |
Variable | n (Min–Max); Mean ± SD | Frequency (%) |
---|---|---|
Age | 12 (35–66); 48.08 ± 8.55 | |
Years since diagnosis | 12 (0.8–28); 16.65 ± 7.44 | |
Outbreak year | 11 (0–2); 0.36 ± 0.67 | |
Walking time (min) | 9 (0.0–120); 51.11 ± 41.06 | |
Sitting time (min) | 9 (0–960); 466.667 ± 304.13 | |
Education level | ||
Primary education Secondary studies Vocational training University studies | 1 (8.3%) | |
1 (8.3%) | ||
6 (50%) | ||
4 (33.3%) | ||
Employment situation | ||
Housewife Part-time employee Full-time employee Retired Permanent disability | 1 (8.3%) | |
1 (8.3%) | ||
5 (41.7%) | ||
3 (25%) | ||
2 (16.7%) | ||
Type of sclerosis | ||
Relapsing–remitting Progressive–secondary | 7 (58.3%) | |
5 (41.7%) | ||
Associated diseases | ||
Absence of other diseases | 12 (100%) | |
Outbreak intensity | ||
Mild Moderate Intense No outbreaks | 2 (18.2%) | |
1 (9.1%) | ||
1 (9.1%) | ||
7 (63.6%) | ||
Fatigue medication | ||
Yes No | 5 (41.7%) | |
7 (58.3%) | ||
Type of fatigue medication | ||
Lioresal Lioresal + Avonex Lioresal + Rebif 44 Other medication No medication | 1 (9.1%) | |
1 (9.1%) | ||
1 (9.1%) | ||
2 (16.7%) | ||
7 (58.3%) | ||
Medical recommendation | ||
Physical activity | 6 (11.3%) | |
Other | 1 (8.3%) | |
No recommendation | 5 (41.7%) | |
Rehabilitation | ||
Yes | 11 (91.7%) | |
No | 1 (8.3%) | |
Intensity rehabilitation | ||
Occasional Periodic | 5 (41.7%) | |
7 (58.3%) | ||
Exercise habits | ||
Occasional Regularly | 2 (16.7%) | |
10 (83.3%) |
Pre-tDCS | Post-tDCS | p | Size Effect | Pre-Exercise | Post-Exercise | p | Size Effect | |
---|---|---|---|---|---|---|---|---|
Median (Range) | Median (Range) | Hedges´ g | Median (Range) | Median (Range) | Hedges´ g | |||
Tinetti | 12.5 (8) | 14.5 (8) | 0.019 * | 0.632 | 11 (11) | 14 (10) | 0.004 ** | 0.418 |
TUG | 9.46 (57.68) | 7.93 (31.15) | 0.012 * | 0.297 | 10.42 (32.73) | 9.02 (29.6) | 0.002 ** | 0.262 |
Beck | 15.5 (26) | 11 (28) | 0.013 * | 0.402 | 15.5 (39) | 9.5 (31) | 0.013 * | 0.540 |
MFIS | 39.5 (31) | 38.5 (45) | 0.028 * | 0.526 | 43 (33) | 36 (52) | 0.003 ** | 0.742 |
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Muñoz-Paredes, I.; Herrero, A.J.; Llamas-Ramos, R.; Rodríguez-Pérez, V.; Seco-Calvo, J. The Effect of Combining Transcranial Direct Current Stimulation Treatment and an Exercise Program on Fragility in a Population with Multiple Sclerosis: Cross-Over Design Trial. Int. J. Environ. Res. Public Health 2022, 19, 12747. https://doi.org/10.3390/ijerph191912747
Muñoz-Paredes I, Herrero AJ, Llamas-Ramos R, Rodríguez-Pérez V, Seco-Calvo J. The Effect of Combining Transcranial Direct Current Stimulation Treatment and an Exercise Program on Fragility in a Population with Multiple Sclerosis: Cross-Over Design Trial. International Journal of Environmental Research and Public Health. 2022; 19(19):12747. https://doi.org/10.3390/ijerph191912747
Chicago/Turabian StyleMuñoz-Paredes, Inés, Azael J. Herrero, Rocío Llamas-Ramos, Vicente Rodríguez-Pérez, and Jesús Seco-Calvo. 2022. "The Effect of Combining Transcranial Direct Current Stimulation Treatment and an Exercise Program on Fragility in a Population with Multiple Sclerosis: Cross-Over Design Trial" International Journal of Environmental Research and Public Health 19, no. 19: 12747. https://doi.org/10.3390/ijerph191912747