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Exercise and Multiple Sclerosis
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Exercise and Multiple Sclerosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 29759

Special Issue Editors

Prof. Dr. Simona Bonavita

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Guest Editor
Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: digital technology; multiple sclerosis; pilates exercise; hydrobike; mood disturbances
Special Issues, Collections and Topics in MDPI journals
Dr. Luigi Lavorgna

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Guest Editor
Ist Clinic of Neurology-University of Campania “Luigi Vanvitelli”, Naples, Italy
Interests: digital technology; multiple sclerosis; social medicine; cardiofitness
Special Issues, Collections and Topics in MDPI journals
Dr. Marcello Moccia

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Guest Editor
1. Federico II University offre Naples, Naples, Italy
2. University College London, London, UK
Interests: multiple sclerosis; biomarkers; neurorehabilitation
Special Issues, Collections and Topics in MDPI journals
Dr. Francesco Brigo

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Guest Editor
Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
Interests: neurology; evidence-based medicine; epilepsy; multiple sclerosis

Special Issue Information

Dear Colleagues,

As many of you already know, multiple sclerosis (MS) is characterised by physical symptoms such as muscle weakness, gait impairment, balance problems, spasticity and fatigue and mental symptoms such as cognitive impairment and depression.

Due to both physical and mental problems and fearing symptoms exacerbation, people with MS (pwMS) decrease their physical activity; inactivity places pwMS at increased risk of comorbid conditions, thus worsening the disease course. Consequently, reduced physical activity may result in increased disability, worse mobility, worse general health and quality of life. Several studies have demonstrated that both aerobic and endurance/strength exercise can lead to significant and important improvements in different areas of cardiorespiratory fitness, muscle strength, flexibility, stability, tiredness, cognition, quality of life and respiratory function in pwMS. With this Special Issue, we hope to encourage submissions that discuss the current state-of-the-art, address ongoing knowledge gaps and focus on ongoing controversies related to exercise and multiple sclerosis.

We look forward to receiving your submission.

Prof. Simona Bonavita
Dr. Luigi Lavorgna
Dr. Marcello Moccia
Dr. Francesco Brigo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Physical activity
  • Multiple sclerosis
  • Endurance training
  • Strength training
  • Cardio fitness
  • Cognition

Related Special Issue

Published Papers (7 papers)

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Research

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7 pages, 3401 KiB  
Article
Physical Exercise Moderates the Effects of Disability on Depression in People with Multiple Sclerosis during the COVID-19 Outbreak
by Antonio Carotenuto, Cristiano Scandurra, Teresa Costabile, Luigi Lavorgna, Giovanna Borriello, Lucia Moiola, Matilde Inglese, Francesca Trojsi, Martina Petruzzo, Antonio Ianniello, Agostino Nozzolillo, Maria Cellerino, Giacomo Boffa, Laura Rosa, Alessandro Chiodi, Giuseppe Servillo, Marcello Moccia, Simona Bonavita, Massimo Filippi, Maria Petracca, Vincenzo Brescia Morra and Roberta Lanzilloadd Show full author list remove Hide full author list
J. Clin. Med. 2021, 10(6), 1234; https://doi.org/10.3390/jcm10061234 - 16 Mar 2021
Cited by 11 | Viewed by 5192
Abstract
Physical disability impacts psychosocial wellbeing in people with multiple sclerosis. However, the role of physical activity in this context is still debated. By taking advantage of a previous survey, conducted online from 22 April to 7 May 2020, we performed a post-hoc analysis [...] Read more.
Physical disability impacts psychosocial wellbeing in people with multiple sclerosis. However, the role of physical activity in this context is still debated. By taking advantage of a previous survey, conducted online from 22 April to 7 May 2020, we performed a post-hoc analysis with the aim to assess the associations between disability, physical exercise, and mental health in multiple sclerosis. We retrieved the following data: (i) sociodemographic information, (ii) changes in lifestyle (including exercise), (iii) physical disability, as measured with the Patient-Determined Disease Steps scale, and (iv) anxiety feelings and depressive symptoms assessed via the items included in the Quality of Life in Neurological Disorders measurement system. Examination of the interaction plot showed that the effect of disability on depression, but not on anxious symptoms, was significant for all levels of physical exercise (low: b = 1.22, 95% C.I. 0.85, 1.58, p < 0.001; moderate: b = 0.95, 95% C.I. 0.66, 1.24, p < 0.001; and high: b = 0.68, 95% C.I. 0.24, 1.13, p = 0.003). Based on these data, we can conclude that disability significantly impacted depression during the COVID-19 pandemic, with physical activity playing a moderating role. Our results suggest that favoring exercise in multiple sclerosis (MS) would ameliorate psychological wellbeing regardless of the level of physical disability. Full article
(This article belongs to the Special Issue Exercise and Multiple Sclerosis)
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7 pages, 239 KiB  
Article
Assessment of Multiple Sclerosis Disability Progression Using a Wearable Biosensor: A Pilot Study
by Gianmarco Abbadessa, Luigi Lavorgna, Giuseppina Miele, Alfredo Mignone, Elisabetta Signoriello, Giacomo Lus, Marinella Clerico, Maddalena Sparaco and Simona Bonavita
J. Clin. Med. 2021, 10(6), 1160; https://doi.org/10.3390/jcm10061160 - 10 Mar 2021
Cited by 24 | Viewed by 2562
Abstract
Background: The evaluation of walking activity of people with multiple sclerosis (pwMS) is desirable. We evaluate the power of the correlation of motor parameters detected by the accelerometer in the Samsung Gear S2 smartwatch with multiple sclerosis (MS) disability measures and patient reported [...] Read more.
Background: The evaluation of walking activity of people with multiple sclerosis (pwMS) is desirable. We evaluate the power of the correlation of motor parameters detected by the accelerometer in the Samsung Gear S2 smartwatch with multiple sclerosis (MS) disability measures and patient reported outcomes (PROs). Methods: We enrolled 25 relapsing remitting MS patients. We assessed disability with the expanded disability status scale, two-minute walking test (2MWT), timed 25-foot walk test (T25FWT), and nine-hole peg test. We collected PROs measuring fatigue, ambulatory ability, depression, quality of life, and bladder/bowel function. Participants were asked to wear the accelerometer for a period of 30 days. Results: The Spearman’s rank correlation coefficient showed a moderate negative correlation between the patient-determined disease steps (PDDS) score with the mean steps/day, a strong negative correlation between the PDDS score with the maximum number of daily steps (MNDS) and a moderate negative correlation between the fatigue severity scale score and MNDS. A moderate negative correlation between MNDS and the 2MWT and a moderate negative correlation between MNDS and the T25FW was found. Conclusion: Our results suggest that motor parameters derived from the accelerometer could be a reliable measure of motor disability in pwMS. Full article
(This article belongs to the Special Issue Exercise and Multiple Sclerosis)
10 pages, 826 KiB  
Article
Movement Velocity as A Measure of Exercise Intensity in Persons with Multiple Sclerosis: A Validity Study
by Luis Andreu-Caravaca, Domingo Jesús Ramos-Campo, Oriol Abellán-Aynés and Jacobo Ángel Rubio-Arias
J. Clin. Med. 2020, 9(8), 2458; https://doi.org/10.3390/jcm9082458 - 31 Jul 2020
Cited by 2 | Viewed by 2342
Abstract
Objectives: This study aims to analyse the validity (agreement between two methods) of the movement propulsive velocity (MPV) as an indicator of relative load in leg press (LP) and bench press (BP) exercises in persons with multiple sclerosis (MS). Methods: 18 persons with [...] Read more.
Objectives: This study aims to analyse the validity (agreement between two methods) of the movement propulsive velocity (MPV) as an indicator of relative load in leg press (LP) and bench press (BP) exercises in persons with multiple sclerosis (MS). Methods: 18 persons with MS (sex = 55% male; age (mean ± SD) = 44.88 ± 10.62 years; body mass = 67.19 ± 10.63 kg; height = 1.66 ± 0.07 m; Expanded Disability Status Scale (EDSS) = 3.12 ± 1.73) performed an incremental loading test in BP and LP exercises in two separate sessions. Individual determination of the one-repetition maximum (1RM) and full load-velocity profile were obtained for each participant. Results: a significant linear relationship was observed between the %1RM load and the MPV in LP (%1RM = −133.58 × MPV + 117.44; r2 = 0.84; standard error of the estimate (SEE) = 9.38%1RM) and BP (%1RM = −95.66 × MPV + 115.26; r2 = 0.86; SEE = 9.82%1RM). In addition, no significant differences were found between the %1RM achieved directly and the %1RM obtained by the equation calculated from the linear regression (LP, p = 0.996; BP, p = 0.749). Conclusions: these results indicate that movement velocity can estimate the relative load in bench press and leg press exercises in persons MS. Full article
(This article belongs to the Special Issue Exercise and Multiple Sclerosis)
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16 pages, 290 KiB  
Article
Understanding the Deterioration of Gait, Postural Control, Lower Limb Strength and Perceived Fatigue Across the Disability Spectrum of People with Multiple Sclerosis
by Pedro Moreno-Navarro, Ramón Gomez-Illán, Carmen Carpena-Juan, Ángel P. Sempere, Francisco J. Vera-Garcia and David Barbado
J. Clin. Med. 2020, 9(5), 1385; https://doi.org/10.3390/jcm9051385 - 08 May 2020
Cited by 7 | Viewed by 2829
Abstract
Disability progression is a prominent feature of multiple sclerosis (MS). However, little is known about the extent to which physical condition parameters and perceived fatigue evolve during the disease. We analyzed how strength, balance, core stability and perceived fatigue differ among different cohorts [...] Read more.
Disability progression is a prominent feature of multiple sclerosis (MS). However, little is known about the extent to which physical condition parameters and perceived fatigue evolve during the disease. We analyzed how strength, balance, core stability and perceived fatigue differ among different cohorts of people with MS (PwMS) with different disability degrees and how these contribute to patients’ gait speed and functional mobility. Sixty-three PwMS divided into three groups according to the “Expanded Disability Status Scale” (MS1: EDSS ≤ 1.5; MS2: 2 ≤ EDSS ≤ 3.5; MS3: 4 ≤ EDSS ≤ 6) and 22 healthy controls (HC) participated in this study. MS1 showed lower balance and hip strength compared to HC. MS2 showed lower balance, core stability, gait speed, and functional mobility than MS1. MS3 showed lower gait speed, functional mobility, balance, and knee flexion strength than MS2. No between-group differences were observed in perceived fatigue. Relative weight analysis showed that strength, balance and core stability explained 60%–70% of the variance in gait speed and functional mobility. The decline of each parameter did not evolve at the same rate across the different stages of the disease, being knee flexion strength and balance the most influential factors in the disability progression. Overall, these results provide useful information to guide exercise prescription at different stages of MS. Full article
(This article belongs to the Special Issue Exercise and Multiple Sclerosis)

Review

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14 pages, 1234 KiB  
Review
Digital Technology in Clinical Trials for Multiple Sclerosis: Systematic Review
by Marcello De Angelis, Luigi Lavorgna, Antonio Carotenuto, Martina Petruzzo, Roberta Lanzillo, Vincenzo Brescia Morra and Marcello Moccia
J. Clin. Med. 2021, 10(11), 2328; https://doi.org/10.3390/jcm10112328 - 26 May 2021
Cited by 17 | Viewed by 4889
Abstract
Clinical trials in multiple sclerosis (MS) have been including digital technology tools to overcome limitations in treatment delivery and disease monitoring. In March 2020, we conducted a systematic search on pubmed.gov and clinicaltrials.gov databases (with no restrictions) to identify all relevant published and [...] Read more.
Clinical trials in multiple sclerosis (MS) have been including digital technology tools to overcome limitations in treatment delivery and disease monitoring. In March 2020, we conducted a systematic search on pubmed.gov and clinicaltrials.gov databases (with no restrictions) to identify all relevant published and unpublished clinical trials, in English language, including MS patients, in which digital technology was applied. We used “multiple sclerosis” and “clinical trial” as the main search words, and “app”, “digital”, “electronic”, “internet” and “mobile” as additional search words, separately. Digital technology is part of clinical trial interventions to deliver psychotherapy and motor rehabilitation, with exergames, e-training, and robot-assisted exercises. Digital technology has been used to standardise previously existing outcome measures, with automatic acquisitions, reduced inconsistencies, and improved detection of symptoms (e.g., electronic recording of motor performance). Other clinical trials have been using digital technology for monitoring symptoms that would be otherwise difficult to detect (e.g., fatigue, balance), for measuring treatment adherence and side effects, and for self-assessment purposes. Collection of outcome measures is progressively shifting from paper-based on site, to internet-based on site, and, in the future, to internet-based at home, with the detection of clinical and treatment features that would have remained otherwise invisible. Similarly, remote interventions provide new possibilities of motor and cognitive rehabilitation. Full article
(This article belongs to the Special Issue Exercise and Multiple Sclerosis)
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18 pages, 628 KiB  
Review
New Strategies for Rehabilitation and Pharmacological Treatment of Fatigue Syndrome in Multiple Sclerosis
by Ewa Zielińska-Nowak, Lidia Włodarczyk, Joanna Kostka and Elżbieta Miller
J. Clin. Med. 2020, 9(11), 3592; https://doi.org/10.3390/jcm9113592 - 07 Nov 2020
Cited by 15 | Viewed by 4406
Abstract
Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system (CNS), with an inflammatory demyelinating basis and a progressive course. The course of the disease is very diverse and unpredictable. Patients face many problems on a daily basis, such [...] Read more.
Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system (CNS), with an inflammatory demyelinating basis and a progressive course. The course of the disease is very diverse and unpredictable. Patients face many problems on a daily basis, such as problems with vision; sensory, balance, and gait disturbances; pain; muscle weakness; spasticity; tremor; urinary and fecal disorders; depression; and rapidly growing fatigue, which significantly influences quality of life among MS patients. Excessive fatigue occurs in most MS patients in all stages of this disease and is named MS-related fatigue. The crucial issue is the lack of effective treatment; therefore, this review focuses not only on the most common treatment methods, but also on additional novel therapies such as whole-body cryotherapy (WBC), functional electrical stimulation (FES), and non-invasive brain stimulation (NIBS). We also highlight the advantages and disadvantages of the most popular clinical scales used to measure fatigue. The entire understanding of the origins of MS-related fatigue may lead to the development of more effective strategies that can improve quality of life among MS patients. A literature search was performed using MEDLINE, EMBASE, and PEDro databases. Full article
(This article belongs to the Special Issue Exercise and Multiple Sclerosis)
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26 pages, 3772 KiB  
Review
Impact of Exercise on Immunometabolism in Multiple Sclerosis
by Remsha Afzal, Jennifer K Dowling and Claire E McCoy
J. Clin. Med. 2020, 9(9), 3038; https://doi.org/10.3390/jcm9093038 - 21 Sep 2020
Cited by 16 | Viewed by 6404
Abstract
Multiple Sclerosis (MS) is a chronic, autoimmune condition characterized by demyelinating lesions and axonal degradation. Even though the cause of MS is heterogeneous, it is known that peripheral immune invasion in the central nervous system (CNS) drives pathology at least in the most [...] Read more.
Multiple Sclerosis (MS) is a chronic, autoimmune condition characterized by demyelinating lesions and axonal degradation. Even though the cause of MS is heterogeneous, it is known that peripheral immune invasion in the central nervous system (CNS) drives pathology at least in the most common form of MS, relapse-remitting MS (RRMS). The more progressive forms’ mechanisms of action remain more elusive yet an innate immune dysfunction combined with neurodegeneration are likely drivers. Recently, increasing studies have focused on the influence of metabolism in regulating immune cell function. In this regard, exercise has long been known to regulate metabolism, and has emerged as a promising therapy for management of autoimmune disorders. Hence, in this review, we inspect the role of key immunometabolic pathways specifically dysregulated in MS and highlight potential therapeutic benefits of exercise in modulating those pathways to harness an anti-inflammatory state. Finally, we touch upon current challenges and future directions for the field of exercise and immunometabolism in MS. Full article
(This article belongs to the Special Issue Exercise and Multiple Sclerosis)
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