Results of a feasibility and initial efficacy clinical trial of a high-intensity interval training program using adaptive equipment in persons with multiple sclerosis who have walking disability.

Background: High intensity interval training (HIIT) has been identified as potential stimulus for eliciting health-promoting physical activity in an efficient manner among persons with multiple sclerosis (MS). The current study aimed to examine the feasibility and initial efficacy of a 12-week HIIT program using a recumbent stepper (RSTEP) in persons with MS who have walking disability. Feasibility outcomes of interest included process (i.

Feasibility and initial efficacy of a high-intensity interval training program using adaptive equipment in persons with multiple sclerosis who have walking disability: study protocol for a single-group, feasibility trial.

Background: There is considerable evidence for the efficacy of moderate-intensity continuous exercise benefitting clinically relevant outcomes in persons with multiple sclerosis (MS). However, persons with MS who have walking disability (pwMS-wd) are severely deconditioned and may achieve superior benefits by engaging in high-intensity interval training (HIIT), especially while utilizing adaptive equipment, such as recumbent arm/leg stepping (RSTEP). The proposed study will assess the feasibility of a 12-week, RSTEP HIIT program in pwMS-wd.

Do subcortical gray matter volumes and aerobic capacity account for cognitive-motor coupling in multiple sclerosis?

Background: There is evidence of cognitive-motor coupling in multiple sclerosis (MS) such that the slowing of cognitive processing speed correlates with the worsening of walking speed and endurance.

Objective: The current study first established the presence of cognitive-motor coupling and second examined the possibility that volumes of subcortical gray matter (SGM) structures and aerobic capacity might explain the coupling of cognitive and motor functions in persons with MS.

Methods: We included data from 62 persons with clinically definite MS who underwent assessments of cognitive processing speed, walking performance, and aerobic capacity, and completed magnetic resonance imaging (MRI) within 7 days of the aforementioned assessments.

Acute High-Intensity Interval Exercise in Multiple Sclerosis with Mobility Disability.

Introduction: Multiple sclerosis (MS) is an immune-mediated, neurological disease that results in physiological deconditioning with increasing disability. High-intensity interval training (HIIT) exercise has induced significant improvements in physiological conditioning in healthy and clinical populations and might be appropriate for persons with MS who have mobility disability. The feasibility and acute effects of HIIT using recumbent stepping in persons with MS who have mobility disability are relatively unknown.

The relationship between corticospinal tract integrity and lower-extremity strength is attenuated when controlling for age and sex in multiple sclerosis.

Muscle weakness, particularly in the lower-extremities, is common in multiple sclerosis (MS) and seemingly results from damage along white matter pathways in the central nervous system including the corticospinal tract (CST). This study examined CST structural integrity indicated by diffusion tensor imaging (DTI) related metrics (fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) as correlates of knee flexor (KF) and knee extensor (KE) muscle strength in MS. We included 36 persons with MS who underwent MRI and measurements of peak KE and KF strength using an isokinetic dynamometer.

Associations of functional connectivity and walking performance in multiple sclerosis.

Background: Persons with multiple sclerosis (MS) often demonstrate impaired walking performance, and neuroimaging methods such as resting state functional connectivity (RSFC) may support a link between central nervous system damage and disruptions in walking.

Objectives: This study examined associations between RSFC in cortical networks and walking performance in persons with MS.

Methods: 29 persons with MS underwent 3-T brain magnetic resonance imaging (MRI) and we computed RSFC among 68 Gy matter regions of interest in the brain.

Gait Variability and Energy Cost of Oveground Walking in Persons With Multiple Sclerosis: A Cross-Sectional Study.

Objective: This study examined the associations between gait variability based on common spatiotemporal parameters and energetic cost of walking in persons with multiple sclerosis.

Design: Eighty-six persons with multiple sclerosis underwent the 6-min walk while wearing a portable metabolic unit. The cost of walking was generated by dividing the net steady-state VO2 (milliliter per kilogram per minute) by walking speed during the 6-min walk.

Do depressive symptoms influence cognitive-motor coupling in multiple sclerosis?

Objective: There is evidence that motor and cognitive impairments often co-occur in multiple sclerosis (MS). There is little research on influences of cognitive-motor coupling, particularly depressive symptoms. This study examined depressive symptoms as a moderator and/or confounder of cognitive-motor coupling in persons with MS.

Sedentary Behavior and Blood Pressure in Patients with Multiple Sclerosis.

Background: Sedentary behavior is a pervasive public health concern in the general population. To date, little is known regarding the possible health risks associated with sedentary behavior in patients with multiple sclerosis (MS), although this population has increased risks of comorbidities such as hypertension.

Methods: This cross-sectional study examined the association between sedentary behavior and blood pressure (BP) in 31 patients with MS and 31 matched controls.

Randomized controlled trial of an e-learning designed behavioral intervention for increasing physical activity behavior in multiple sclerosis.

Background: Internet-delivered, behavioral interventions represent a cost-effective, broadly disseminable approach for teaching persons with multiple sclerosis (MS) the theory-based skills, techniques, and strategies for changing physical activity.

Objectives: This pilot, randomized controlled trial examined the efficacy of a newly developed Internet website based on e-learning approaches that delivered a theory-based behavior intervention for increasing physical activity and improving symptoms, walking impairment, and neurological disability.

Methods: Participants with MS ( = 47) were randomly assigned into behavioral intervention ( = 23) or waitlist control ( = 24) conditions delivered over a six-month period.

Self-efficacy and Walking Performance in Persons With Multiple Sclerosis.

Background And Purpose: Impairment of walking function is a prevalent and burdensome feature of multiple sclerosis (MS), and represents a primary focus of rehabilitation research and clinical care. Research examining self-efficacy as a correlate of walking performance in MS is lacking; self-efficacy represents a theory-based, modifiable target of rehabilitation approaches for improving walking outcomes. This cross-sectional study examined the association between self-efficacy and walking performance in persons living with MS.

Objectively measured sedentary behavior and brain volumetric measurements in multiple sclerosis.

Aim: This study examined the association between sedentary behavior patterns and whole brain gray matter (GM), white matter (WM) and subcortical GM structures in persons with multiple sclerosis (MS).

Methods: 36 persons with MS wore an accelerometer and underwent a brain MRI. Whole brain GM and WM and deep GM structures were calculated from 3D T1-weighted structural brain images.

Reliability, precision, and clinically important change of the Nine-Hole Peg Test in individuals with multiple sclerosis.

This study evaluated the reliability, precision, and clinically important change of the Nine-Hole Peg Test (9-HPT) over a 1-week period. Sixty-nine patients with multiple sclerosis completed the 9-HPT on two occasions 1 week apart. Test-retest reliability was based on intraclass correlation coefficient, and precision was based on standard error of measurement and coefficient of variation.

Individual and Co-occurring SNAP Risk Factors: Smoking, Nutrition, Alcohol Consumption, and Physical Activity in People with Multiple Sclerosis.

Smoking, poor nutrition, excess alcohol consumption, and insufficient physical activity underlie most preventable causes of morbidity in the general population and may be associated with comorbidities and health outcomes in multiple sclerosis (MS). However, the frequency of co-occurrence of these risk factors in people with MS remains unclear. Sixty-nine individuals with MS completed self-report measures of smoking status, nutrition, alcohol use, physical activity levels, and sociodemographic and clinical characteristics.

Co-occurring Risk Factors in Multiple Sclerosis.

Objective: We examined individual and co-occurring risk factors as correlates of health outcomes in persons with multiple sclerosis (MS).

Methods: Sixty-nine participants with MS completed measures of nutrition, physical activity levels, comorbidity and neuroperformance. The data were analyzed using t-test analyses in SPSS Statistics 22.

Reliability of Accelerometer Scores for Measuring Sedentary and Physical Activity Behaviors in Persons With Multiple Sclerosis.

This brief research note examined the reliability of scores from an accelerometer as measures of sedentary and physical activity behaviors in persons with multiple sclerosis (MS). The analysis was performed on a combined data set from 2 previous longitudinal investigations of physical activity in MS. We focused on the number of days required to reliably estimate sedentary behavior, based on time spent in sedentary behavior per day and number of sedentary breaks, number of long sedentary bouts, and average length of sedentary bouts per day.

Diffusion tensor imaging of the corticospinal tract and walking performance in multiple sclerosis.

Research has identified a significant relationship between DTI (Diffusion Tensor Imaging) indices in the Corticospinal Tract (CST) and disability status in persons with multiple sclerosis (MS). To date, there is little known about the association between DTI indices of the CST with walking and gait outcomes in MS. This study examined the associations among DTI indices [fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD)] of the CST with walking and gait outcomes in persons with MS.

Fully automated open-source lesion mapping of T2-FLAIR images with FSL correlates with clinical disability in MS.

Background: T2 Lesion Volume (T2LV) has been an important biomarker for multiple sclerosis (MS). Current methods available to quantify lesions from MR images generally require manual adjustments or multiple images with different contrasts. Further, implementations are often not easily or openly accessible.

Mobility disability and the pattern of accelerometer-derived sedentary and physical activity behaviors in people with multiple sclerosis.

Objective: Low physical activity and high sedentary behavior levels are major concerns in persons with multiple sclerosis (MS) and these differ depending on the level of mobility disability. However, the manner in which daily activity is accumulated is currently unknown in this population.

Methods: A secondary analysis was performed on a combined data set of persons with MS from two previous investigations of physical activity and symptomatic or quality of life outcomes in the United States over a two year period (2007-2009).

Preliminary validation of the short physical performance battery in older adults with multiple sclerosis: secondary data analysis.

Background: There are relatively few standard, objective measures for studying physical function among older adults with multiple sclerosis (MS), yet such measures are necessary considering the shift in prevalence and associated consequences of both MS and older age on physical function. We undertook a preliminary examination of the construct validity of Short Physical Performance Battery (SPPB) scores in older adults with MS based on an expected differential pattern of associations with measures of lower and upper extremity function.

Methods: The sample included 48 persons with MS aged 50 years and older who were enrolled in a pilot, randomized controlled trial of exercise training.

Physical Fitness Assessment Across the Disability Spectrum in Persons With Multiple Sclerosis: A Comparison of Testing Modalities.

Background And Purpose: Appropriate assessment of physical fitness (ie, aerobic capacity and muscular strength) is necessary for the design and evaluation of exercise training in multiple sclerosis (MS). However, this is challenging in persons with substantial disability, because of physical inaccessibility and insensitivity of certain exercise testing modalities. This study compared different methods of measuring cardiorespiratory (arm ergometer vs recumbent stepper) and muscular (hand-held dynamometry vs computerized dynamometry) fitness across the MS disability spectrum.

The descriptive epidemiology of daily sitting time as a sedentary behavior in multiple sclerosis.

Background: Sedentary behavior is pervasive among the general population, but little is known about the epidemiology of this behavior in multiple sclerosis (MS).

Objective: We compared self-reported sitting time (ST), as a measure of sedentary behavior, between persons with MS and healthy controls, and examined ST across demographic and clinical characteristics of those with MS.

Methods: 1081 persons with MS and 150 healthy controls self-reported ST based on the International Physical Activity Questionnaire (IPAQ), and completed the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and a demographic/clinical scale.

No association between body composition and cognition in ambulatory persons with multiple sclerosis: A brief report.

There is evidence that body fat is inversely associated with cognitive functioning in adults from the general population, and this has been associated with systemic inflammation. The association between body fat and cognition might further be augmented in the presence of an immune-mediated, inflammatory disease such as multiple sclerosis (MS). This cross-sectional study investigated the associations between objective measures of body composition and cognitive function in 60 persons with MS.

Objectively Measured Physical Activity Is Associated with Brain Volumetric Measurements in Multiple Sclerosis.

Background: Little is known about physical activity and its association with volumes of whole brain gray matter and white matter and deep gray matter structures in persons with multiple sclerosis (MS).

Purpose: This study examined the association between levels of physical activity and brain volumetric measures from magnetic resonance imaging (MRI) in MS.

Method: 39 persons with MS wore an accelerometer for a 7-day period and underwent a brain MRI.