Cardiovascular hemodynamic response to peak exercise in individuals with multiple sclerosis.

Multiple sclerosis (MS) is a chronic neurological condition resulting in decreased aerobic capacity (peak VO). The hemodynamic responses to peak exercise in MS are unknown. Further, it is unknown if the hemodynamic responses are due to disease or fitness.

Tele-exercise in multiple sclerosis: Systematic review and meta-analysis of effects on fatigue, depression, and overall health.

Background: Multiple sclerosis (MS) profoundly influences fatigue, depression, various physical and mental symptoms, and quality of life (QoL). Rehabilitation, including exercise training, has improved outcomes of MS, yet is often undertaken in facilities with direct supervision which present substantial barriers for accessibility and scalability. The delivery of exercise remotely via technology (tele-exercise) might overcome those barriers and improve outcomes in MS.

Comparison of practice-related changes in dual task walking performance and neural efficiency between older adults with progressive and relapsing-remitting multiple sclerosis.

Background: There is limited research comparing both performance and brain control of walking between older adults with progressive and relapsing-remitting MS.

Objective: This study compared older adults with progressive and relapsing-remitting MS for differences in prefrontal cortex (PFC) activation in single- and dual-task-walking and practice-related effects on neural efficiency, walking, and cognitive performances.

Methods: Older adults with progressive (n = 32, age=65±6ys) and relapsing-remitting (n = 63, age=65±4ys) MS completed three conditions (single-task walk, single-task-alpha, i.

Randomized Controlled Trials of Rehabilitation in Multiple Sclerosis: Barriers and Unmet Needs.

Randomized controlled trials (RCTs) provide the foundation of evidence-based practice for the application of rehabilitation as complementary of medications for filling in the gaps and enhancing outcomes in people with multiple sclerosis (MS). This paper identifies seven field-wide areas of relevance for RCTs of rehabilitation that are barriers for (a) knowledge translation and implementation, (b) impact among those who most need rehabilitation, and (c) the field and its value in comprehensive MS care. The seven field-wide areas include improving the quality of RCTs; implementing discovery models for informing selection of interventions; focusing on primary end-points in samples screened for presence of symptoms/dysfunction; exploring response heterogeneity as an avenue for precision medicine; quantifying adherence and compliance for guiding future prescriptions; understanding mechanisms of outcomes through experimental medicine; and extending research into under-researched populations.

Heterogeneity of aerobic fitness changes with exercise training in progressive multiple sclerosis: Secondary, exploratory analysis of data from the CogEx trial.

Background: There is heterogeneity of aerobic fitness (VO) changes with a standardized exercise training stimulus in the general population (i.e. some participants demonstrate improvements, others no change, and some a reduction in VO).

Cognitive Function in Frail Older Adults With Multiple Sclerosis: An Exploratory Study Using Secondary Data Analysis.

Background: Studies addressing frailty in the context of multiple sclerosis (MS) are emergent. This study explores cognitive function in older adults with MS as a function of frailty status.

Methods: This cross-sectional study used baseline data from a feasibility randomized controlled trial of a home-based exercise program for older adults with MS.

The Actionability of Physical Activity Guidelines for Multiple Sclerosis Care: A Systematic Review and AACTT Framework Analysis.

Objective: This study aimed to conduct a systematic review of clinical guidelines, guidance documents and consensus statements regarding physical activity (PA) promotion by health care providers (HCPs) to people with multiple sclerosis (MS) and to assess the methodological quality, and actionability of the recommendations. The protocol was registered with Prospero (CRD42023495137).

Data Sources: Clinical guidelines, guidance documents and consensus statements (hereafter guidelines) published in English between 2013 and 2023 were identified through extensive gray and scientific literature searches, and through contacting relevant HCP organizations in English speaking countries.

Vascular function in multiple sclerosis: Systematic review with meta-analysis.

Background: Vascular comorbidities are prevalent in persons with multiple sclerosis (MS), yet less is known about underlying vascular function (VF). We performed a systematic review with meta-analysis of studies that compared VF in persons with MS and healthy controls and examined factors that may moderate the difference in vascular outcomes between groups.

Methods: We conducted a systematic search using PubMed/MEDLINE, CINAHL, and Embase from inception through March 2024.

Randomized Controlled Trial of the Behavioral Intervention for Increasing Physical Activity in Multiple Sclerosis Project: Fidelity Monitoring and Outcomes.

Treatment fidelity is a key component for assessing the reliability and validity of clinical trials in behavioral medicine. This manuscript reports on the outcomes of a pre-planned fidelity monitoring protocol for a Phase-III clinical trial, project Behavioral Intervention for Physical Activity in Multiple Sclerosis (BIPAMS). The fidelity monitoring protocol included the five areas of the National Institutes of Health Behavior Change Consortium with primary data sources including: coaching call checklists, coaching logs, auditing of coaching calls by experts, behavioral resource bank within the treatment group, review of participant website log-ins, review of participant self-monitoring, and team meetings for discussing participant progress and protocol adherence.

Advancements and Challenges in Exercise Training for Multiple Sclerosis: Comprehensive Review and Future Directions for Randomized Controlled Trials.

Exercise training represents a health behavior for the treatment and management of the multi-faceted manifestations of multiple sclerosis (MS). This paper provides a comprehensive overview of evidence from randomized controlled trials (RCTs) regarding benefits, safety, participation, and guidelines for exercise training in MS, based on systematic reviews and meta-analyses. The paper then provides our opinions based on extensive experience regarding challenges for improving and expanding future RCTs that will advance our understanding of exercise training in MS.

Brain hemodynamic responses and fall prediction in older adults with multiple sclerosis.

Objective: We examined whether brain hemodynamic responses, gait, and cognitive performances under single- and dual-task conditions predict falls during longitudinal follow-up in older adults with multiple sclerosis (OAMS) with relapsing-remitting and progressive subtypes.

Methods: Participants with relapsing-remitting ( = 53, mean age = 65.02 ± 4.

Reliability and Validity of the Godin Leisure-Time Exercise Questionnaire Health Contribution Score in its Use with Adults with ADHD.

As Attention-Deficit/Hyperactivity Disorder (ADHD) may have an unknown influence on the self-reports of physical activity of adults with ADHD and there is a need for high quality self-report assessments of this kind, we examined the test-retest reliability and construct validity of the Godin Leisure-Time Exercise Questionnaire-Health Contributions Score (GLTEQ-HCS) in its use with 35 adults with Attention-Deficit/Hyperactivity Disorder (ADHD) (26 females, 9 males; age = 28.7, = 6.3 years).

Disability Moderates Dual Task Walking Performance and Neural Efficiency in Older Adults With Multiple Sclerosis.

Background: Mobility and cognitive impairment are prevalent and co-occurring in older adults with multiple sclerosis (OAMS), yet there is limited research concerning the role of disability status in the cognitive control of gait among OAMS.

Objective: We investigated the levels of prefrontal cortex (PFC) activation, using oxygenated hemoglobin (HbO), during cognitively-demanding tasks in OAMS with lower and higher disability using functional near-infrared spectroscopy (fNIRS) to: (1) identify PFC activation differences in single task walk and cognitively-demanding tasks in OAMS with different levels of disability; and (2) evaluate if disability may moderate practice-related changes in neural efficiency in OAMS.

Methods: We gathered data from OAMS with lower (n = 51, age = 65 ± 4 years) or higher disability (n = 48, age = 65 ± 5 years), using a cutoff of 3 or more, in the Patient Determined Disease Steps, for higher disability, under 3 different conditions (single-task walk, Single-Task-Alpha, and Dual-Task-Walk [DTW]) administered over 3 counterbalanced, repeated trials.

Rehabilitation-Specific Predictors of Pain Intensity and Physical Activity Levels in Individuals With Acetabular Dysplasia 6 Months After Periacetabular Osteotomy.

Introduction: Individuals with acetabular dysplasia often report hip joint instability, pain, and poor hip-related function. Periacetabular osteotomy (PAO) is a surgical procedure that aims to reposition the acetabulum to improve joint congruency and improve pain and function. We aimed to examine the influence of presurgery clinical measures on functional recovery following PAO and the associations among clinical outcomes after PAO.

Remotely-delivered exercise training program for improving physical and cognitive functions among older adults with multiple sclerosis: Protocol for an NIH stage-I randomized controlled trial.

Background: Older adults with multiple sclerosis (MS) present with low physical activity participation, cognitive and ambulatory dysfunctions, and compromised quality of life (QOL).

Objective: We propose a NIH Stage-I, randomized controlled trial (RCT) that examines the feasibility and efficacy of a 16-week theory-based, remotely-delivered, exercise training program for improving cognitive and physical functions in older adults with MS who have moderate mobility disability without severe cognitive impairment.

Methods: This Stage-I study utilizes a parallel-group RCT design.

Rationale and methodology for examining the combination of aerobic exercise and cognitive rehabilitation on new learning and memory in persons with multiple sclerosis and mobility disability: Protocol for a randomized controlled trial.

Background: This paper describes the protocol for a Phase I/II, parallel-group, single-blind randomized controlled trial (RCT). The RCT investigates the combined effects of 12-weeks of aerobic exercise training (AET) integrated with virtual reality (VR) and cognitive rehabilitation (CR) on new learning and memory in 78 persons with multiple sclerosis (MS) who have mobility disability and objective impairments in learning and memory.

Methods: Participants will undergo baseline assessments consisting of neuropsychological testing, neuroimaging, self-report questionnaires, and cardiorespiratory fitness.

Validation of scores from a telephone administered multiple sclerosis walking scale-12 in persons with multiple sclerosis.

Background: The Multiple Sclerosis Walking Scale-12 (MSWS-12) has typically been delivered through paper-and-pencil or computer-based administration.

Purpose: This study examined the validity of inferences from scores derived via a telephone administration of the MSWS-12 applied as part of screening of participants with walking dysfunction into a clinical trial of exercise training in MS.

Method: The MSWS-12 was administered on two occasions separated by approximately 2 weeks through the telephone and then in-person (i.

Preferred Behavior Change Techniques for Physical Activity Interventions among Persons Newly Diagnosed with Multiple Sclerosis: A Qualitative Study.

There is increasing interest by researchers and clinicians in behavior change interventions for promoting physical activity in persons newly diagnosed with MS. Ideally, such interventions require the delivery of behavior change techniques (BCTs) based on theory and the selection of BCTs might further require tailoring for this MS subpopulation. The current study examined BCTs preferred by persons newly diagnosed with MS for informing the design and delivery of physical activity behavior change interventions in early-stages of MS.

A Narrative Review of Intermittent Fasting With Exercise.

Intermittent fasting is a dietary pattern that encompasses the 5:2 diet, alternate-day fasting, and time-restricted eating. All 3 involve alternating periods of fasting and ad libitum eating. Like other dietary strategies, intermittent fasting typically induces loss of both fat mass and lean mass.

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.

Cognitive rehabilitation effects on grey matter volume and Go-NoGo activity in progressive multiple sclerosis: results from the CogEx trial.

Background: Research on cognitive rehabilitation (CR) and aerobic exercise (EX) to improve cognition in progressive multiple sclerosis (PMS) remains limited. CogEx trial investigated the effectiveness of CR and EX in PMS: here, we present MRI substudy volumetric and task-related functional MRI (fMRI) findings.

Methods: Participants were randomised to: 'CR plus EX', 'CR plus sham EX (EX-S)', 'EX plus sham CR (CR-S)' and 'CR-S plus EX-S' and attended 12-week intervention.

Life space assessment and falls in older adults with multiple sclerosis.

Background/objective: Falls research in older adults with MS (OAMS) is scarce, and no studies have reported on the association between life-space mobility and falls in this group. Herein, we hypothesized that higher baseline life-space scores would be associated with reduced odds of reporting falls during follow-up, and explored whether the association differed by MS subtype (progressive vs. relapsing-remitting).