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MS research update - Pilates exercise helps a wide range of people with MS - 22 August 2013

Summary

Two research papers were published this week which demonstrate the benefit of Pilates for people with MS. One study looked at the benefits for people who used wheelchairs and the second study examined the benefits for people with various levels of walking capacity.

For people in wheelchairs, there were significant improvements in sitting stability, sitting posture, pain in the shoulders and back and there was less impact of MS on their daily life after doing a 12 week course of Pilates. They also reported increased confidence as well as various physical, functional, psychological and social benefits.

In the second study, people with MS with various levels of walking ability had improvements in balance, mobility and upper and lower extremity muscle strength after undertaking an eight week course of Pilates.

Background

People with MS are encouraged to stay active as much as possible but not to "work through" fatigue as this symptom is quite different from the tiredness experienced by people who do not have MS.

To stay active, it is best to choose an exercise that you enjoy so that exercise is as appealing as possible. Different types of exercise will have different benefits. Two studies published this week looked at the benefits of Pilates. One study was with people in wheelchairs (study 2) and one was with people who had a range of walking abilities (study 1).

Pilates exercises concentrate on slow, measured, repetitive movements with the intention of strengthening and balancing lesser-used muscles as well as improving core strength.

Study 1: people with a range of walking abilities

How this study was carried out

26 people with MS who were not wheelchair users were divided into two groups. The first group of 18 people undertook an eight week programme of Pilates. The control group of eight people did abdominal breathing and active extremity exercises at home.

The ability to balance and the mobility of all the participants were measured as well as the muscle strength of the upper and lower extremities. The timed up and go test was also used. This test records the time that a person takes to rise from a chair, walk three metres, turn around, walk back to the chair, and sit down again with any mobility aids that they would normally use. The person's confidence in their balance skills while undertaking every day activities was also assessed.

What was found

Improvements were seen in balance, mobility, and upper and lower extremity muscle strength in the group who had done Pilates but not in the control group.

What does it mean?

Pilates exercise particularly focuses on balance and strengthening exercises and benefits balance, mobility and muscle strength in people with MS with a range of walking abilities.

Guclu-Gunduz A, Citaker S, Irkec C, et al.
The effects of pilates on balance, mobility and strength in patients with multiple sclerosis..
NeuroRehabilitation. 2013 Jul 12. [Epub ahead of print]
abstract

Study 2: people in wheelchairs

How this study was carried out

15 people with MS who used a wheelchair undertook a 12 week Pilates programme. Assessments were performed before the programme began and again after six weeks and 12 weeks. The assessments measured sitting stability, posture, pain, fatigue and function. The impact of MS on daily life was measured using the MSIS-29 scale which looks at a wide range of abilities including the capacity to do physically demanding tasks, feelings stiff or taking longer to do things.

What was found

After 12 weeks, participants had significant improvements in sitting stability, sitting posture, pain in the shoulders and back and there was less impact of MS on their daily lives as measured in their assessments. In addition, the majority of participants described various physical, functional, psychological and social benefits from learning Pilates which reflected an increased confidence in doing the activities of daily life.

Everyone said that they enjoyed the classes and most people wanted to continue with them after the study had ended.

What does it mean?

Pilates worked well to improve sitting stability and posture and also decreased pain for people with MS who used wheelchairs. In addition it was safe and enjoyable.

The authors point out that this was only a small study and that larger studies would be valuable.

van der Linden ML, Bulley C, Geneen LJ, et al.
Pilates for people with multiple sclerosis who use a wheelchair: feasibility, efficacy and participant experiences..
Disabil Rehabil. 2013 Aug 19. [Epub ahead of print]
abstract

More about Pilates

Pilates is one of many options available for people with MS to stay active.

An MS Trust funded pilot study looked at how core stability training, like Pilates, can benefit people with MS. This is being followed up by a larger multicentre study, also funded by the MS Trust. 

You can read more about Pilates on the NHS Choices web site. It includes advice on what to look out for when choosing a class or teacher. Further information is also available from the Body Control Pilates Association.

We also have a range of resources on the MS Trust website, including:

Research by topic areas...

Symptoms and symptom management

Shaygannejad V, Ashtari F, Zare M, et al.
Seizure characteristics in multiple sclerosis patients.
J Res Med Sci. 2013 Mar;18(Suppl 1):S74-7.
abstract

Najafi MR, Toghianifar N, Etemadifar M, et al.
Circadian rhythm sleep disorders in patients with multiple sclerosis and its association with fatigue: A case-control study.
J Res Med Sci. 2013 Mar;18(Suppl 1):S71-3
abstract

Ruffion A, Castro-Diaz D, Patel H, et al.
Systematic review of the epidemiology of urinary incontinence and detrusor overactivity among patients with neurogenic overactive bladder.
Neuroepidemiology. 2013 Aug 8;41(3-4):146-155. [Epub ahead of print]
abstract

MS relapses

Rakusa M, Murphy O, McIntyre L, et al.
Testing for urinary tract colonization before high-dose corticosteroid treatment in acute multiple sclerosis relapses: prospective algorithm validation.
Eur J Neurol. 2013 Mar;20(3):448-52.
abstract

Disease modifying treatments

Hadjigeorgiou GM, Doxani C, Miligkos M, et al.
A network meta-analysis of randomized controlled trials for comparing the effectiveness and safety profile of treatments with marketing authorization for relapsing multiple sclerosis.
J Clin Pharm Ther. 2013 Aug 20. doi: 10.1111/jcpt.12090. [Epub ahead of print]
abstract

Other treatments

Linsenmeyer TA.
Use of botulinum toxin in individuals with neurogenic detrusor overactivity: State of the art review.
J Spinal Cord Med. 2013 Sep;36(5):402-19.
abstract

Rehabilitation

Salhofer-Polanyi S, Windt J, Sumper H, et al.
Benefits of inpatient multidisciplinary rehabilitation in multiple sclerosis.
NeuroRehabilitation. 2013 Jul 12. [Epub ahead of print]
abstract

Psychological aspects

Amato M, Goretti B, Viterbo R, et al.
Computer-assisted rehabilitation of attention in patients with multiple sclerosis: results of a randomized, double-blind trial.
Mult Scler. 2013 Aug 19. [Epub ahead of print]
abstract

Goverover Y, Chiaravalloti N, Deluca J.
The influence of executive functions and memory on self-generation benefit in persons with multiple sclerosis.
J Clin Exp Neuropsychol. 2013 Aug 19. [Epub ahead of print]
abstract

Physical activity

Feys P, Tytgat K, Gijbels D, et al.
Effects of an 1-day education program on physical functioning, activity and quality of life in community living persons with multiple sclerosis.
NeuroRehabilitation. 2013 Aug 7. [Epub ahead of print]
abstract

Bayraktar D, Guclu-Gunduz A, Yazici G, et al.
Effects of Ai-Chi on balance, functional mobility, strength and fatigue in patients with multiple sclerosis: A pilot study.
NeuroRehabilitation. 2013 Aug 7. [Epub ahead of print]
abstract

Citaker S, Guclu-Gunduz A, Yazici G, et al.
Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis.
NeuroRehabilitation. 2013 Jul 9. [Epub ahead of print]
abstract

Hansen D, Wens I, Dendale P, et al.
Exercise-onset heart rate increase is slowed in multiple sclerosis patients: Does a disturbed cardiac autonomic control affect exercise tolerance?
NeuroRehabilitation. 2013 Jun 20. [Epub ahead of print]
abstract

Brichetto G, Rinaldi S, Spallarossa P, et al.
Efficacy of physical therapy in multiple sclerosis as measured with the modified fatigue impact scale and ambulation index: A retrospective study.
NeuroRehabilitation. 2013 Jun 20. [Epub ahead of print]
abstract

Prognosis

Kalron A, Dvir Z, Gurevich M, et al.
Do motor impairments detected on onset of multiple sclerosis suggest an early second attack? A prospective one year single center study.
NeuroRehabilitation. 2013 Aug 7. [Epub ahead of print]
abstract

Horakova D, Zivadinov R, Weinstock-Guttman B, et al.
Environmental factors associated with disease progression after the first demyelinating event: results from the multi-center SET study.
PLoS One. 2013;8(1):e53996.
abstract
Read the full text of this paper

Self-management

Ashtari F, Jamshidi F, Shoormasti RS, et al.
Cow's milk allergy in multiple sclerosis patients.
J Res Med Sci. 2013 Mar;18(Suppl 1):S62-5.
abstract

Neufeld P, Kniepmann K.
Gateway to wellness: an occupational therapy collaboration with the national multiple sclerosis society.
Occup Ther Health Care. 2001;13(3-4):67-83.
abstract

Review

Hauser SL, Chan JR, Oksenberg JR.
Multiple sclerosis: Prospects and promise.
Ann Neurol. 2013 Aug 16. [Epub ahead of print]
abstract

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