Comparison of postural balance in women with multiple sclerosis and healthy controls.

Purpose. The primary purpose of this study was to compare balance in women with Multiple Sclerosis (MS), and healthy controls. The secondary purpose was to investigate the relationship between balance and Expanded Disability Status Scores (EDSS) in patients with MS. Methods. Subjects included 67 women with MS (X= 43.9 +/- 1.2 years) and 45 healthy controls (X = 40.4 +/- 2.4 years). The MS group was diagnosed with this form of neurological disorder by a single MS neurologist and had a score of ≤ 5 on the EDSS. Both groups included women between 18-64 years of age who underwent a series of six balance measures by the use of the Neurocom Balance Master. The MS group also filled out the MSQOL-54, and the healthy controls the PAR-Q and a Health Status Questionnaire. Results. There was a significant difference for weight between the MS (X = 76.8 +/- 2.8 kg) group and healthy controls (X = 64.3 +/- 1.6 kg), with the MS group being significantly heavier (p< 0.01), but no significant differences were found for age or height (p>0.05). For the following balance measures (deg/sec), there was a significant difference between the two groups, with the MS group doing worse for unilateral stance eyes open, unilateral stance eyes closed, tandem walk end sway, and MCTSIB measures standing on foam surface with closed eyes (p< 0.01). Step quick turn (deg), did not differ significantly between the MS group and the healthy control group after adjusting for age (p>0.05). Evaluating the EDSS subcomponents, there was a significant difference for sensory function and duration of disease in the MS group (p< 0.05). Conclusions. The results from this study indicate significantly more postural instability in the MS group when compared to healthy controls. Also, the group diagnosed with MS for 10.1-20yrs had more impaired sensory function as measured by the EDSS compared to the other MS groups (.1-10yrs and 20.1-33yrs) (p< 0.05)

Telerehabilitation in Multiple Sclerosis: Results of a Randomized Feasibility and Efficacy Pilot Study

A prospective, randomized, three-arm, evaluator blinded study to demonstrate the feasibility of a telerehabilitation (TR) program in individuals with ambulatory deficits secondary to Multiple Sclerosis (MS) and evaluate its efficacy when compared to conventional on-site physical therapy (PT) was completed. Thirty participants were evaluated at baseline and randomized to one of three groups with intervention lasting 8 weeks: Group 1 (control)- customized unsupervised home-based exercise program (HEP) 5 days a week; Group 2 (TR)- remote PT supervised via audio/visual real-time telecommunication twice weekly; Group 3 (PT)- in-person PT at the medical facility twice weekly. Outcomes included patient reported outcomes (PROs) obtained through questionnaires, and measurements of gait and balance performed with bedside tests and a computerized system. Functional gait assessment improved from baseline in all three groups. There were no significant differences between the TR and the conventional PT groups for a variety of outcome measures. TR is a feasible method to perform PT in persons with MS and has comparable efficacy to conventional in-person PT as measured by patient reported outcomes and objective outcomes of gait and balance

Arterial Compliance in Multiple Sclerosis: A Pilot Study

A reduction in arterial compliance in patients with autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus has been previously reported. It is caused by the effect that systemic inflammation has on the cardiovascular system. Multiple sclerosis (MS), an immune-mediated disease that exclusively affects the central nervous system (CNS), has a significant inflammatory component that is limited to that compartment. The potential effects of its inflammatory mediators in the cardiovascular system are largely unknown. Purpose: To examine large (C1) and small arterial compliance (C2) in patients with MS and compare them with healthy age-matched controls. To also determine whether any differences in C1 and C2 indices between participants diagnosed with relapsing remitting MS (RR-MS), secondary progressive MS (SP-MS), and controls exist. Methods: A total of 26 men and women between the ages of 18 and 64 diagnosed with MS and 25 healthy controls volunteered for this study. Arterial compliance was measured by using pulse contour analysis (PCA), which records and analyzes the blood pressure waveform data from the Arterial Pulse Wave Sensors. Results: Significant differences in C1 and C2 were found between young RR-MS and healthy young controls (P .05) were seen for C1 or C2 values between older RR-MS, SP-MS, and healthy controls. Conclusion: Arterial compliance is significantly compromised in young individuals with MS, compared with age-matched controls, but not for older individuals, suggesting a systemic effect of an inflammatory process that predominantly affects the CNS.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

The influence of obesity on falls and quality of life

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Physical activity is related to quality of life in older adults

BACKGROUND: Physical activity is associated with health-related quality of life (HRQL) in clinical populations, but less is known whether this relationship exists in older men and women who are healthy. Thus, this study determined if physical activity was related to HRQL in apparently healthy, older subjects. METHODS: Measures were obtained from 112 male and female volunteers (70 ± 8 years, mean ± SD) recruited from media advertisements and flyers around the Norman, Oklahoma area. Data was collected using a medical history questionnaire, HRQL from the Medical Outcomes Survey short form-36 questionnaire, and physical activity level from the Johnson Space Center physical activity scale. Subjects were separated into either a higher physically active group (n = 62) or a lower physically active group (n = 50) according to the physical activity scale. RESULTS: The HRQL scores in all eight domains were significantly higher (p < 0.05) in the group reporting higher physical activity. Additionally, the more active group had fewer females (44% vs. 72%, p = 0.033), and lower prevalence of hypertension (39% vs. 60%, p = 0.041) than the low active group. After adjusting for gender and hypertension, the more active group had higher values in the following five HRQL domains: physical function (82 ± 20 vs. 68 ± 21, p = 0.029), role-physical (83 ± 34 vs. 61 ± 36, p = 0.022), bodily pain (83 ± 22 vs. 66 ± 23, p = 0.001), vitality (74 ± 15 vs. 59 ± 16, p = 0.001), and social functioning (92 ± 18 vs. 83 ± 19, p = 0.040). General health, role-emotional, and mental health were not significantly different (p > 0.05) between the two groups. CONCLUSION: Healthy older adults who regularly participated in physical activity of at least moderate intensity for more than one hour per week had higher HRQL measures in both physical and mental domains than those who were less physically active. Therefore, incorporating more physical activity into the lifestyles of sedentary or slightly active older individuals may improve their HRQL

The influence of obesity on calf blood flow and vascular reactivity in older adults

OBJECTIVE: To determine whether differences in vascular reactivity existed among normal weight, overweight, and obese older men and women, and to examine the association between abdominal fat distribution and vascular reactivity. METHODS: Eighty-seven individuals who were 60 years of age or older (age = 69 ± 7 yrs; mean ± SD) were grouped into normal weight (BMI < 25; n = 30), overweight (BMI ≥ 25 and < 30; n = 28), or obese (BMI ≥ 30; n = 29) categories. Calf blood flow (BF) was assessed by venous occlusion strain-gauge plethysmography at rest and post-occlusive reactive hyperemia. RESULTS: Post-occlusive reactive hyperemia BF was lower (p = 0.038) in the obese group (5.55 ± 4.67 %/min) than in the normal weight group (8.34 ± 3.89 %/min). Additionally, change in BF from rest to post-occlusion in the obese group (1.93 ± 2.58 %/min) was lower (p = 0.001) than in the normal weight group (5.21 ± 3.59 %/min), as well as the percentage change (75 ± 98 % vs. 202 ± 190 %, p = 0.006, respectively). After adjusting for age, prevalence in hypertension and calf skinfold thickness, change in BF values remained lower (p < 0.05) in obese subjects compared to the normal weight subjects. Lastly, the absolute and percentage change in BF were significantly related to BMI (r = -0.44, p < 0.001, and r = -0.37, p < 0.001, respectively) and to waist circumference (r = -0.36, p = 0.001, and r = -0.32, p = 0.002). CONCLUSION: Obesity and abdominal adiposity impair vascular reactivity in older men and women, and these deleterious effects on vascular reactivity are independent of conventional risk factors

The Relationship Between Arterial Elasticity and Metabolic Syndrome Features

The purpose of this study was to examine the effects of metabolic syndrome (MS) features on arterial elasticity of the large and small arteries in apparently healthy adults, to examine the effect of clustered features of MS, and to determine which features are most predictive of large and small artery elasticity. The subjects for this study consisted of 126 men and women, age 45 years and older. The subjects rested supine while pulse contour analysis was measured from the radial artery by using an HDI/Pulsewave CR-2000 instrument (Hypertension Diagnostic, Inc) to assess arterial elasticity in the large and small arteries. Medical history was obtained along with body mass index, waist circumference, body surface area, and blood pressure. Large artery elasticity was lower (p=0.002) in subjects with hypertension (12.7 ∓4.3 mL/mm Hg × 10) than in those with normotension (15.0 ∓4.2 mL/mm Hg × 10; mean ∓ SD), and small artery elasticity was lower (p=0.001) as well (3.9 ∓2.3 mL/mm Hg × 100 vs 5.3 ∓2.5 mL/mm Hg × 100). Large artery elasticity was lower (p=0.02) in obese subjects (12.2 ∓4.9 mL/mm Hg × 10) than in nonobese subjects (14.2 ∓4.5 mL/mm Hg × 10), and large artery elasticity was lower (p=0.04) in subjects with abdominal obesity (12.2 ∓4.5 mL/mm Hg × 10) than in those without (14.5 ∓4.8 mL/mm Hg × 10). Large artery elasticity decreased as the number of features of MS increased (p<0.01). Multiple regression showed that body mass index and the presence of hypertension were predictors of large artery elasticity (R =0.61, R 2 =0.37, p=0.003, SEE = 3.60 mL/mm Hg × 10), and hypertension was a predictor of small artery elasticity (R =0.53, R 2 =0.28, p=0.001, SEE = 2.12 mL/mm Hg × 100). Hypertension and obesity are the features of MS that are most predictive of impairment in large and small artery elasticity in apparently healthy middle-aged and older adults. Furthermore, impairment in large artery elasticity is more evident in subjects with at least three features of MS.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Acute and Chronic Effects of Whole-Body Vibration on Balance, Postural Stability, and Mobility in Women With Multiple Sclerosis

The acute and chronic effects of whole-body vibration (WBV) on balance, postural stability, and mobility were evaluated in 21 women with relapsing-remitting multiple sclerosis (MS) randomly assigned to control (n = 9) or experimental (n = 12) groups. To assess acute responses, outcome variables were assessed before and immediately after a session of WBV (five 30-second bouts of vibration; frequency 30 Hz; amplitude 3 mm; 1-minute rest intervals) during their first visit (week 1) using field (Timed-Up and Go; 500-m walk; Berg Balance Scale) and laboratory tests (NeuroCom Balance Master and EquiTest System—Sensory Organization Test, Adaptation Test, Limits of Stability, Modified Clinical Test for Sensory Integration of Balance, Unilateral Stance, Tandem Walk, Step/Quick Turn). Acute responses were also measured after their fifth visit for only the Adaptation and Sensory Organization tests. For the chronic responses, participants were exposed to the WBV protocol once a week, for a total of 5 weeks, and then at week 5, were reassessed with the Adaptation and the Sensory Organization tests. Neither acute nor chronic exposure to the WBV protocols used in this study resulted in significant improvements (P > .05) in balance, postural stability, or mobility as assessed by either field or laboratory tests. However, based on promising results from other studies that have used WBV with other clinical populations, either alone or in conjunction with exercise, additional studies that increase the dose of vibration exposure, both acutely and chronically, should be conducted in patients with MS.Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.Ye

Evaluation of Power Production Asymmetry during Cycling in Persons with Multiple Sclerosis

Lower limb asymmetries have been observed in persons with multiple sclerosis (PwMS), and have been associated with mobility impairment. An incremental cycling test was performed on a cycle ergometer to determine peak power output (PPO) and peak oxygen consumption (VO2peak). Then, participants cycled at 50%, 60%, and 70% of their PPO to assess the contribution of each lower limb to power production. Two-way repeated measures ANOVA was used to detect group × intensity differences in power production asymmetry. Eight PwMS and six healthy individuals (Non-MS) completed the study. No statistically significant (p > 0.05) group × intensity interactions or main effects were present when examining between-limb differences in power production. The current data do not indicate a statistically significant difference in power production asymmetry between groups and exercise intensities. Previous research has established a 10% difference between contralateral limbs as a threshold for asymmetry. The average asymmetry in power production in PwMS exceeded the 10% threshold at all measured outputs, suggesting the presence of asymmetry in power production.Ye