Fatigue in multiple sclerosis: general and perceived fatigue does not depend on corticospinal tract dysfunction.

Background: Multiple sclerosis (MS) is an autoimmune disorder of the CNS in which inflammation, demyelination, and axonal damage of the central nervous system coexist. Fatigue is one of the most disabling symptoms in MS and little is known about the neurophysiological mechanisms involved. Methods: To give more mechanistic insight of fatigue in MS, we studied a cohort of 17 MS patients and a group of 16 age-matched healthy controls. Baseline Fatigue Severity Scales and Fatigue Rating were obtained from both groups to check the level of fatigue and to perform statistical correlations with fatigue-induced neurophysiologic changes. To induce fatigue we used a handgrip task. During the fatiguing task, we evaluated fatigue state (using a dynamometer) and after the task we evaluated the Borg Rating of Perceived Exertion Scale. Transcranial magnetic stimulation and peripheral electric stimulation were used to assess corticospinal tract and peripheral system functions before and after the task. Results: Clinically significant fatigue and central motor conduction time were greater in patients than in controls, while motor cortex excitability was decreased and maximal handgrip strength reduced in patients. Interestingly, fatigue state was positively correlated to perceived fatigue in controls but not in patients. Furthermore, in the presence of similar fatigue state over time, controls showed a significant fatigue-related reduction in motor evoked potential (a putative marker of central fatigue) whereas this effect was not seen in patients. Conclusions: in MS patients the pathogenesis of fatigue seems not driven by the mechanisms directly related to corticospinal function (that characterize fatigue in controls) but seems probably due to other “central abnormalities” upstream to primary motor cortex.post-print1473 K

Exercise Interventions for Improving Flexibility in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

[ES] Background and objectives: People with multiple sclerosis (MS) often experience limitations in joint range of motion, which is linked to spasticity and continued inactivity. Low flexibility levels in this population have been linked to postural problems and muscular pain. Therefore, the purpose of this study was to conduct a systematic review and a meta-analysis aimed at identifying the characteristics and methodological quality of investigations studying the effects of exercise interventions on the flexibility levels of people with MS. Materials and Methods: Three electronic databases (MEDLINE/PubMed, SPORTDiscus and Scopus) were systematically searched up to May 2019 for intervention studies focused on the effects of exercise on the flexibility levels of people with MS. A meta-analysis, including randomized controlled trials (RCT), which reported information regarding the effects of exercise on flexibility, was also conducted. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database, and the Quality Assessment Tool for Before–After Studies, with no control group. The quality of the information reported, regarding the programs conducted, was assessed by means of the Consensus on Exercise Reporting Template (CERT) scale. Results: Seven studies, four RCTs and three uncontrolled investigations were finally selected. The methodological quality of the RCTs was considered “poor” in one study, and “good” and “excellent” in two studies and one investigation, respectively. The three uncontrolled studies showed a methodological quality between “fair” and “poor”. Following the CERT scale, four studies were graded as “high” and three as “low”. Findings from the meta-analysis indicated no significant effects on hamstring flexibility, or the range of motion in the hips, knees or ankles. Conclusions: There is preliminary evidence from individual studies which indicates that people with MS can improve their lower limb flexibility following participation in physical exercise programs, but the meta-analysis did not confirm these findings

Exercise Interventions for Improving Flexibility in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis.

Background and objectives: People with multiple sclerosis (MS) often experience limitations in joint range of motion, which is linked to spasticity and continued inactivity. Low flexibility levels in this population have been linked to postural problems and muscular pain. Therefore, the purpose of this study was to conduct a systematic review and a meta-analysis aimed at identifying the characteristics and methodological quality of investigations studying the effects of exercise interventions on the flexibility levels of people with MS. Materials and Methods: Three electronic databases (MEDLINE/PubMed, SPORTDiscus and Scopus) were systematically searched up to May 2019 for intervention studies focused on the effects of exercise on the flexibility levels of people with MS. A meta-analysis, including randomized controlled trials (RCT), which reported information regarding the effects of exercise on flexibility, was also conducted. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database, and the Quality Assessment Tool for Before–After Studies, with no control group. The quality of the information reported, regarding the programs conducted, was assessed by means of the Consensus on Exercise Reporting Template (CERT) scale. Results: Seven studies, four RCTs and three uncontrolled investigations were finally selected. The methodological quality of the RCTs was considered “poor” in one study, and “good” and “excellent” in two studies and one investigation, respectively. The three uncontrolled studies showed a methodological quality between “fair” and “poor”. Following the CERT scale, four studies were graded as “high” and three as “low”. Findings from the meta-analysis indicated no significant effects on hamstring flexibility, or the range of motion in the hips, knees or ankles. Conclusions: There is preliminary evidence from individual studies which indicates that people with MS can improve their lower limb flexibility following participation in physical exercise programs, but the meta-analysis did not confirm these findings.post-print1388 K

Towards a Rapid Screening of Liver Grafts at the Operating Room Using Mid-Infrared Spectroscopy

The estimation of steatosis in a liver graft is mandatory prior to liver transplantation, as the risk of graft failure increases with the level of infiltrated fat. However, the assessment of liver steatosis before transplantation is typically based on a qualitative or semiquantitative characterization by visual inspection and palpation and histological analysis. Thus, there is an unmet need for transplantation surgeons to have access to a diagnostic tool enabling an in situ fast classification of grafts prior to extraction. In this study, we have assessed an attenuated total reflection−Fourier transform infrared (ATR−FTIR) spectroscopic method compatible with the requirements of an operation room for the evaluation of the lipid content in human livers. A set of human liver biopsies obtained from organs intended for transplantation were analyzed by expert pathologists, ATR−FTIR spectroscopy, lipid biochemical analysis, and UPLC−ESI(+/−)TOFMS for lipidomic profiling. Comparative analysis of multisource data showed strong correlations between ATR−FTIR, clinical, and lipidomic information. Results show that ATR−FTIR captures a global picture of the lipid composition of the liver, along with information for the quantification of the triradylglycerol content in liver biopsies. Although the methodology performance needs to be further validated, results support the applicability of ATR−FTIR for the in situ determination of the grade of liver steatosis at the operation room as a fast, quantitative method, as an alternative to the qualitative and subjective pathological examination

Análisis del tiempo de reacción en personas con y sin discapacidad intelectual en función del deporte practicado

The aim of this study was to analyze the differences in the reaction time (RT) to a visual stimulus between athletes with intellectual disabilities and without disabilities, as well as to compare the differences in gender and sport practiced. 38 athletes took part in the study (19 with intellectual disabilities and 19 without disabilities) divided according to the sport practiced; athletics, swimming, team sports, gymnastics and martial arts. The instrument used was the Dynavision D2, a speed of reaction meter that sends stimuli in succession to the athletes so that they react rapidly. It was demonstrated that the RT is lower in athletes without disability compared with athletes with intellectual disability (p < 0.05). There being no significant differences in RT between subjects with and without disabilities who engaged in martial arts and when comparing each group among the different popular sports. The mean values of RT are higher in men than in women in both groups, although there was no significant difference between them. The results of this study will help to plan the training of these athletesEl objetivo de este estudio ha sido analizar las diferencias en cuanto al tiempo de reacción (TR) ante un estímulo visual entre deportistas con discapacidad intelectual y sin discapacidad, así como comparar las diferencias en función del género y el deporte que se practica. Para ello participaron un total de 38 deportistas (19 con discapacidad intelectual y 19 sin discapacidad) divididos en función del deporte que practicaban: atletismo, natación, deportes colectivos, gimnasia y artes marciales. El instrumento utilizado fue el Dynavision D2, un reacciómetro visual que manda estímulos de forma sucesiva a los deportistas para que respondan de forma rápida. Se demostró que el TR es menor en deportistas sin discapacidad en comparación a deportistas con discapacidad (p < 0.05), no apreciándose diferencias significativas en el TR entre sujetos con y sin discapacidad que realizaban artes marciales, ni al comparar cada grupo entre los distintos deportes practicados. Los valores medios de tiempo de reacción son mayores en hombres que en mujeres en ambos grupos, aunque no se apreciaron diferencias significativas entre ellos. Los resultados de este estudio ayudarían a planificar mejor el entrenamiento de estos deportistasActividad Física y Deport

Efectos de dos programas de entrenamiento de potencia e hipertrofia sobre la densidad mineral ósea y la potencia media en personas con esclerosis múltiple durante 7 semanas. Estudio preliminar

La alteración en la conducción nerviosa que produce la EM conlleva un deterioro funcional. Concretamente, este deterioro produce pérdidas de masa muscular, densidad mineral ósea (DMO) y potencia, así como un aumento de la masa grasa. En general, el ejercicio físico ha mostrado mejoras a nivel funcional, sin embargo, el entrena-miento de fuerza parece mostrar los mejores resultados para estos parámetros. El propósito de este estudio fue evaluar los efectos de dos programas de entrenamiento de potencia e hipertrofia sobre la DMO y la potencia en personas con EM. Participaron 10 sujetos con EM con una media de edad de 56 años, de los cuales ocho eran mujeres y dos hombres. La muestra fue dividida en dos grupos de forma aleatoria. A cada grupo se le asignó un programa de entrenamiento de forma aleatoria. Se obtuvieron medidas de la DMO, potencia, fuerza y velocidad antes y después de ambos programas de entrenamiento. Se encontraron diferencias significativas en las variables DMO en el grupo de entrenamiento de hipertrofia (EH) y en la potencia del grupo de entrenamiento de potencia (EP). No se encontraron diferencias significativas entre ambos grupos para ninguna del resto de variables. El entrenamiento de hipertrofia reduce la DMO y no mejora la potencia, fuerza y velocidad. Mientras que el entrena-miento de potencia mejora la potencia y no mejora la composición corporal de este tipo de poblaciónThe alteration in nerve conduction produced by MS leads to functional displacement. Specifically, this increase produces losses of muscle mass, bone mineral density (BMD) and power as well as an increase in fat mass. In general, physical exercise has shown improvements at the functional level, however, strength training seems to show the best results for these parameters. The purpose of this study was to evaluate the effects of two power and hypertrophy training programs on BMD and potency in people with MS. Ten subjects with MS participated with a mean age of 56 years, of which eight were women and two men. The sample was divided into two groups randomly. Each group is assigned a training program randomly. BMD, power, strength and speed measurements were obtained before and after both training programs. Differences were found in the BMD variables in the hypertrophy training group (EH) and in the potency of the power training group (PE). No differences found between both groups were found for any of the other variables. Hypertrophy training reduces BMD and does not improve power, strength and speed. While power training improves potency and does not improve the body composition of this type of populationActividad Física y Deport

Efectos de dos programas de entrenamiento de potencia e hipertrofia sobre la densidad mineral ósea y la potencia media en personas con esclerosis múltiple durante 7 semanas. Estudio preliminar.

La alteración en la conducción nerviosa que produce la EM conlleva un deterioro funcional. Concretamente, este deterioro produce pérdidas de masa muscular, densidad mineral ósea (DMO) y potencia, así como un aumento de la masa grasa. En general, el ejercicio físico ha mostrado mejoras a nivel funcional, sin embargo, el entrenamiento de fuerza parece mostrar los mejores resultados para estos parámetros. El propósito de este estudio fue evaluar los efectos de dos programas de entrenamiento de potencia e hipertrofia sobre la DMO y la potencia en personas con EM. Participaron 10 sujetos con EM con una media de edad de 56 años, de los cuales ocho eran mujeres y dos hombres. La muestra fue dividida en dos grupos de forma aleatoria. A cada grupo se le asignó un programa de entrenamiento de forma aleatoria. Se obtuvieron medidas de la DMO, potencia, fuerza y velocidad antes y después de ambos programas de entrenamiento. Se encontraron diferencias significativas en las variables DMO en el grupo de entrenamiento de hipertrofia (EH) y en la potencia del grupo de entrenamiento de potencia (EP). No se encontraron diferencias significativas entre ambos grupos para ninguna del resto de variables. El entrenamiento de hipertrofia reduce la DMO y no mejora la potencia, fuerza y velocidad. Mientras que el entrenamiento de potencia mejora la potencia y no mejora la composición corporal de este tipo de población.post-print263 K

Effects of Fatigue Induced by Repetitive Movements and Isometric Tasks on Reaction Time

[Abstract] Purpose: The understanding of fatigue of the human motor system is important in the fields of ergonomics, sport, rehabilitation and neurology. In order to understand the interactions between fatigue and reaction time, we evaluated the effects of two different fatiguing tasks on reaction time. Methods: 83 healthy subjects were included in a case-control study with three arms where single and double choice reaction time tasks were performed before and after 2 min fatiguing task (an isometric task, a finger tapping task and at rest). Results: After an isometric task, the right-fatigued hand was slower in the choice component of a double choice reaction time task (calculated as the individual difference between single and double choice reaction times); also, the subjects that felt more fatigued had slower choice reaction time respect to the baseline assessment. Moreover, in relationship to the performance decay after two minutes, finger tapping task produces more intense fatigability perception. Conclusions: We confirmed that two minutes of isometric or repetitive tasks are enough to produce fatigue. The fatigue perception is more intense for finger tapping tasks in relation to the performance decay. We therefore confirmed that the two fatiguing tasks produced two different kind of fatigue demonstrating that with a very simple protocol it is possible to test subjects or patients to quantify different form of fatigue.Ministerio de Economía y Competitividad; SAF2016-80647-

Evaluación de un programa de entrenamiento de fuerza en personas con esclerosis múltiple.

Objetivo: evaluar los efectos de un programa de 10 semanas de entrenamiento de fuerza muscular en pacientes con Esclerosis Múltiple. Métodos: con un grupo de once sujetos (7 mujeres y 4 hombres) con esclerosis múltiple, con un rango en la puntuación de la escala “Expanded disability status scale” entre 6 y 8, edad media de 46.45 ± 6.89 años, se realizó un programa de fuerza de 10 semanas, a razón de dos sesiones por semana, complementadas con una sesión fisioterapéutica. La muestra fue dividida entre participantes ambulantes y no ambulantes. Se llevaron a cabo mediciones de fuerza, equilibrio, composición corporal y calidad de vida antes y después del programa de intervención. Resultados: se encontraron diferencias significativas en las variables de carga (kg), fuerza media total (N), fuerza máxima (N), potencia media total (W) en la prueba press de banca y sentadilla en el grupo ambulante, y en el grupo no ambulante en test de extensión de hombro; y en las variables de relaciones interpersonales, salud física y psicológica, en el cuestionario “WHOQOL-BREF”. No se observaron diferencias significativas en las variables de equilibrio y composición corporal. Conclusiones: un programa de entrenamiento de fuerza de 10 semanas de duración, en pacientes con esclerosis múltiple con una puntuación entre 6 y 8 en la escala “Expanded disability status scale” consiguió mejoras a nivel psicológico, social y físico. Con respecto a la fuerza, se encuentran mejoras que podrían mejorar la funcionalidad en la realización de las actividades de la vida diaria. Por otro lado, no se encontraron diferencias en el test del equilibrio y tampoco en la composición corporal de ambos grupos.post-print345 K

Evaluación de un programa de entrenamiento de fuerza en personas con esclerosis múltiple

Objective: To evaluate the effects of a 10-week resistance training program in patients. Methodology:A group of eleven subjects (7 women and 4 men) with multiple sclerosis with a range in the “Expanded disa-bility status scale” score between 6 and 8, mean age 46.45 ± 6.89 years-old, participated in this investiga-tion. It was carried out a 10-week resistance program, twice per week, complemented with a physiotherapy session. Sample was divided in walking group and in the non-walking group. Measurements of strength, ba-lance, body composition and quality of life were taken before and after the intervention program. Results:Significant differences were found in the variables load (kg), total medium strength (N), maximum strength (N), total medium power (W) in the bench press and squat in the walking group and in shoulder extension test in the non-walking group; and interpersonal relationships, physical and psychological health, by the application of “WHOQOL -BREF” questionnaire. There were no significant differences in balance and body composition variables. Conclusion: The 10-week strength training program in patients with multiple sclerosis with a score between 6 and 8 on the scale “Ex-panded disability status scale” showed improvements at a psychological, social and physical levels. About strength variables, it was found improvements that could improve functionality in the activities of daily life. Furthermore, balance test and body composition did not show significant changes in both groups.Objetivo: evaluar los efectos de un programa de 10 semanas de entrenamiento de fuerza muscular en pa-cientes con Esclerosis Múltiple. Métodos: con un grupo de once sujetos (7 mujeres y 4 hombres) con esclerosis múltiple, con un rango en la puntuación de la esca-la “Expanded disability status scale” entre 6 y 8, edad media de 46.45 ± 6.89 años, se realizó un programa de fuerza de 10 semanas, a razón de dos sesiones por semana, complementadas con una sesión fisioterapéu-tica. La muestra fue dividida entre participantes ambu-lantes y no ambulantes. Se llevaron a cabo mediciones de fuerza, equilibrio, composición corporal y calidad de vida antes y después del programa de intervención. Resultados: se encontraron diferencias significativas en las variables de carga (kg), fuerza media total (N), fuerza máxima (N), potencia media total (W) en la prueba press de banca y sentadilla en el grupo ambulante, y en el gru-po no ambulante en test de extensión de hombro; y en las variables de relaciones interpersonales, salud física y psicológica, en el cuestionario “WHOQOL-BREF”. No se observaron diferencias significativas en las variables de equilibrio y composición corporal. Conclusiones: un pro-grama de entrenamiento de fuerza de 10 semanas de duración, en pacientes con esclerosis múltiple con una puntuación entre 6 y 8 en la escala “Expanded disability status scale” consiguió mejoras a nivel psicológico, social y físico. Con respecto a la fuerza, se encuentran mejoras que podrían mejorar la funcionalidad en la realización de las actividades de la vida diaria. Por otro lado, no se encontraron diferencias en el test del equilibrio y tam-poco en la composición corporal de ambos grupos.Actividad Física y Deport