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3. Effects of Physical Therapy and Dalfampridine on Function and Quality of Life in Nonambulatory Individuals With Multiple Sclerosis: A Randomized Controlled Trial.

Author

Bromley, Lacey E. and Weinstock-Guttman, Bianca

Subjects
PHYSICAL therapy, REPEATED measures design, MULTIPLE sclerosis, PLACEBOS, T-test (Statistics), DATA analysis, RESEARCH funding, FUNCTIONAL assessment, STATISTICAL sampling, HUMAN research subjects, QUESTIONNAIRES, EXERCISE therapy, AMINOPYRIDINES, RANDOMIZED controlled trials, TREATMENT duration, TREATMENT effectiveness, DESCRIPTIVE statistics, QUALITY of life, INFORMED consent (Medical law), ANALYSIS of variance, FRIEDMAN test (Statistics), STATISTICS, DATA analysis software, COGNITION, NONPARAMETRIC statistics
Abstract

BACKGROUND: Decreases in mobility, quality of life (QOL) and cognition are commonly seen in people with multiple sclerosis (MS). Physical therapy (PT) and exercise have been shown to improve many symptoms in ambulatory individuals with MS; however, evidence in nonambulatory people with MS is lacking. Dalfampridine is a US Food and Drug Administration-approved medication for MS that treats impaired ambulation by enhancing nerve conduction. To our knowledge, no study has examined the combined effect of PT and dalfampridine and very few studies have examined dalfampridine's effect on function in individuals with more progressive disease. The purpose of this study was to examine the effectiveness of PT combined with dalfampridine or a placebo on function, QOL, and cognition in nonambulatory individuals with MS. In addition, we explored the benefits of PT in all participants to increase the extremely limited research in this population. METHODS: Adults with MS were randomly assigned to receive dalfampridine (n = 13) or placebo (n = 14) for 12 weeks in conjunction with PT treatment 2 times a week. Function, QOL, and cognition were assessed at baseline, 6 weeks, and 12 weeks. RESULTS: There was a significant time x group interaction for the Multiple Sclerosis Quality of Life-54 favoring the placebo group. Both groups significantly improved on the 9-Hole Peg Test (left arm only), sitting lateral reach (right), transferring from wheelchair to mat, and repeated sit to stand. CONCLUSIONS: The addition of dalfampridine to physical therapy did not improve function, QOL, or cognitive processing speed. Importantly, this study demonstrated an overall benefit in function and QOL with physical therapy 2 times a week for 12 weeks for nonambulatory individuals with MS. [ABSTRACT FROM AUTHOR]

Published
2024
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6. sj-docx-1-mso-10.1177_20552173221099186 - Supplemental material for A prospective study to validate the expanded timed get-up-and-go in a population with multiple sclerosis

Author

Jakimovski, Dejan, Kavak, Katelyn S, Zakalik, Karen, Bromley, Lacey, Ozel, Osman, Qutab, Natasha, Eckert, Svetlana P, Kolb, Channa, and Weinstock-Guttman, Bianca

Subjects
FOS: Clinical medicine, 110904 Neurology and Neuromuscular Diseases, Neuroscience
Abstract

Supplemental material, sj-docx-1-mso-10.1177_20552173221099186 for A prospective study to validate the expanded timed get-up-and-go in a population with multiple sclerosis by Dejan Jakimovski, Katelyn S Kavak, Karen Zakalik, Lacey Bromley, Osman Ozel, Natasha Qutab, Svetlana P Eckert, Channa Kolb and Bianca Weinstock-Guttman in Multiple Sclerosis Journal – Experimental, Translational and Clinical

Published
2022
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7. Three-Day Dietary Manipulation in Multiple Sclerosis: Exercise and Fatigue Outcomes

Author

Bromley, Lacey E., Horvath, Peter J., Bennett, Susan E., Weinstock-Guttman, Bianca, Rideout, Todd C., Browne, Richard W., and Ray, Andrew D.

Subjects
Articles
Abstract

BACKGROUND: In persons with multiple sclerosis (MS), the effect of nutrition on exercise performance and fatigue remains unknown. The objective was to determine whether a 3-day diet high in triglycerides (FAT) compared with a 3-day diet high in carbohydrates (CARB) would improve fatigue and exercise performance in persons with MS. METHODS: A randomized controlled crossover design was incorporated to study FAT versus CARB on submaximal cycling endurance (60% of peak oxygen consumption), substrate utilization, and fatigue in 12 persons with mild-to-moderate MS (Expanded Disability Status Scale score, 2.0–5.0) and 12 age- and sex-matched controls. RESULTS: There were no differences in cycling time between diets in either group (P = .29). The MS group had no changes in fatigue between diets (P = .64); the control group demonstrated increased total mental fatigue after FAT (P = .05). The control group increased carbohydrate oxidation by 24% at rest and 13% during exercise after CARB. Similarly, the control group significantly increased fat oxidation after FAT by 22% at rest and 68% during exercise (P = .01). These changes were not seen in the MS group. Compared with controls, persons with MS oxidized approximately 50% less fat during exercise after FAT (P = .05). CONCLUSIONS: Neither CARB nor FAT altered submaximal exercise performance or baseline fatigue in the MS group. The results suggest that persons with MS are unable to adapt to dietary changes and oxidize fatty acids as efficiently as controls.

Published
2021

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