BACKGROUND: Back pain is a common but often underestimated symptom of patients with MS that can negatively influence their quality of life. However there are only limited number of studies comparing the effect of different types of exercise and use of telerehabilitation on back pain in MS. Therefore, the aim of the study is to compare whether telerehabilitation alone is as effective as conventional outpatient physiotherapy followed by online exercise. METHODS: This single-centre intervention study compared the impact of different individual outpatient physiotherapy treatments (Group 1 - individual Pilates exercise or Group 2 - strength training) and telerehabilitation alone (individual Pilates exercise with a physiotherapist online). The primary objective was to compare the effect of interventions on back pain (assessed using the Visual Analogue Scale and McGill Pain Questionnaire) and quality of life (Multiple Sclerosis Quality of Life-54). Secondary aims were to compare effect of interventions on spine and thorax mobility, functional mobility (assessed using the Timed 25 foot walk test, Six Spot Step test), respiratory muscle strenght and patient reported outcomes (assessed using he Hospital Anxiety and Depression Scale, Fatigue Severity Scale). RESULTS: 45 people with MS were enrolled in the study (3 men, age:48.4± SD 11,5, Expanded Disability Status Scale (EDSS): 3.3±SD 1,1) and 36 people completed the entire exercise program. All types of exercise intervention showed a positive effect on the reduction of back pain, quality of life and fatigue. The interventions also increased respiratory muscle strength and increased thorax mobility, but we did not find any effect of interventions on gait tests. There were no difference in effect on outcome measures between different types of exercise interventions. CONCLUSION: Telerehabilitation, involving individual exercise sessions with a physiotherapist, has a comparable effect on reducing back pain, improving quality of life, and enhancing respiratory muscle strength in people with MS as individual Pilates or strength training.
- MeSH
- bolesti zad * rehabilitace MeSH
- dospělí MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- odporový trénink metody MeSH
- roztroušená skleróza * rehabilitace komplikace MeSH
- stupeň závažnosti nemoci MeSH
- techniky cvičení a pohybu metody MeSH
- techniky fyzikální terapie * MeSH
- telerehabilitace * MeSH
- terapie cvičením metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Článek představuje možnosti rehabilitační péče (konkrétně fyzioterapie) u osob s roztroušenou sklerózou s těžkým neurologickým deficitem (EDSS ≥ 7,0). Teoretické poznatky jsou ilustrovány daty z naší pilotní studie domácí fyzioterapie u čtyř pacientů.
The article presents the possibilities of rehabilitation care (specifically physiotherapy) for people with multiple sclerosis with severe neurological deficit (EDSS ≥ 7.0). Theoretical findings are illustrated with data from our pilot study of home physiotherapy in 4 patients.
Background: The aim of our pilot study was to assess the feasibility and effectiveness of individual balance telerehabilitation for people with multiple sclerosis (MS). Methods: In this pilot study 20 individuals with MS with balance impairment were included (10 in experimental, 10 in control group). The experimental group underwent 12 weeks of individual telerehabilitation (with direct synchronous contact between the physiotherapist and the patient). The control group received conventional outpatient physiotherapy. The standardized tests of balance and functional mobility were assessed at baseline and after intervention. Results: Comparing the two groups, the experimental group achieved statistically significant improvement in balance: the BBS test (p=0.002), TUG (p=0.048), functional test standing on one limb (p=0.01), and subjectively perceived balance with the ABC Scale questionnaire (p=0.041). The substantive significance (Cohen's d) when comparing the two groups reached a large effect size in the BBS (d=0.83) and standing on one limb (d=1.06) and in the MSWS-12 (d=0.78) and ABC Scale questionnaire (d=0.78). Conclusion: Telerehabilitation interventions represent an increasing trend and our data suggest that individually delivered online telerehabilitation can be effective in the treatment of balance and functional mobility disorders in MS.
Úvod: Roztroušená skleróza je chronické neurodegenerativní onemocnění na autoimunitním podkladě, v jehož komplexní terapii hrají kromě farmakoterapie nedílnou roli také režimová opatření vč. pohybové aktivity. Mnoha klinickými studiemi byl prokázán pozitivní vliv pravidelné pohybové aktivity na symptomy onemocnění, přesto se však zdá, že jsou osoby s tímto onemocněním nedostatečně pohybově aktivní. Cílem naší studie proto bylo zjistit míru a typ pohybové aktivity, které se osoby s RS v ČR věnují, a jak do jejich pohybového režimu zasáhl vliv pandemie koronaviru. Metodika: Studie byla realizována formou mezinárodního dotazníkového šetření. V rámci této práce jsou prezentovány pouze výsledky od českých pacientů. Výsledky: Celkem se studie zúčastnilo 265 osob s RS (z toho 55 mužů), zastoupeni byli pacienti nově diagnostikovaní až po pacienty v chronickém stadiu (s délkou onemocnění více než 20 let). Většina respondentů (více než 80 %) se věnuje nějaké formě pohybu, přičemž nejčastější aktivitou byly chůze, zdravotní cvičení nebo jízda na kole. Pouze 64 % však naplňuje doporučené množství pohybové aktivity podle guidelines. Během pandemie také významně stouplo využívání moderních technologií při cvičebních aktivitách. Závěr: Informace o běžném pohybovém režimu pacientů mohou pomoci neurologům a rehabilitačním odborníkům lépe plánovat cvičení a pohybové aktivity pro tuto skupinu pacientů.
Introduction: Multiple sclerosis (MS) is a chronic autoimmune neurodegenerative disease. In which, in addition to pharmacotherapy, regimen measures play an integral role in complex therapy, including physical activity. Many clinical studies have demonstrated the positive effect of regular physical activity on on the symptoms of the disease, yet people with the disease seem to be insufficiently physically active. Therefore, the aim of our study was to evaluate the level of and type of physical activity that people with MS in the Czech Republic engage in, and how their exercise regimen was affected by the impact of the coronavirus pandemic. Methodology: The study was realized in the form of an international questionnaire survey. Only results from Czech patients are presented in this paper. Results: A total of 265 people with MS (55 men) participated in the study, from newly diagnosed to chronic stage patients (with disease duration of more than 20 years). The majority of respondents (more than 80%) engaged in some form of exercise, with walking, health exercises or cycling being the most common activities. However, only 64% were meeting the recommended amount of exercise according to the guidelines. The use of modern technology in exercise activities also increased significantly during the pandemic. Conclusion: Information on patients’ usual exercise regimens can help neurologists and rehabilitation professionals to better plan exercise and physical activities for this group of patients.
- MeSH
- COVID-19 MeSH
- dospělí MeSH
- elektrické vybavení a zdroje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- pohybová aktivita * MeSH
- průzkumy a dotazníky MeSH
- roztroušená skleróza * MeSH
- senioři MeSH
- statistika jako téma MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
Background: Information about the level of physical activities in people with multiple sclerosis (MS) is available from a number of countries, but not from Central European countries. No data has been published from the Czech Republic so far. The aim of our study was to investigate the type and level of physical activities/exercise in people with MS in the Czech Republic, along with the clinical factors that may influence these physical activities. This information can assist nurses in advising on complex patient care. Methods: The clinical assessment included: the Godin–Shephard Leisure Time Physical Activity Questionnaire (GLTEQ), the 25-foot walk test (T25FW), the 2 Minute Walk Test (2MWT), the Fatigue Severity Scale (FSS), and a study-specific questionnaire that reports experience with sports and sport activities or rehabilitation exercises. Results: In our sample of 308 people with MS, 63% reported engaging in some form of physical activity. Men exercise more regularly, while irregular exercise predominates among women. Cycling and swimming are the most popular forms of physical activity for both genders. Only one third of participants exercise several times a week – as per medical recommendations. When comparing the mean values, men are classified as active and women as moderately active (according to the GLTEQ questionnaire scores). In our sample, no strong correlations were found between physical activity level and the clinical characteristics of the patients. Weak correlations were found only for fatigue (r = –0.32), neurological disability (r = –0.22), and walking ability (r = 0.25). Conclusion: Since regular physical activity is considered an integral part of the complex treatment of MS patients, this information can help nurses in counselling patients.
INTRODUCTION: One of the most debilitating problems encountered by people with multiple sclerosis (MS) is the loss of balance and coordination. Our study aimed to comprehensively evaluate the effectiveness of one year of Tai-chi exercise in patients with MS using both subjective and objective methods, including posturography. METHODS: This was a single-group longitudinal one-year study performed from the 1st of January 2019 to the 1st of January 2020. The primary outcomes of interest were the Mini-Balance Evaluation Systems Test (Mini-BESTest) and static posturography measures as objective methods to detect subtle changes associated with postural control/balance impairment. Secondary outcomes were measures of depression, anxiety, cognitive performance, and quality of life. All objective and subjective parameters were assessed four times: at baseline, and after three, six and 12 months of regular Tai-chi training. The difference was calculated as a subtraction of baseline values from every timepoint value for each measurement. If the normality test was passed, parametric one-sample t-test was used, if failed, Wilcoxon signed ranks test was used to test the difference between the baseline and each timepoint. Alpha was set to 0.017 using Bonferroni correction for multiple comparisons. RESULTS: Out of 25 patients with MS enrolled, 15 women with MS (mean age 44.27 years) were included for statistical analyses after completing the 12-month program. After 12 months, significant improvements were found in all objective balance and gait tests: Mini-BESTest (p<0.001), static posturography measures (total area of the centre of foot pressure - TA; p = 0.015), 25 Feet Walk Test (25FWT; p = 0.001), anxiety (Beck Anxiety Inventory - BAI; p = 0.005) and cognition tests (Paced Auditory Serial Addition Test - PASAT; p = 0.003). Measures of depression (Beck Depression Inventory - BDI; p = 0.071), cognition (Symbol Digit Modalities Test - SDMT; p = 0.079), and health-related quality of life (European Quality of Life 5-Dimensions Questionnaire - EQ-5D-5L; p = 0.095) showed a trend of improvement but were not significant, which could be the result of a small sample and increased bias due the type II error. CONCLUSION: According to these preliminary results, this study indicates the possible beneficial effects of long-term Tai-chi training on patients with MS. Although these findings need to be confirmed by further studies with a larger sample of participants of both genders and require more rigorous randomized controlled trials (RCT) design, our findings support the recommendation of regular and long-term Tai-chi exercise in patients with MS. GOV IDENTIFIER (RETROSPECTIVELY REGISTERED): NCT05474209.
- MeSH
- dospělí MeSH
- kognice MeSH
- kvalita života MeSH
- lidé MeSH
- posturální rovnováha MeSH
- prospektivní studie MeSH
- roztroušená skleróza * komplikace terapie MeSH
- taiči * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- balneologie metody MeSH
- lidé MeSH
- reflexní terapie metody MeSH
- roztroušená skleróza * rehabilitace MeSH
- techniky fyzikální terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Background:Research in telerehabilitation (TR) in neurology tends to focus on patients with low to moderate disability. For neurology patients with severe mobility limitations, TR can help to enable rehabilitation for people whose mobility limitations make it difficult for them to access rehabilitation facilities. The aim of this study is to evaluate the interest of people with neurological disability caused by multiple sclerosis (MS) in TR services.Methods:This electronic survey targeted individuals with MS, specifically those with a higher level of disability.Results:A total of 355 patients with MS (155 with severe disabilities) participated in this study. There was no difference in interest in rehabilitation between people with mild-to-moderate and severe disabilities (p = 0.1258, confidence interval [CI] = 95%). However, we found a higher interest in upper limb exercises (p = 0.0006, CI = 95%) and balance training (p = 0.0000, CI = 95%) among people with higher disability.Conclusion:The results of this study may help to improve the planning and targeting of TR interventions, where a different focus of intervention is appropriate for patients with different levels of disability. This may enable TR to be maximally tailored to patient capabilities and current greatest limitations. For example, for people with severe disabilities, it is appropriate to focus on training the upper limb function to maintain self-sufficiency and implement interventions to prevent falls.
- MeSH
- lidé MeSH
- omezení pohyblivosti MeSH
- roztroušená skleróza * rehabilitace MeSH
- telerehabilitace * metody MeSH
- terapie cvičením metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: The aim of the present systematic review was to investigate the effects of voluntary walking interventions in persons with multiple sclerosis (pwMS). For this purpose, we developed a framework to describe the components of walking interventions. DATA SOURCES: Two databases (MEDLINE/PubMed and EMBASE) were searched in January 2023. STUDY SELECTION: Included studies enrolled pwMS and evaluated walking interventions with a duration of 2 weeks or longer. Further, they evaluated at least one walking-related outcome. Both RCTs and non-controlled studies were enrolled. DATA EXTRACTION: Data were extracted using a customized spreadsheet, which included detailed information on patient characteristics, interventions, outcomes, and results. Based on the extracted results, the effect sizes (ES, Hedge's g) of the walking interventions were calculated if possible. The methodological quality of the included studies and their reporting was determined using the TESTEX evaluation tool. DATA SYNTHESIS: Data from a total of n = 200 pwMS was included from N = 7 RCT ́s (from 3 we used within-group data) and N = 5 single-group studies. On average 91.7 ± 9.9 % of the planned walking sessions were attended, 8.7 ± 10.5 % of the participants dropped out, and very few adverse events occurred. Walking interventions improved walking performance during short distance walk tests (ES ranging from -0.21 to -0.72, "walking time") and long distance walk tests (ES ranging from 0.27 to 0.72, "walking distance"). CONCLUSIONS: Voluntary walking interventions appear to be safe and effective at improving walking performance in pwMS. However, well-powered walking intervention studies are needed to confirm these promising effects. The simplicity of walking interventions makes them highly relevant for ambulatory pwMS.
- MeSH
- chůze MeSH
- lidé MeSH
- roztroušená skleróza * terapie MeSH
- test chůzí MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
Kyselina hyaluronová (KH) je lineární, přirozeně se vyskytující polysacharid o vysoké molekulové hmotnosti. Je součástí řady bio logických procesů, zejména regulačních, protizánětlivých, imunosupresivních nebo antiproliferativních. Významně váže vodu a podílí se na udržování viskoelasticity tkání, na supramolekulárním prostorovém uspořádání proteoglykanů v extracelulární matrix a na regulaci osmotického tlaku, což významně ovliňuje homogenitu tkáně a její homeostatickou integritu. Díky těmto vlastnostem lze neimunogenní KH použít v mnoha klinických aplikacích. V otorinolaryngologii jsou možnosti jejího využití široké zejména v otologii, laryngologii, rinologii nebo při léčbě zánětlivý stavů a keloidních jizev. Ně kte ré potenciální oblasti využití jsou stále ve stadiu experimentu (genová terapie).
Hyaluronic acid (HA) is a linear, naturally occurring polysaccharide of high molecular weight. It is part of a number of bio logical processes, especially regulatory, anti-inflammatory, immunosuppressive or antiproliferative. It significantly binds water and participates in the maintenance of tissue viscoelasticity, in the supramolecular spatial arrangement of proteoglycans in the extracellular matrix and in the regulation of osmotic pressure, which significantly affects tissue homogeneity and its homeostatic integrity. Due to these properties, non-immunogenic HA can be used in many clinical applications. In otorhinolaryngology, the possibilities of its use are wide, especially in otology, laryngology, rhinology or in the treatment of inflammatory conditions and keloid scars. Some potential areas of use are still in the experimental stage (gene therapy).
