Exercise and Brain Health in MS
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional

Summary: 
      Physical activity is now recognized as a therapy for Multiple Sclerosis (MS) that not only
      improves physical fitness and functional mobility, but there is some evidence that it may
      also positively influence the more invisible symptoms of the disease that represent "brain
      health" - fatigue, depression and cognitive impairment. One important feature of physical
      activity is that it reduces inflammation throughout the body and the brain. The goal of this
      research is to determine whether people with MS feel less fatigue, depression and cognitive
      impairment after a program of exercise because there is a decrease in the state of
      inflammation in the brain.
    

Detailed description: 
      Multiple Sclerosis (MS) is a chronic, degenerative disease of the central nervous system,
      characterized by inflammatory demyelination and axonal degeneration. MS affects approximately
      1 in 500 Canadians. There is no cure for MS and the heterogeneous symptoms of the disease
      makes it difficult to prescribe effective treatment strategies for disease management. While
      the progression, severity and specific symptom profile vary from person to person, there are
      three key symptoms associated with brain health- fatigue, depression and cognitive
      impairment- that invariably lead to poor quality of life and increased health care costs.
      Unfortunately, the majority of people with MS suffer from these symptoms (fatigue affects
      ~90%, depression affects ~50% and cognitive impairment affects 40-65%) and a critical
      challenge with MS is that these symptoms do not present individually. For example, persons
      with MS who experience depression are more likely to also experience fatigue and/or cognitive
      impairment, which together may be more detrimental to quality of life than each symptom
      alone.

      New evidence suggests that the three symptoms affecting brain health may be interrelated
      through a common mechanism of inflammation. Further, physical exercise is known to reduce
      inflammation and thus is a prime candidate for a novel therapeutic approach to symptom
      management through its effect on modulating the inflammatory response. Indeed, physical
      activity is already used to improve the physical status of individuals with MS and
      evidence-based physical activity guidelines (PAGs) for MS have been developed to guide
      prescription. However, the guidelines have not been tested for their effects on reducing
      inflammation and brain health disease systems. Therefore, the proposed research will be the
      first to evaluate the clinical utility of the PAGs for MS in reducing brain health disease
      symptoms and improving quality of life, and the first to comprehensively determine the
      putative effects of inflammation on these symptoms.
    

Intervention name(s): Twice-weekly exercise
Intervention type(s): Other
Intervention description(s): An individualized exercise plan, incorporating aerobic and resistance exercises, following the Physical Activity Guideline recommendations will be provided for each participant.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Basic Science