August 2017: Multiple Sclerosis

Spotlight on Aquatics & Multiple Sclerosis

The pool is custom-made for treating multiple sclerosis

Recent publication which show how water works for multiple sclerosis

Multiple sclerosis (MS) is the most frequent disabling neurological disease in young and middle-aged adults in North American. Aquatic exercise has been part of the physical therapy arsenal for MS rehabilitation for several decades, with reports of improved strength, endurance, work and power being reported for over 40 years ago.  Aquatic treatments have historically been given at water temperatures below 85ºF because of concern about functional deterioration at higher temperatures, with clinical exacerbation of MS reported after core temperature increased. However, this is no longer considered a cut-and-dry matter. Aquatic exercise in 94ºF water has been reported to produce improvement in mobility and manual muscle test grades without fatigue or heat sensitivity.

Clinical reports and trials of aquatic exercise for MS have largely reported beneficial subjective effects and general health enhancement, which are important in maintaining motivation, stamina and optimism during the long-term treatment and rehabilitation of a chronic disease. Specific beneficial effects on strength, fatigue, spasticity and mental state have been found in controlled trials of aquatic therapy for MS, but many of the trials were not clearly randomized or otherwise rigorously controlled and so could not figure into a bigger picture. The economic (cost/benefit) implications of aquatic therapy have also not generally been addressed in clinical studies, and the necessary warm-water swimming facilities may be costly relative to demonstrable benefit. 

Clinical series and controlled trials to date suggest that water exercise makes patients “feel better”, and that they may for this reason attain a better quality of life than with other types of rehabilitation. Various modalities have been tried with varying degrees of success in patients with multiple sclerosis to improve balance and proprioception and research has been carried out throughout the world to assess the effects of aquatic therapy in such patients. There are several reasons for people with impairments related to MS to consider exercise as a part of their weekly routine. These reasons include: 

  • Improvement in aerobic or cardiovascular fitness
  • Improvement in strength 
  • Reduction of risks for cardiovascular disease 
  • Reduction in the risk of falls through improvement in balance 
  • Enhancement of the overall quality of life  

All of these benefits should be considered when weighing the value of aquatic therapy and exercise for the patient with multiple sclerosis. 

RECENT ANNOTATED REFERENCES

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Bahmani, D., Farnia, V., & Shakeri, J. (2015). The comparison of the effect of yoga and aquatic exercises on depression and fatigue in patients with multiple sclerosis. Pharmacopsychiatry, 25(6), 52. Retrieved from https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-003...

Bakry, W., Salem, Y., & Elokda, A. (2015). Effectiveness of aquatic exercise program for patients with multiple sclerosis: A systematic review. Physiotherapy (United Kingdom). Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed13&NEWS=N&A...

Bakry, W., Salem, Y., Elokda, A., & Liu, H. (2015). Effectiveness of aquatic exercise program for patients with multiple sclerosis: a systematic review. Physiotherapy, 101, e1328. http://doi.org/10.1016/j.physio.2015.03.1255

Barbar, A., Bahadoran, R., & Ghasemzadeh, Y. (2014). The effect of aquatic exercise on balance of adults with multiple sclerosis. European Journal of Experimental Biology, 4(1), 38–43. Retrieved from http://pelagiaresearchlibrary.com/european-journal-of-experimental-biolo...

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Garopoulou, V., & Tsimaras, V. (2014). The effect of an aquatic training program on walking ability and quality of life of patients with multiple sclerosis. Journal of Physical Education and Sport, 14(1), 106–114. Retrieved from http://search.proquest.com/openview/9c0ab10735b1b2ea975734c851bfe7d2/1?p...

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Imanipour, V., Seyedhosseini, M., & Tarmast, D. (2015). Effect of 10 weeks aquatic training on serum Cytokines in the women with multiple sclerosis. Indian Journal of Applied & Pure Biology, 30(1), 61–66. Retrieved from http://www.biology-journal.com/fulltext/v30i1/ijapb30-1-9.pdf

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