Physiological fitness in people with advanced multiple sclerosis

Arthur R Chaves; Thomas Edwards; Zain Awadia; Vanessa Morin; Lisa A S Walker; Jennifer L Reed; Lara A Pilutti

doi:10.1016/j.msard.2024.105854

Physiological fitness in people with advanced multiple sclerosis

Mult Scler Relat Disord. 2024 Nov:91:105854. doi: 10.1016/j.msard.2024.105854. Epub 2024 Aug 29.

Authors

Arthur R Chaves¹, Thomas Edwards², Zain Awadia², Vanessa Morin³, Lisa A S Walker⁴, Jennifer L Reed⁵, Lara A Pilutti⁶

Affiliations

¹ Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.
² School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
³ Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
⁴ The Ottawa Hospital Research Institute, Ottawa, ON, Canada; The University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada; Carleton University, Department of Psychology, Ottawa, ON, Canada.
⁵ School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁶ Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; The University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada. Electronic address: [email protected].

PMID: 39245024
DOI: 10.1016/j.msard.2024.105854

Abstract

Introduction: Physiological fitness, encompassing cardiorespiratory fitness (CRF) and body composition, are important markers of overall health, functional capacity, and quality of life in general and clinical populations. Characterizing fitness is important for the development of tailored interventions and strategies to optimize well-being across the spectrum of disability in multiple sclerosis (MS). While existing research has explored fitness in people with mild-to-moderate disability, there is a scarcity of data in people with advanced MS (Expanded Disability Severity Scale, EDSS≥7.0).

Objective: To characterize CRF and body composition and their associations with fatigue, quality of life, and function in individuals with advanced MS.

Methods: Participants (n=18, mean age=60.7 years-old, median EDSS=7.5) underwent a cardiopulmonary exercise test and dual-energy X-ray absorptiometry scanning. Main outcomes included peak volume of oxygen uptake (V̇O_2peak) and whole and regional body fat, lean mass, bone mineral content, and bone density. Symptoms of fatigue (Modified Fatigue Impact Scale, MFIS), quality of life (29-item MS Impact Scale, MSIS-29), and daily function (Late-Life Function and Disability Instrument, LLFDI) were collected.

Results: Participants exhibited notably low CRF levels (V̇O_2peak=9.8 mL/min/kg) and poor body composition (lower lean mass, bone mineral content and density) compared to previous studies in the general population and in individuals with MS with lower disability. V̇O_2peak was most consistently associated with function in daily life (LLFDI scores, r_s≥0.637, p≤0.004).

Conclusion: These findings reinforce the potential importance of physiological fitness to preserve function in people with advanced MS.

Keywords: Body composition; Cardiorespiratory fitness; Exercise; Function; Multiple sclerosis; Quality of life.

MeSH terms

Absorptiometry, Photon
Aged
Body Composition* / physiology
Cardiorespiratory Fitness* / physiology
Exercise Test
Fatigue* / etiology
Fatigue* / physiopathology
Female
Humans
Male
Middle Aged
Multiple Sclerosis* / physiopathology
Oxygen Consumption / physiology
Physical Fitness / physiology
Quality of Life*
Severity of Illness Index