What is the level of self-reported physical activity in people with multiple sclerosis in the Czech Republic?

Klára Novotná 1, 2 *, Barbora Šmejkalová 2, Dana Horáková 1, Renata Větrovská 3, 4
1 Charles University and General University Hospital in Prague, First Faculty of Medicine, Department of Neurology and Center of Clinical Neuroscience, Prague, Czech Republic 2 Charles University and General University Hospital in Prague, First Faculty of Medicine, Department of Rehabilitation Medicine, Prague, Czech Republic 3 Charles University and General University Hospital in Prague, First Faculty of Medicine, Department of Sport Medicine, Prague, Czech Republic 4 College of Physical Education and Sport Palestra, Prague, Czech Republic

Korespondenční autor: Klára Novotná (novotna.klara.k@gmail.com)

ISSN 1804-7181 (On-line)

Full verze:
Full version

Submitted:5. 4. 2024
Accepted: 14. 5. 2024
Published online: 30. 6. 2024

Summary

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.

Keywords: Exercise; Motivation; Multiple sclerosis; Physical activity

Literatura

1. Anens E, Emtner M, Zetterberg L, Hellström K (2014). Physical activity in subjects with multiple sclerosis with focus on gender differences: a survey. BMC Neurol 14: 47. DOI: 10.1186/1471–2377–14– 47.

2. Anens E, Zetterberg L, Urell C, Emtner M, Hellström K (2017). Self-reported physical activity correlates in Swedish adults with multiple sclerosis: a cross-sectional study. BMC Neurol 17(1): 204. DOI: 10.1186/s12883–017–0981–4.

3. Asano M, Duquette P, Andersen R, Lapierre Y, Mayo NE (2013). Exercise barriers and preferences among women and men with multiple sclerosis. Disabil Rehabil 35(5): 353–361. DOI: 10.3109/096382­88.2012.742574.

4. Azevedo MR, Araújo CL, Reichert FF, Siqueira FV, da Silva MC, Hallal PC (2007). Gender differences in leisure-time physical activity. Int J Public Health 52(1): 8–15. DOI: 10.1007/s00038–006–5062–1.

5. Carling A, Forsberg A, Gunnarsson M, Nilsagård Y (2017). CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study. Mult Scler 23(10): 1394–1404. DOI: 10.1177/135245­8516677591.

6. Contrò V, Schiera G, Macchiarella A, Sacco A, Lombardo G, Proia P (2017). Multiple sclerosis: physical activity and well-being. Trends in Sport Sciences 2(24): 53–58.

7. Cramer H, Lauche R, Azizi H, Dobos G, Langhorst J (2014). Yoga for multiple sclerosis: a systematic review and meta-analysis. PLoS One 9(11): e112414. DOI: 10.1371/journal­.pone.0112414.

8. Dalgas U, Langeskov-Christensen M, Stenager E, Riemenschneider M, Hvid LG (2019). Exercise as medicine in multiple sclerosis – time for a paradigm shift: preventive, symptomatic, and diseasemodifying aspects and perspectives. Curr Neurol Neurosci Rep 19(11): 88. DOI: 10.1007/s11910–019– 1002–3.

9. Diechmann MD, Campbell E, Coulter E, Paul L, Dalgas U, Hvid LG (2021). Effects of exercise training on neurotrophic factors and subsequent neuroprotection in persons with multiple sclerosis – a systematic review and meta-analysis. Brain Sci 11(11): 1499. DOI: 10.3390/brain­sci11111499.

10. Dlugonski D, Joyce RJ, Motl RW (2012). Meanings, motivations, and strategies for engaging in physical activity among women with multiple sclerosis. Disabil Rehabil 34(25): 2148–2157. DOI: 10.3109/096382­88.2012.677935.

11. Gijbels D, Eijnde BO, Feys P (2011). Comparison of the 2-and 6-minute walk test in multiple sclerosis. Mult Scler 17(10): 1269–1272. DOI: 10.1177/135245­8511408475.

12. Giovannoni G, Butzkueven H, Dhib-Jalbut S, Hobart J, Kobelt G, Pepper G, et al. (2016). Brain health: time matters in multiple sclerosis. Mult Scler Relat Disord 9(Suppl. 1): S5–S48. DOI: 10.1016/j.msar­d.2016.07.003.

13. Godin G (2011). The Godin–Shephard leisure-time physical activity questionnaire. The Health & Fitness Journal of Canada 4(1): 18–22. DOI: 10.14288/hfjc­.v4i1.82.

14. Hamrik Z, Sigmundová D, Kalman M, Pavelka J, Sigmund E (2014). Physical activity and sedentary behaviour in Czech adults: results from the GPAQ study. Eur J Sport Sci 14(2): 193–198. DOI: 10.1080/174613­91.2013.822565.

15. Hoang PD, Gandevia SC, Herbert RD (2014). Prevalence of joint contractures and muscle weakness in people with multiple sclerosis. Disabil Rehabil 236(19): 1588–1593. DOI: 10.3109/096382­88.2013.854841.

16. Kahraman T, Savci S, Coskuner-Poyraz E, Ozakbas S, Idiman E (2015). Determinants of physical activity in minimally impaired people with multiple sclerosis. Clin Neurol Neurosurg 138: 20–24. DOI: 10.1016/j.cli­neuro.2015.07­.018.

17. Kalb R, Brown TR, Coote S, Costello K, Dalgas U, Garmon E, et al. (2020). Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course. Mult Scler 26(12): 1459–1469. DOI: 10.1177/135245­8520915629.

18. Kaufman M, Moyer D, Norton J (2020). The significant change for the Timed 25– foot Walk in the multiple sclerosis functional composite. Mult Scler 6(4): 286–290. DOI: 10.1177/135245­850000600411.

19. Kjølhede T, Vissing K, Dalgas U (2012). Multiple sclerosis and progressive resistance training: a systematic review. Mult Scler 18(9): 1215–1228. DOI: 10.1177/135245­8512437418.

20. Klaren RE, Motl RW, Dlugonski D, Sandroff BM, Pilutti LA (2013). Objectively quantified physical activity in persons with multiple sclerosis. Arch Phys Med Rehabil 94(12): 2342–2348. DOI: 10.1016/j.apmr­.2013.07.011.

21. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989). The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10): 1121–1123. DOI: 10.1001/archne­ur.1989.00520460115­022.

22. Langeskov-Christensen M, Grøndahl Hvid L, Nygaard MKE, Ringgaard S, Jensen HB, Nielsen HH, et al. (2021). Efficacy of high-intensity aerobic exercise on brain MRI measures in multiple sclerosis. Neurology 96(2): e203–e213. DOI: 10.1212/WNL.00000000000­11241.

23. Latimer-Cheung AE, Pilutti LA, Hicks AL, Martin Ginis KA, Fenuta AM, MacKibbon KA, Motl RW (2013). Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil 94(9): 1800–1828.e3. DOI: 10.1016/j.apmr­.2013.04.020.

24. Learmonth YC, Motl RW (2021). Exercise training for multiple sclerosis: a narrative review of history, benefits, safety, guidelines, and promotion. Int J Environ Res Public Health 18(24): 13245. DOI: 10.3390/ijerph182413245.

25. Learmonth YC, Adamson BC, Balto JM, Chiu CY, Molina-Guzman I, Finlayson M, et al. (2017). Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: a qualitative study. Health Expect 20(4): 574–583. DOI: 10.1111/hex.12482.

26. Mostert S, Kesselring J (2002). Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Mult Scler 8(2): 161–168. DOI: 10.1191/135245­8502ms779oa.

27. Motl RW, Pilutti LA (2012). The benefits of exercise training in multiple sclerosis. Nat Rev Neurol 8(9): 487–497. DOI: 10.1038/nrneu­rol.2012.136.

28. Motl RW, McAuley E, Sandroff BM, Hubbard EA (2015). Descriptive epidemiology of physical activity rates in multiple sclerosis. Acta Neurol Scand 131(6): 422–425. DOI: 10.1111/ane.12352.

29. Motl RW, McAuley E, Snook EM (2005). Physical activity and multiple sclerosis: a meta-analysis. Mult Scler 11(4): 459–463. DOI: 10.1191/135245­8505ms1188oa.

30. Motl RW, Sandroff BM, Kwakkel G, Dalgas U, Feinstein A, Heesen C, et al. (2017). Exercise in patients with multiple sclerosis. Lancet Neurol 16(10): 848–856. DOI: 10.1016/S1474– 4422(17)30281–8.

31. Mulligan H, Treharne GJ, Hale LA, Smith C (2013). Combining self-help and professional help to minimize barriers to physical activity in persons with multiple sclerosis: a trial of the “Blue Prescription” approach in New Zealand. J Neurol Phys Ther 37(2): 51–57. DOI: 10.1097/ NPT.0b013e31829­2799e.

32. Rasova K, Havrdova E, Brandejsky P, Zalisova M, Foubikova B, Martinkova P (2006). Comparison of the influence of different rehabilitation programmes on clinical, spirometric and spiroergometric parameters in patients with multiple sclerosis. Mult Scler 12(2): 227–234. DOI: 10.1191/135248­506ms1248oa.

33. Riemenschneider M, Hvid LG, Ringgaard S, Nygaard MKE, Eskildsen SF, Gaemelke T, et al. (2022). Investigating the potential disease-modifying and neuroprotective efficacy of exercise therapy early in the disease course of multiple sclerosis: The Early Multiple Sclerosis Exercise Study (EMSES). Mult Scler 28(10): 1620–1629. DOI: 10.1177/135245­85221079200.

34. Riemenschneider M, Hvid LG, Stenager E, Dalgas U (2018). Is there an overlooked “window of opportunity” in MS exercise therapy? Perspectives for early MS rehabilitation. Mult Scler 24(7), 886–894. DOI: 10.1177/135245­8518777377.

35. Rooney S, McFadyen A, Wood L, Moffat F, Paul L (2019). Minimally important difference of the fatigue severity scale and modified fatigue impact scale in people with multiple sclerosis. Mult Scler Relat Disord 35: 158–163. DOI: 10.1016/j.msar­d.2019.07.028.

36. Sánchez-Lastra MA, Martínez-Aldao D, Molina AJ, Ayán C (2019). Pilates for people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 28: 199–212. DOI: 10.1016/j.msar­d.2019.01.006.

37. Sikes EM, Richardson EV, Cederberg KJ, Sasaki JE, Sandroff BM, Motl RW (2019). Use of the Godin leisure-time exercise questionnaire in multiple sclerosis research: a comprehensive narrative review. Disabil Rehabil 41(11): 1243–1267. DOI: 10.1080/096382­88.2018.1424956.

38. Streber R, Peters S, Pfeifer K (2016). Systematic review of correlates and determinants of physical activity in persons with multiple sclerosis. Arch Phys Med Rehabil 97(4): 633–645. DOI: 10.1016/j. apmr.2015.11.020.

39. Thomas S, Thomas PW, Kersten P, Jones R, Green C, Nock A, et al. (2013). A pragmatic parallel arm multi-centre randomised controlled trial to assess the effectiveness and cost-effectiveness of a groupbased fatigue management programme (FACETS) for people with multiple sclerosis. J Neurol Neurosurg Psychiatry 84(10): 1092–1099. DOI: 10.1136/jnnp-2012–303816.

40. Vachova M (2012). Global Epidemic of Multiple Sclerosis. Cesk Slov Neurol N 75/108(6): 701–706.

41. Zou L, Wang H, Xiao Z, Fang Q, Zhang M, Li T, et al. (2017). Tai chi for health benefits in patients with multiple sclerosis: A systematic review. PloS One 12(2): e0170212. DOI: 10.1371/journal. pone.0170212.