Complementary and alternative therapies in multiple sclerosis: a systematic literature classification and analysis

Characteristics and expectations of people with multiple sclerosis using complementary therapies: A cross-sectional survey from the swiss multiple sclerosis registry

BACKGROUND

Understanding the characteristics and expectations of people with multiple sclerosis (pwMS) who utilize complementary therapies can help integrate these therapies into conventional care.

OBJECTIVES

To describe the characteristics of pwMS who use complementary therapies, their general reasons and targeted symptoms, and their expectations regarding the effects of these therapies.

METHODS

A cross-sectional survey of pwMS from the Swiss Multiple Sclerosis Registry was conducted from October 2022 to August 2023.

RESULTS

888 pwMS participated (39.3 % participation rate). 48.2 % had used complementary therapies in the last six months. The most typical reasons were to improve quality of life (43.9 %) and alleviate MS symptoms (37.8 %). Participants expected manual therapies and natural substances to be most effective for physiological complaints, with median effectiveness scores of 7 (interquartile range [IQR]: 5-9 and 5-8). Mind-body therapies and natural substances were also expected to be the most effective for psychological complaints (median of 7 and 6, IQR: 3.5-8 and 3-8). Complementary therapies were considered safe (median safety scores ranging from 7 to 9).

CONCLUSIONS

PwMS frequently use complementary therapies, and their reasons and expectations can differ. Understanding the characteristics of pwMS who use complementary therapies, their reasons for use, and their expectations can support tailoring MS treatment.

Innovative Complementary Cooling Intervention for Women's Multiple Sclerosis Symptoms: A Mixed-Methods Study

Purpose: This mixed-methods study examined the relationship between multiple sclerosis symptoms to perceived severity, frequency of Uhthoff's phenomenon, the effectiveness of complementary cooling therapy on women's symptom clusters, and quality of life. This study explored the experiences of women with multiple sclerosis when using the Opal Cool Wrap related to heat intolerance, a complementary alternative therapy. Methods: Quantitative analysis of results from surveys from 62 women and seven qualitative semi-structured interviews with a subset of women who completed the surveys validated and illustrated the quantitative findings. Findings: Significant improvement in perceived severity for health transition, physical functioning, role-physical, bodily pain, and social functioning based on pre-/post-cooling therapy use. Three themes emerged from seven interviews: (1) being overheated impacts the quality of life; (2) cool wrap, a helpful tool for managing heat symptoms; and (3) strategies to remain cool. Conclusion: This study provides a comprehensive mixed-methods lens on the unique challenges women with multiple sclerosis face and information for disease management. Heat-related multiple sclerosis symptom clusters and Uhthoff's phenomenon women experience are common and impact safety, independence, health, and quality of life. Identifying complementary strategies such as cool showers and a cooling device to prevent and manage heat-related symptoms is a priority.

Effects of walking interventions in persons with multiple sclerosis-A systematic review

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.

[Restorative capability of traditional Chinese medicine in autoimmune diseases of nervous system: a literature review]

Autoimmune diseases of the nervous system are characterized by the formation of pronounced neurological deficiency and often lead to disability. Complementary medicine as an adjuvant or preventive therapy of various diseases, including autoimmune ones, is increasingly attracting the attention of doctors and researchers. Traditional Chinese medicine (TCM) has a complex of treatment methods, including acupuncture, phytotherapy, nutrition, physical exercises and other methods that are often used in common with the recognized approaches of the official medical science. The article describes the TCM methods application in autoimmune diseases of nervous system, presents the practical experience of using acupuncture, phytotherapy, diet, physical exercises. It was concluded that TCM is important and frequently underestimated health care resource, especially in prevention and treatment of autoimmune diseases of nervous system.

Effects of Dietary Modification Based on Complementary and Alternative Iranian Medicine in Patients with Secondary-Progressive Multiple Sclerosis: A Randomized Controlled Clinical Trial

Objectives: To evaluate the efficacy of dietary modifications based on complementary and alternative Iranian medicine (CAIM) in patients with secondary-progressive multiple sclerosis (SPMS). Design: In this randomized controlled trial, 70 SPMS patients were randomized to receive either a moderate-nature diet based on Persian medicine (as intervention) or usual diet plus health-related diet recommendations (as control) for 2 months. Serum high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), Expanded Disability Status Scale (EDSS), Modified Fatigue Impact Scale (MFIS), State-Trait Anxiety Inventory (STAI), Global Pain Scale (GPS), Gastrointestinal Symptom Rating Scale (GSRS), anthropometric measurements, and quality of life (QOL) were assessed at baseline and end of trial. Analysis of covariance was performed, and the results were adjusted for potential confounders using SPSS v.14. Results: All participants completed the study for 2 months. There were significant improvements across the mean changes of hs-CRP (-0.1 ± 0.2 mg/L for intervention vs. -0.01 ± 0.13 mg/L for control; padjusted = 0.012), MFIS (-11.0 ± 11.8 vs. -0.7 ± 9.9; padjusted <0.001), GSRS (-19.9 ± 16.3 to 1.2 ± 17.5; padjusted <0.001), GPS (padjusted = 0.032), and QOL (padjusted <0.05). No significant difference was observed across the ESR, EDSS, STAI, and anthropometric measurements. Conclusion: Dietary modifications based on CAIM may improve inflammation and clinical manifestations in SPMS patients. Nonetheless, further trials are required to confirm these findings. Clinical Trial Registration: IRCT20181113041641N2.

Effects of Tele-Pilates and Tele-Yoga on Biochemicals, Physical, and Psychological Parameters of Females with Multiple Sclerosis

BACKGROUND

People with multiple sclerosis (PwMS) suffer from some comorbidities, including physical and psychiatric disorders, low quality of life (QoL), hormonal dysregulation, and hypothalamic-pituitary-adrenal axis dysfunction. The current study aimed to investigate the effects of eight weeks of tele-yoga and tele-Pilates on the serum levels of prolactin and cortisol and selected physical and psychological factors.

METHODS

Forty-five females with relapsing remitting multiple sclerosis, based on age (18-65), expanded disability status scale (0-5.5), and body mass index (20-32), were randomly assigned to tele-Pilates, tele-yoga, or control groups (n = 15). Serum blood samples and validated questionnaires were collected before and after interventions.

RESULTS

Following online interventions, there was a significant increase in the serum levels of prolactin (p = 0.004) and a significant decrease in cortisol (p = 0.04) in the time × group interaction factors. In addition, significant improvements were observed in depression (p = 0.001), physical activity levels (p < 0.001), QoL (p ≤ 0.001), and the speed of walking (p < 0.001).

CONCLUSION

Our findings suggest that tele-yoga and tele-Pilates training could be introduced as patient-friendly, non-pharmacological, add-on therapeutic methods for increasing prolactin and decreasing cortisol serum levels and achieving clinically relevant improvements in depression, walking speed, physical activity level, and QoL in female MS patients.