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van der Linden ML, Kos D, Moumdjian L, Kalron A, Coote S, Smedal T, Arntzen EC, Tayfur SN, Pedullà L, Tacchino A, Jonsdottir J, Santoyo-Medina C, Novotna K, Yazgan YZ, Nedeljkovic U, Learmonth YC. Changes in physical activity participation during the COVID-19 pandemic in people with multiple sclerosis: An international survey study. Ann Phys Rehabil Med 2023; 66:101798. [PMID: 37967488 DOI: 10.1016/j.rehab.2023.101798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/02/2023] [Accepted: 09/20/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Marietta L van der Linden
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University Edinburgh, Musselburgh EH21 6UU, United Kingdom; Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org).
| | - Daphne Kos
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101 box 1501, 3001 Leuven, Belgium; National Multiple Sclerosis Center Melsbroek, Vanheylenstraat 16, 1820 Melsbroek, Belgium
| | - Lousin Moumdjian
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); UMSC Hasselt, Pelt, Belgium; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, 3590 Diepenbeek Belgium; IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Miriam Makebaplein 1, 9000 Gent, Belgium
| | - Alon Kalron
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 55 Haim Levanon st, Tel-Aviv, Israel; Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. 2 Derech Sheba st, Ramat-Gan, Israel
| | - Susan Coote
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Multiple Sclerosis Society of Ireland and Physical Activity for Health Research Centre, Ireland; University of Limerick, Limerick, V94 T9PX Ireland
| | - Tori Smedal
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Post-box 1400, 5021 Bergen, Norway; The Norwegian Multiple sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Ellen Christin Arntzen
- Faculty of Nursing and Health Science, Nord University, Universitetsalleen 11, 8026 Bodø, Norway; Department of Health and Work, Nordland Hospital Trust, Gidsken Jakobsens vei 32, 8008 Bodø, Norway
| | - Sümeyra N Tayfur
- Centre for Applied Social Sciences, Queen Margaret University Edinburgh, Musselburgh EH21 6UU, United Kingdom
| | - Ludovico Pedullà
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149 Genoa, Italy
| | - Andrea Tacchino
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149 Genoa, Italy
| | - Johanna Jonsdottir
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148 Milan, Italy
| | - Carme Santoyo-Medina
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/ Josep Trueta sn, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - Klara Novotna
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 30, Prague Czech Republic; Department of Rehabilitation Medicine, First Faculty of Medicine and General University Hospital in Prague, Albertov 7, Prague, Czech Republic
| | - Yonca Zenginler Yazgan
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Büyükçekmece Yerleşkesi, Alkent 2000 Mahallesi, Yiğittürk Caddesi, No:5/9/1, 34500 Büyükçekmece, Istanbul, Turkey
| | - Una Nedeljkovic
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Centre for Physical medicine and Rehabilitation, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica starijeg 8, Belgrade, Serbia
| | - Yvonne C Learmonth
- Rehabilitation in Multiple Sclerosis (RIMS, www.eurims.org); Discipline of Exercise Science, Murdoch University, Perth, WA 6150, Australia; Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Ageing, Murdoch University, WA 6150, Australia; Perron Institute for Neurological and Translational Science, Perth, WA 6009 Australia
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Pedullà L, Santoyo-Medina C, Novotna K, Moumdjian L, Smedal T, Arntzen EC, van der Linden ML, Learmonth Y, Kalron A, Güngör F, Nedeljkovic U, Kos D, Jonsdottir J, Coote S, Tacchino A. Physical Activity in Multiple Sclerosis: Meeting the Guidelines at the Time of the COVID-19 Pandemic. J Neurol Phys Ther 2023; 47:112-121. [PMID: 36753458 DOI: 10.1097/npt.0000000000000430] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND PURPOSE Regular physical activity (PA) helps to reduce the severity of physical and mental symptoms and improves quality of life in people with multiple sclerosis (PwMS). Based on current evidence and expert opinion, the recent multiple sclerosis guidelines recommend at least 150 minutes/week of PA. This study presents the results of a survey analyzing whether and how PwMS met the guidelines before and during the pandemic. METHODS We developed and disseminated an international online survey between December 2020 and July 2021, investigating changes in self-reported PA type, duration, frequency, and intensity due to the COVID-19 outbreak in PwMS with differing disability levels. RESULTS Among respondents (n = 3810), 3725 were eligible. The proportion of those who conducted at least one activity decreased with increasing disability level at both time points (pre and during). Overall 60% of respondents met the guidelines before the pandemic (mild: 64.43%; moderate: 51.53%; severe: 39.34%; χ 2(2) = 109.13, P < 0.01); a reduction of approximately 10% occurred during the pandemic in all disability groups (mild: 54.76%; moderate: 42.47%; severe: 29.48%; χ 2(2) = 109.67, P < 0.01). Respondents with higher disability participated more in physical therapy and less in walking, cycling, and running at both time points. Most respondents reported practicing PA at a moderate intensity at both time points; frequency and duration of sessions decreased as disability level increased. DISCUSSION AND CONCLUSIONS The percentage of those meeting the guidelines reduced with increasing disability level and during the pandemic. PA type and intensity varied widely across the disability categories. Interventions accounting for disability level are required to enable more PwMS to reap the benefits of PA.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A415 ).
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Affiliation(s)
- Ludovico Pedullà
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy (L.P., A.T.); Rehabilitation in Multiple Sclerosis (RIMS), Leuven, Belgium (L.P., C.S.-M., K.N., L.M., T.S., E.C.A., M.L.L., Y.L., A.K., F.G., U.N., D.K., J.J., S.C., A.T.); Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (C.S.-M.); Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain (C.S.-M.); Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic (K.N.); Department of Rehabilitation Medicine, First Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic (K.N.); UMSC Hasselt, Pelt, Belgium (L.M.); REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium (L.M.); IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Gent, Belgium (L.M.); The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway (T.S.); The Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway (T.S.); Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway (T.S.); Faculty of Nursing and Health Science, Nord University, Bodø, Norway (E.C.A.); Department of Health and Work, Nordland Hospital Trust, Bodø, Norway (E.C.A.); Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, Musselburgh, United Kingdom (M.L.L.); Discipline of Exercise Science, Murdoch University, Perth, Australia (Y.L.); Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Ageing, Murdoch University, Perth, Australia (Y.L.); Perron Institute for Neurological and Translational Science, Perth, Australia (Y.L.); Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel (A.K.); Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel (A.K.); Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey (F.G.); Centre for Physical Medicine and Rehabilitation, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia (U.N.); Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium (D.K.); National Multiple Sclerosis Center Melsbroek, Melsbroek, Belgium (D.K.); IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy (J.J.); Multiple Sclerosis Society of Ireland and Physical Activity for Health Research Centre, Dublin, Ireland (S.C.); and University of Limerick, Limerick, Ireland (S.C.)
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Tomanovic Vujadinovic S, Ilic N, Selakovic I, Nedeljkovic U, Krstic N, Mujovic N, Dubljanin Raspopovic E, Jovanovic D. TENS Improves Cisplatin-Induced Neuropathy in Lung Cancer Patients. Medicina (Kaunas) 2022; 58:medicina58101405. [PMID: 36295566 PMCID: PMC9611034 DOI: 10.3390/medicina58101405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/07/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022]
Abstract
Background: Cisplatin-induced peripheral neuropathy is a common complication of cisplatin therapy, which develops in most patients with lung cancer. There are no effective preventive measures and once it occurs there is no effective therapy, except symptomatic. In this study, we aimed to assess the effect of transcutaneous electrical nerve stimulation (TENS) therapy on the pain intensity and the quality of life of patients with cisplatin-induced neuropathy. Material and Methods: A prospective cohort study was performed from 2013 to 2018, at the Clinical Center of Serbia. After the initial evaluation of 106 newly diagnosed patients with lung cancer, 68 patients did not have peripheral neuropathy. These 68 patients continued in the study and started the cisplatin chemotherapy. Forty of these patients developed cisplatin-induced neuropathy, which was manifested by neuropathic symptoms and proven by ENG examination. All patients with cisplatin-induced neuropathy were treated with TENS therapy. Their neuropathic pain and quality of life were evaluated using the following questionnaires at diagnosis, after cisplatin therapy and after four weeks of TENS use: DN4, VAS scale, EORTC QLQ-C30 and FACT-L. Results: Two thirds (68%) of the patients with cisplatin-induced neuropathy were male and the majority were smokers (70%). Adenocarcinoma was the most common (38%), followed by squamous (33%) and small-cell carcinoma (28%). The application of TENS therapy had a positive effect on reducing the neuropathic pain and increasing the quality of life for patients with painful cisplatin-induced neuropathy. The VAS and DN4 scores significantly decreased after TENS therapy, in comparison to its values after cisplatin therapy (p < 0.001). After TENS therapy, patients had significantly higher values in most of the domains of EORTC QLQ-C30 and FACT- L, in comparison with the values after cisplatin therapy (p < 0.001). Conclusion: The application of TENS therapy has a positive effect on reducing neuropathic pain and increasing the quality of life for patients with lung cancer and cisplatin-induced neuropathy.
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Affiliation(s)
- Sanja Tomanovic Vujadinovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Correspondence:
| | - Nela Ilic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivan Selakovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Una Nedeljkovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Nevena Krstic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Natasa Mujovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Emilija Dubljanin Raspopovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Center for Physical Medicine and Rehabilitation, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Dragana Jovanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Clinic of Pulmonology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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Moumdjian L, Smedal T, Arntzen EC, van der Linden ML, Learmonth Y, Pedullà L, Tacchino A, Novotna K, Kalron A, Yazgan YZ, Nedeljkovic U, Kos D, Jonsdottir J, Santoyo-Medina C, Coote S. The impact of the COVID-19 pandemic on physical activity and associated technology use in persons with multiple sclerosis: an international RIMS-SIG Mobility survey study. Arch Phys Med Rehabil 2022; 103:2009-2015. [PMID: 35760106 PMCID: PMC9233892 DOI: 10.1016/j.apmr.2022.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/12/2022] [Accepted: 06/05/2022] [Indexed: 11/23/2022]
Abstract
Objective To investigate the impact of the COVID-19 pandemic on physical activity in persons with multiple sclerosis (PwMS). Design Multicenter international online survey study. Setting The survey was conducted within 11 participating countries. Each country launched the survey using online platforms from May to July 2021. Participants This was an electronic survey study targeting PwMS (N=3725). Intervention Not applicable. Main Outcome Measures The survey ascertained physical activity performance and its intensity, the nature of the activities conducted, and the use of technology to support home-based physical activity before and during the pandemic. Results A total of 3725 respondents completed the survey. Prepandemic, the majority (83%) of respondents reported being physically active, and this decreased to 75% during the pandemic. This change was significant for moderate- and high-intensity activity (P<.0001). Activities carried out in physiotherapy centers, gyms, or pools decreased the most. Walking was the most frequently performed activity prepandemic (27%) and increased during the pandemic (33%). A total of 24% of those inactive during the pandemic had no intention of changing their physical activity behavior post pandemic. A total of 58% of the respondents did not use technology to support physical activity during the pandemic. Of those who did use technology, wearables were most used (24%). Of those currently nonactive (25%) expressed a preference for an in-person format to conduct physical activity post pandemic. Conclusions Physical activity performance, especially activities at moderate and high intensities, decreased during the pandemic in PwMS compared with prepandemic. Walking and using wearables gained popularity as ways to stay active. As we move toward an endemic COVID-19, a call for action to develop interventions focused on walking programs with specific emphasis on increasing physical activity of PwMS is proposed.
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Affiliation(s)
- Lousin Moumdjian
- UMSC Hasselt, Pelt, Belgium; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, 3590, Diepenbeek Belgium; IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Miriam Makebaplein 1, 9000, Gent; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org.
| | - Tori Smedal
- The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Post-box 1400, 5021 Bergen, Norway; The Norwegian Multiple sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Ellen Christin Arntzen
- Faculty of Nursing and Health Science, Nord University, Universitetsalleen 11, 8026 Bodø, Norway; Department of Health and Work, Nordland Hospital Trust, Gidsken Jakobsens vei 32, 8008 Bodø, Norway; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Marietta L van der Linden
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University Edinburgh, Musselburgh EH21 6UU, United Kingdom; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Yvonne Learmonth
- Discipline of Exercise Science, Murdoch University, Perth, WA, 6150, Australia; Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Ageing, Murdoch University, WA, 6150, Australia; Perron Institute for Neurological and Translational Science, Perth, WA, 6009 Australia; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Ludovico Pedullà
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149, Genoa, Italy; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149, Genoa, Italy; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Klara Novotna
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 30, Prague Czech Republic; Department of Rehabilitation Medicine, First Faculty of Medicine and General University Hospital in Prague, Albertov 7, Prague, Czech Republic; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Alon Kalron
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 55 Haim Levanon st, Tel-Aviv, Israel.; Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. 2 Derech Sheba st, Ramat-Gan, Israel.; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Yonca Zenginler Yazgan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Büyükçekmece Yerleşkesi, Alkent 2000 Mahallesi, Yiğittürk Caddesi, No:5/9/1, 34500, Büyükçekmece, Istanbul, Turkey.; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Una Nedeljkovic
- Centre for Physical medicine and Rehabilitation,University Clinical Centre of Serbia, Faculty of Medicine,University of Belgrade, Dr Subotica starijeg 8, Belgrade,Serbia,; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org.
| | - Daphne Kos
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101 box 1501, 3001 Leuven, Belgium; National Multiple Sclerosis Center Melsbroek, Vanheylenstraat 16, 1820 Melsbroek, Belgium; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Johanna Jonsdottir
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148 Milan, Italy; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Carme Santoyo-Medina
- Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.; Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/ Josep Trueta sn, 08195 Sant Cugat del Vallès, Barcelona, Spain.; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
| | - Susan Coote
- Multiple Sclerosis Society of Ireland and Physical Activity for Health Research Centre, Ireland; University of Limerick, Limerick, V94 T9PX Ireland; Rehabilitation in Multiple Sclerosis (RIMS), www.eurims.org
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Kalron A, Ehling R, Baert I, Smedal T, Rasova K, Heric-Mansrud A, Elorriage I, Nedeljkovic U, Tachino A, Gargul L, Gusowski K, Cattaneo D, Borgers S, Hebert J, Dalgas U, Feys P. Improving our understanding of the most important items of the Multiple Sclerosis Walking Scale-12 indicating mobility dysfunction: Secondary results from a RIMS multicenter study. Mult Scler Relat Disord 2020; 46:102511. [PMID: 32949848 DOI: 10.1016/j.msard.2020.102511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/08/2020] [Accepted: 09/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is currently the most widely validated, patient-reported outcome measure assessing patients' perception of the impact of multiple sclerosis (MS) on walking ability. To date, the majority of previous studies investigating the MSWS-12 have focused on the total score despite individual items being potentially informative. Therefore, our objective was to examine the associations between the individual items of the MSWS-12 and mobility and whether these associations depend on disability level. METHODS Participants completed the MSWS-12, Two-Minute Walk Test (2MWT), Timed 25-Foot Walk (T25FW), Timed Up and Go Test (TUG) and the Four Square Step Test (FSST). Subsequently, they were divided into two groups according to their disability level, classified as either "mildly" or "moderately-severely" disabled. The correlation between individual items of the MSWS-12 and clinical measures of mobility were separately examined by Spearman's correlation coefficients; linear regression analyses were performed for each disability group, with/without adjusting for cognition, age and gender. RESULTS 242 people with MS (PwMS), 108 mildly and 134 moderately-severely disabled, were included. Stronger correlations between the MSWS-12 items and mobility tests were found in the mildly disabled compared to the moderately-severely disabled group. The linear regression analysis showed that in the mildly disabled, item 9 (use of support outdoors) explained 35.4%, 30.8%, and 23.7% of the variance related to the 2MWT, T25FW and TUG, respectively. As for the moderately-severely disabled, the linear regression analysis presented a model which included item 8 (use of support indoors), explaining 31.6%, 18.0%, 20.2% and 9.5% of the variance related to the 2MWT, T25FWT, TUG and FSST, respectively. CONCLUSIONS Items 8 and 9 of the MSWS-12 focusing on the patient's use of walking support in and outdoors, provide a robust indicator of mobility capabilities for mildly and moderately-severely disabled PwMS.
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Affiliation(s)
- Alon Kalron
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel.
| | - Rainer Ehling
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria; Karl Landsteiner Institut für Interdisziplinäre Forschung am Reha Zentrum Münster, Münster, Austria
| | - Ilse Baert
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Tori Smedal
- Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, and Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Kamila Rasova
- Department of Rehabilitation, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Iratxe Elorriage
- Association of Multiple Sclerosis of Biscay (ADEMBI), Bilbao, Spain
| | - Una Nedeljkovic
- Clinic of Physical Medicine and Rehabilitation, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Andrea Tachino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Leszek Gargul
- John Paul II Rehabilitation Centre for People with Multiple Sclerosis, Borne Sulinowo, Poland
| | - Klaus Gusowski
- Neurological Rehabilitation Centre Quellenhof, Sana AG, Germany
| | - Davide Cattaneo
- LaRiCE Lab: Gait and Balance Disorders Laboratory, Don Gnocchi Foundation I.R.C.C.S, Milan, Italy
| | | | - Jeffrey Hebert
- School of Medicine, University of Colorado Anschutz Medical Campus, United States
| | - Ulrik Dalgas
- The Research Unit in Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Peter Feys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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6
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Affiliation(s)
- Lousin Moumdjian
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; IPEM - Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Gent, Belgium
| | - Una Nedeljkovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
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Tomanovic-Vujadinovic S, Jovanovic D, Ilic N, Dubljanin-Raspopovic E, Nedeljkovic U, Ilic B, Samardzic N, Ceriman V, Stevic Z, Markovic-Denic L. Clinical and electrophysiological features of peripheral neuropathy in older patients with lung carcinoma. VOJNOSANIT PREGL 2020. [DOI: 10.2298/vsp180308051t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Peripheral nervous system affection in people with lung cancer is commonly associated with paraneoplastic neuropathy. However, clinical studies evaluating the frequency, clinical, and electrophysiological characteristics of peripheral neuropathies which are not related to onconeuronal antibodies, in this, on average, older population of patients, are very rare. The aim of this study was to define the frequency, as well as clinical and electrophysiological characteristics of idiopathic neuropathies in patients suffering from lung cancer in early stages of the diseases. Methods. Clinical and electrophysiological data of 105 elderly subjects (age 63.4 ? 7.8 years) suffering from lung carcinoma who underwent extensive neurological and electrophysiological evaluation (nerve conduction studies) between 2013?2018 were estimated. Exclusion criteria were ?classical? paraneoplastic neurological syndromes with onconeuronal antibodies present, as well as patients with typical known causes of peripheral neuropathy (e.g. diabetes, alcoholism, chronic renal insufficiency, vitamin deficiencies, etc.). Results. There were 19.1% patients with clinically manifest neuropathies, with additional 37.1% patients with only electrophysiological abnormalities. The most frequent pathophysiological pattern was axonal pathology (71.2%) with predominantly distal and symmetrical distribution (86.4%). Conclusion. Patients with lung cancer in the early stages of the disease show a high incidence of clinically minor damage of the nerves, according to the pattern of chronic sensomotor distal neuropathy, with predominance of axonal damage. These findings underline the importance of a detailed clinical and electrophysiological evaluation in this category of patients who are without the typical etiological factors for peripheral neuropathies since, during cancer therapy, patients undergo a series of treatments with additional risk for the development/aggravation of neuropathy.
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Affiliation(s)
- Sanja Tomanovic-Vujadinovic
- Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Dragana Jovanovic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic of Pulmonology, Belgrade, Serbia
| | - Nela Ilic
- Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Emilija Dubljanin-Raspopovic
- Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Una Nedeljkovic
- Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Branka Ilic
- Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia
| | | | - Vesna Ceriman
- Clinical Center of Serbia, Clinic of Pulmonology, Belgrade, Serbia
| | - Zorica Stevic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic of Neurology, Belgrade, Serbia
| | - Ljiljana Markovic-Denic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Institute of Epidemiology, Belgrade, Serbia
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8
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Baert I, Smedal T, Kalron A, Rasova K, Heric-Mansrud A, Ehling R, Elorriaga Minguez I, Nedeljkovic U, Tacchino A, Hellinckx P, Adriaenssens G, Stachowiak G, Gusowski K, Cattaneo D, Borgers S, Hebert J, Dalgas U, Feys P. Responsiveness and meaningful improvement of mobility measures following MS rehabilitation. Neurology 2018; 91:e1880-e1892. [DOI: 10.1212/wnl.0000000000006532] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/02/2018] [Indexed: 01/12/2023] Open
Abstract
ObjectiveTo determine responsiveness of functional mobility measures, and provide reference values for clinically meaningful improvements, according to disability level, in persons with multiple sclerosis (pwMS) in response to physical rehabilitation.MethodsThirteen mobility measures (clinician- and patient-reported) were assessed before and after rehabilitation in 191 pwMS from 17 international centers (European and United States). Combined anchor- and distribution-based methods were used. A global rating of change scale, from patients' and therapists' perspective, served as external criteria when determining the area under the receiver operating characteristic curve (AUC), the minimally important change (MIC), and the smallest real change (SRC). Patients were stratified into 2 subgroups based on disability level (Expanded Disability Status Scale score ≤4 [n = 72], >4 [n = 119]).ResultsThe Multiple Sclerosis Walking Scale–12, physical subscale of the Multiple Sclerosis Impact Scale–29 (especially for the mildly disabled pwMS), Rivermead Mobility Index, and 5-repetition sit-to-stand test (especially for the moderately to severely disabled pwMS) were the most sensitive measures in detecting improvements in mobility. Findings were determined once the AUC (95% confidence interval) was above 0.5, MIC was greater than SRC, and results were comparable from the patient and therapist perspective.ConclusionsResponsiveness, clinically meaningful improvement, and real changes of frequently used mobility measures were calculated, showing great heterogeneity, and were dependent on disability level in pwMS.
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9
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Ilic N, Dubljanin Raspopovic E, Nedeljkovic U, Tomanovic Vujadinovic S. The combined effect of non-invasive cortical stimulation and motor training on hand motor deficit in chronic stroke. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Rasova K, Freeman J, Martinkova P, Pavlikova M, Cattaneo D, Jonsdottir J, Henze T, Baert I, Van Asch P, Santoyo C, Smedal T, Beiske AG, Stachowiak M, Kovalewski M, Nedeljkovic U, Bakalidou D, Guerreiro JMA, Nilsagård Y, Dimitrova EN, Habek M, Armutlu K, Donzé C, Ross E, Ilie AM, Martić A, Romberg A, Feys P. The organisation of physiotherapy for people with multiple sclerosis across Europe: a multicentre questionnaire survey. BMC Health Serv Res 2016; 16:552. [PMID: 27716390 PMCID: PMC5053346 DOI: 10.1186/s12913-016-1750-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the organisational set-up of physiotherapy services across different countries is increasingly important as clinicians around the world use evidence to improve their practice. This also has to be taken into consideration when multi-centre international clinical trials are conducted. This survey aimed to systematically describe organisational aspects of physiotherapy services for people with multiple sclerosis (MS) across Europe. METHODS Representatives from 72 rehabilitation facilities within 23 European countries completed an online web-based questionnaire survey between 2013 and 2014. Countries were categorised according to four European regions (defined by United Nations Statistics). Similarities and differences between regions were examined. RESULTS Most participating centres specialized in rehabilitation (82 %) and neurology (60 %), with only 38 % specialising in MS. Of these, the Western based Specialist MS centres were predominately based on outpatient services (median MS inpatient ratio 0.14), whilst the Eastern based European services were mostly inpatient in nature (median MS inpatient ratio 0.5). In almost all participating countries, medical doctors - specialists in neurology (60 %) and in rehabilitation (64 %) - were responsible for referral to/prescription of physiotherapy. The most frequent reason for referral to/prescription of physiotherapy was the worsening of symptoms (78 % of centres). Physiotherapists were the most common members of the rehabilitation team; comprising 49 % of the team in Eastern countries compared to approximately 30 % in the rest of Europe. Teamwork was commonly adopted; 86 % of centres based in Western countries utilised the interdisciplinary model, whilst the multidisciplinary model was utilised in Eastern based countries (p = 0.046). CONCLUSION This survey is the first to provide data about organisational aspects of physiotherapy for people with MS across Europe. Overall, care in key organisational aspects of service provision is broadly similar across regions, although some variations, for example the models of teamwork utilised, are apparent. Organisational framework specifics should be considered anytime a multi-centre study is conducted and results from such studies are applied.
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Affiliation(s)
- Kamila Rasova
- Department of rehabilitation, Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic. .,Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic.
| | - Jenny Freeman
- Faculty of Health and Human Science, Plymouth University, Playmouth, PL6 8BH, England
| | - Patricia Martinkova
- Institute of Computer Science, Academy of Sciences of the Czech Republic, Pod Vodarenskou vezi 2, Prague 8, 182 07, Czech Republic
| | - Marketa Pavlikova
- Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic
| | - Davide Cattaneo
- Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy
| | - Johanna Jonsdottir
- Neurorehabilitation at the Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy
| | - Thomas Henze
- PASSAUER WOLF Reha-Zentrum Nittenau, Rehabilitations klinik für Neurologie-Geriatrie-Urologie, Eichendorffstr. 21, D-93149, Nittenau, Germany
| | - Ilse Baert
- Hasselt University, Campus Diepenbeek, REVAL Rehabilitation Research Institute (BIOMED), Agoralaan building A, B-3590, Diepenbeek, Belgium
| | - Paul Van Asch
- Fit Up, Fitness- and Physiotherapy Center, Mechelsesteen weg 192a, 2550, Kontich, Belgium
| | - Carme Santoyo
- Cemcat, Neurorehabilitation Unit, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Tori Smedal
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway.,Department of Physiotherapy, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway
| | | | | | | | - Una Nedeljkovic
- Clinic for physical medicine and rehabilitation, Clinical Center of Serbia, Pasterova 2, 11000, Belgrade, Serbia
| | - Daphne Bakalidou
- Technological Educational Institute of Athens, 24, Mitrodorou street, Ak. Pratonos, 10441, Athens, Greece
| | - José Manuel Alves Guerreiro
- School of Health Sciences, Health Research Unit, Polytechnic Institute of Leiria, Campus 2 - Morro do Lena - Alto do Vieiro, 2411-901, Leiria, Portugal
| | - Ylva Nilsagård
- Faculty of Medicine and Health, Örebro University Region, SE- 701 82, Örebro, Sweden
| | - Erieta Nikolikj Dimitrova
- Institute of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ss Cyril and Methodius" University, Elisie Popovski 28, 1000, Skopje, Macedonia, Republic of The former Yugoslav
| | - Mario Habek
- Referral Center for Demyelinating Diseases of the Central Nervous System University Department of Neurology Zagreb School of Medicine and University Hospital Center, Kispaticeva 12, HR-10000, Zagreb, Croatia
| | - Kadriye Armutlu
- Physical Therapy and Rehabilitation departmant of Health Science Faculty, Hacettepe University, Ankara, Turkey
| | - Cécile Donzé
- Groupe Hospitalier de l'institut Catholique de Lille, Department of physical Medicine and Rehabilitation hospital Saint Philibert, Faculté Libre de Médecine, Univ Nord de France, F-59000, Lille, France
| | - Elaine Ross
- St. James's Hospital, St. James's street, Dublin 8, Ireland
| | - Ana Maria Ilie
- "Elias" University Emergency Hospital, 17 Marasti Bulevard, Bucharest, 01146, Romania
| | - Andrej Martić
- Divison of Neurology, Neurorehabilitation unit, University Medical Centre Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia
| | - Anders Romberg
- Masku Neurological Rehabilitation Centre, Physiotherapy, Vaihemäentie 10, PO Box 15, 21251, Masku, Finland
| | - Peter Feys
- Hasselt University, Campus Diepenbeek, REVAL Rehabilitation Research Institute (BIOMED), Agoralaan building A, B-3590, Diepenbeek, Belgium
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11
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Nedeljkovic U, Raspopovic ED, Ilic N, Vujadinovic ST, Soldatovic I, Drulovic J. Effectiveness of rehabilitation in multiple sclerosis relapse on fatigue, self-efficacy and physical activity. Acta Neurol Belg 2016; 116:309-15. [PMID: 26563405 DOI: 10.1007/s13760-015-0563-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
Relapse of disease is one of the most prominent characteristics of multiple sclerosis. Effectiveness of rehabilitation programmes on fatigue, self-efficacy (SE) and physical activity (PA) has not been investigated so far in context of relapse. The aim of our study was to examine if rehabilitation programme in addition to high-dose methylprednisolone (HDMP) during relapse of disease can influence fatigue, SE and PA more than corticosteroid therapy alone. Patients were randomized in control group receiving only HDMP and experimental group which was in addition included in rehabilitation programme. Outcome measures used were Fatigue Severity Scale (FSS), Multiple Sclerosis Self- Efficacy scale (MSSES), Godin Leisure-Time Exercise Questionnaire (GLTEQ), completed on baseline, 1 and 3 months later. There was no significant change in FSS in both time points, despite different trend seen between groups. The mean MSSES for function and control improved significantly in treatment group after 1 month (807.1 ± 96.8, p = 0.005; 665.3 ± 145.1, p = 0.05) and 3 months (820 ± 83.5, p = 0.004; 720.0 ± 198.2, p = 0.016.) compared to baseline values. The mean GLTEQ score was significantly higher in the treatment group compared to the control at both follow-up time points (45.7 ± 7.6, p < 0.001; 34.3 ± 22.4, p < 0.01). Rehabilitation started along with corticosteroid treatment induced significant improvement in PA compared to HDMP therapy alone. It also influenced noticeable changes in self-efficacy, but effect on fatigue was insufficient.
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Affiliation(s)
- Una Nedeljkovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia.
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia.
| | - Emilija Dubljanin Raspopovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Nela Ilic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Sanja Tomanovic Vujadinovic
- Clinic for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Ivan Soldatovic
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
| | - Jelena Drulovic
- School of Medicine, University of Belgrade, Doktora Subotica 8, 11000, Belgrade, Serbia
- Neurology Clinic, Clinical Centre of Serbia, Doktora Subotica 6, 11000, Belgrade, Serbia
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12
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Nedeljkovic U, Dackovic J, Tepavcevic DK, Basuroski ID, Mesaros S, Pekmezovic T, Drulovic J. Multidisciplinary rehabilitation and steroids in the management of multiple sclerosis relapses: a randomized controlled trial. Arch Med Sci 2016; 12:380-9. [PMID: 27186184 PMCID: PMC4848347 DOI: 10.5114/aoms.2015.47289] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 09/18/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Periodic relapses are one of the main characteristics of multiple sclerosis (MS), from which recovery is often incomplete despite high-dose methylprednisolone (HDMP) treatment. The aim of our study was to evaluate the potential benefits of short-term HDMP combined with multidisciplinary rehabilitation (MDR) in persons with MS in relapse in order to assess whether combination of steroid therapy with MDR is more beneficial than steroid therapy alone. MATERIAL AND METHODS This investigation was conducted as a randomized controlled trial. The MS patients were eligible if they had an established diagnosis and relapse requiring application of HDMP. Forty-nine patients were included in the study and randomized to control and treatment groups, and 37 completed the study. High-dose methylprednisolone was administered to all patients. The treatment group additionally underwent an MDR program over a 3-week period. All outcome measures were completed at baseline and 1 and 3 months later. RESULTS The Expanded Disability Status Scale (EDSS) and Functional Independence Measure (FIM) motor scores improved statistically significantly 1 month after HDMP, in both treatment and control groups. During the study period, in the treatment group, a sustained large effect size (ES) was found for both physical and mental composite scores of Multiple Sclerosis Quality of Life-54 (MSQoL-54), while in the controls, a sustained moderate ES was demonstrated only for physical composite score. CONCLUSIONS Our findings suggest that MDR improves MS relapse outcome.
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Affiliation(s)
- Una Nedeljkovic
- Clinic of Physical Medicine and Rehabilitation, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Dackovic
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Irena Dujmovic Basuroski
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sarlota Mesaros
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana Pekmezovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Drulovic
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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13
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Rasova K, Martinkova P, Pavlikoma M, Cattaneo D, Jonsdottir J, Henze T, Baert I, Van Asch P, Santovo C, Smedal T, Beiske AG, Stachowiak M, Kovalewski M, Nedeljkovic U, Bakalidou D, Alves-Guerreiro J, Nilsagård Y, Dimitrova EN, Habek M, Armutlu K, Donzé C, Ross E, Ilie AM, Martić A. Physical therapy provision in multiple sclerosis across Europe: a regional lottery? Eur J Phys Rehabil Med 2015; 51:850-852. [PMID: 26334364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- K Rasova
- Third Medical Faculty Charles University in Prague, Prague, Czech Republic -
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14
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Nedeljkovic U, Dubljanin-Raspopovic E, Ilic N, Dackovic J, Dujmovic I. Endurance and resistance training in rehabilitation of patients with multiple sclerosis. VOJNOSANIT PREGL 2014. [DOI: 10.2298/vsp130116003n] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Una Nedeljkovic
- Clinical Center of Serbia, Clinic for Physical Medicine and Rehabilitation, Belgrade
| | - Emilija Dubljanin-Raspopovic
- Clinical Center of Serbia, Clinic for Physical Medicine and Rehabilitation, Belgrade + Faculty of Medicine, Belgrade
| | - Nela Ilic
- Clinical Center of Serbia, Clinic for Physical Medicine and Rehabilitation, Belgrade + Faculty of Medicine, Belgrade
| | | | - Irena Dujmovic
- Clinical Center of Serbia, Neurology Clinic, Belgrade + Faculty of Medicine, Belgrade
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15
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Dubljanin Raspopovic E, Nedeljkovic U, Tomanovic S, Bumbasirevic M. THU0378 Predictors of One-Year Mortality in Elderly Hip Fracture Patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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