Multiple Sclerosis

A Pilot Study of Mindfulness Training for the Cognitive and Psychological Symptoms with Multiple Sclerosis

psyjdc Leave a comment

A Pilot Study of Mindfulness Training for the Cognitive and Psychological Symptoms with Multiple Sclerosis

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” Amit Sood

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, physical impairment, depression, and poor sleep quality. In addition, there are marked deficits in cognition in around half of MS patients that include impairments in memory, information processing speed, executive functioning, attention, and verbal fluency. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. It has also been shown to improve the symptoms of multiple sclerosis.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605592/, Blankespoor and colleagues investigated the ability of mindfulness training to relieve the psychological symptoms, including cognitive impairments, with Multiple Sclerosis (MS). In a pilot study, they recruited patients with MS and provided them with an 8-week Mindfulness-Based Stress Reduction (MBSR) program consisting of meditation, body scan, and yoga practice. The participants met in group sessions for 2.5 hours once a week and also performed home practice. The participants were measured before and one week after training for mindfulness, depression, multiple sclerosis quality of life, fatigue, self-compassion, and cognitive ability including tests of memory, visuospatial memory, processing speed, working memory, attention, and executive function.

 

They found that in comparison to baseline measures, after MBSR training the patients showed significant improvements in their psychological states including their physical and emotional quality of life, self-compassion, and mindfulness. Unfortunately, the patients did not show cognitive impairments at baseline. So, it was not surprising that the only cognitive ability that significantly improved was visuospatial processing.

 

Unfortunately, the study was flawed in a number of ways. In particular the lack of a control comparison condition opens the way for a large number of alternative, confounding, explanations for the results. Also, there was a 30% dropout rate which raises the possibility that only those who felt better continued and were measured after treatment. Finally, the lack of baseline impairment in cognitive abilities precluded the assessment of the effectiveness of MBSR to improve these common symptoms of MS. The study needs to be repeated in a Randomized Controlled Clinical Trial (RCT) with procedures implemented to maximize patient retention and with patients who demonstrate cognitive impairment prior to treatment.

 

Patients with Multiple Sclerosis suffer in many ways and it will be important to determine if mindfulness training can reduce the suffering.

 

“Studies in multiple sclerosis, these have shown that mindfulness can improve quality of life and help people cope better with their MS. The studies also found that it decreased stress, anxiety and depression.” – MSTrust

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Blankespoor, R. J., Schellekens, M. P. J., Vos, S. H., Speckens, A. E. M., & de Jong, B. A. (2017). The Effectiveness of Mindfulness-Based Stress Reduction on Psychological Distress and Cognitive Functioning in Patients with Multiple Sclerosis: a Pilot Study. Mindfulness, 8(5), 1251–1258. http://doi.org/10.1007/s12671-017-0701-6

 

Abstract

Patients with multiple sclerosis (MS) often suffer from psychological distress and cognitive dysfunctioning. These factors negatively impact the health-related quality of life. Only recently behavioral therapeutic approaches are being used to treat psychological distress in MS. The aim of the present pilot study was not only to investigate the effectiveness of mindfulness-based stress reduction (MBSR) on psychological distress but also to explore whether it can improve cognitive functioning among patients with MS. Outpatients of the MS Center of the Radboud University Medical Center (Radboudumc) were invited to participate in an MBSR training. Psychological and cognitive measures were administered pre- and post-intervention. Twenty-five MS patients completed the MBSR training and psychological measures, of which 16 patients completed the cognitive tests. Significant improvements were found in depressive symptoms, quality of life, fatigue, mindfulness skills, and self-compassion. Of the cognitive tests, performance on a visual spatial processing test significantly improved after the intervention. Overall, this pilot study showed promising results of the effects of MBSR on reducing psychological distress, and it suggests MBSR might improve cognitive functioning in MS patients. Future randomized controlled trials should be conducted to confirm the possible effectiveness of MBSR—and its long-term effects—on psychological and cognitive functioning in MS patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605592/

Improve Fatigue and Multiple Sclerosis Psychological Symptoms with Mindfulness

psyjdc Leave a comment

Improve Fatigue and Multiple Sclerosis Psychological Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness may help people better respond to stress by fostering healthier coping strategies. For example, study participants who reported higher levels of mindfulness were less likely to rely on coping strategies, such as denial, disengagement and self-blame. They were also more likely to use more-positive strategies, such as information gathering, planning and seeking out social support. Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” – Amit Sood

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. It has also been shown to improve the symptoms of multiple sclerosis.

 

In today’s Research News article “Mindfulness-based cognitive therapy severely fatigued multiple sclerosis patients: A waiting list controlled study.” See summary below or view the full text of the study at: https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2237, Hoogerwerf and colleagues recruited patients with multiple sclerosis and kept them on a waiting list for 10 weeks and then provided them with 10 weeks of Mindfulness-Based Cognitive Therapy (MBCT) in groups of 12. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. They were measured at baseline after the 10-week waiting period, after treatment and 3 months later for fatigue, mindfulness, anxiety, depression, quality of life, sleeping problems, daily cognitive mistakes, catastrophizing, coping styles, and cognitive ability.

 

They found that during the 10-week waiting period symptoms generally did not significantly change, but after the MBCT training there were significant improvements in fatigue, mindfulness, anxiety, depression, daily cognitive mistakes, catastrophizing, and emotion focused coping styles. These improvements were sustained at the 3-month follow-up. Hence, MBCT training appeared to produce marked and lasting improvements in the psychological symptoms of multiple sclerosis. There is a need to repeat this study with a stronger randomized controlled clinical trial. The positive results make a compelling case for such a trial.

 

Mindfulness training has been shown to produce improvements in fatigue, emotion regulation, anxiety, depression, cognitive performance, coping strategies, worry and catastrophizing, and of course mindfulness. The present study confirms that these benefits also accrue to patients with multiple sclerosis and are maintained. This suggests that MBCT training or other mindfulness trainings may be helpful in relieving the symptoms of this life-long progressive neurological disease. This will hopefully allow them to cope better with their disease and generally make their lives better

 

So, improve fatigue and multiple sclerosis psychological symptoms with mindfulness.

 

“Studies in multiple sclerosis, these have shown that mindfulness can improve quality of life and help people cope better with their MS. The studies also found that it decreased stress, anxiety and depression.” – MS Trust

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Hoogerwerf AEW, Bol Y, Lobbestael J, Hupperts R, van Heugten CM. Mindfulness-based cognitive therapy severely fatigued multiple sclerosis patients: A waiting list controlled study. J Rehabil Med. 2017 Jun 8. doi: 10.2340/16501977-2237

 

Abstract

BACKGROUND:

Fatigue is the most common symptom in multiple sclerosis. Evidence-based treatment options are scarce.

OBJECTIVE:

To study the feasibility and potential effectiveness of mindfulness-based cognitive therapy in severely fatigued multiple sclerosis patients.

METHODS:

Non-randomized pilot study with a wai-ting list control period including 59 multiple sclerosis patients with severe fatigue.

PRIMARY OUTCOME MEASURE:

fatigue severity subscale of the Checklist Individual Strength-20. Secondary measures: Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire, subscale sleep of the Symptom Checklist-90, Cognitive Failure Questionnaire, Fatigue Catastrophizing Scale, Coping Inventory of Stressful Situations, and Five Facet Mindfulness Questionnaire-Short Form. Measurements were taken before treatment (double baseline), after treatment, and at follow-up (3 months).

RESULTS:

Adherence rate was 71%. Eight out of 10 participants who completed the intervention were satisfied with the intervention. Significant time effects were found for 7 out of 11 outcome measures (p = 0.006 to < 0.001). The effect size was moderate for all outcome measures that were significant post-treatment and/or at follow-up (Ƞ² = 0.10-0.17). Improvements were maintained at follow-up. Of the completers, 46% showed a clinically relevant change regarding fatigue.

CONCLUSION:

Mindfulness-based cognitive therapy is feasible in severely fatigued multiple sclerosis patients and has positive results in the reduction of severe fatigue and several psychological factors.

https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2237

Mindfulness Improves Stress and Psychological Well-Being in Patients with Multiple Sclerosis

psyjdc Leave a comment

Mindfulness Improves Stress and Psychological Well-Being in Patients with Multiple Sclerosis

 

By John M. de Castro, Ph.D.

 

“Studies show that for some people with MS, chronic exposure to stress is associated with worsening neurological symptoms and increased brain lesions. . . and relapses. Researchers believe that mindfulness may help people better respond to stress by fostering healthier coping strategies.” – Amit Sood

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. There is thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life over the lifespan. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. A number of forms of mindfulness training including meditation, yoga, and tai chi have been shown to improve the symptoms of multiple sclerosis. Since, the Mindfulness Based Stress Reduction (MBSR) program incorporates meditation, yoga, and body scan, it may be particularly helpful for patients with MS.

 

In today’s Research News article “Mindfulness-based stress reduction for people with multiple sclerosis – a feasibility randomised controlled trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434553/, Simpson and colleagues perform a pilot study of the effectiveness of a Mindfulness Based Stress Reduction (MBSR) program for the symptoms of multiple sclerosis. They recruited adults with Multiple Sclerosis and randomly assigned them to either receive 8 weeks, once a week for 90 minutes, of Mindfulness Based Stress Reduction (MBSR) or a wait-list control condition. Patients were encouraged to practice daily at home. They were measured before and after treatment and three months later for perceived stress, quality of life, fatigue mental health, social support, cognitive function, pain, visual function, bladder function, bowel function, sexual satisfaction, mindfulness, self-compassion, and emotional lability.

 

They found that immediately after treatment the MBSR group compared to the wait-list controls had significant improvements in their quality of life with small effect size and in perceived stress, depression, self-compassion, anxiety, and positive emotions with large effect sizes. For the most part these effects were maintained at the three-month follow-up. These results need to be replicated in a large randomized controlled clinical trial with an active control group.

 

The results demonstrate that MBSR has relatively large beneficial effects on the quality of life and psychological well-being of patients with multiple sclerosis that appear to endure, at least for three months after treatment. It will be important to see if continued practice at home can maintain the benefits for long periods of time.

 

But it is clear that mindfulness improves stress and psychological well-being in patients with multiple sclerosis

 

“Studies in multiple sclerosis, these have shown that mindfulness can improve quality of life and help people cope better with their MS. The studies also found that it decreased stress, anxiety and depression.” – Multiple Sclerosis Trust

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Simpson, R., Mair, F. S., & Mercer, S. W. (2017). Mindfulness-based stress reduction for people with multiple sclerosis – a feasibility randomised controlled trial. BMC Neurology, 17, 94. http://doi.org/10.1186/s12883-017-0880-8

 

Abstract

Background

Multiple sclerosis (MS) is a stressful condition. Mental health comorbidity is common. Stress can increase the risk of depression, reduce quality of life (QOL), and possibly exacerbate disease activity in MS. Mindfulness-Based Stress Reduction (MBSR) may help, but has been little studied in MS, particularly among more disabled individuals.

Methods

The objective of this study was to test the feasibility and likely effectiveness of a standard MBSR course for people with MS. Participant eligibility included: age > 18, any type of MS, an Expanded Disability Status Scale (EDSS).

Results

Fifty participants were recruited and randomised (25 per group). Trial retention and outcome measure completion rates were 90% at post-intervention, and 88% at 3 months. Sixty percent of participants completed the course. Immediately post-MBSR, perceived stress improved with a large effect size (ES 0.93; p < 0.01), compared to very small beneficial effects on QOL (ES 0.17; p = 0.48). Depression (ES 1.35; p < 0.05), positive affect (ES 0.87; p = 0.13), anxiety (ES 0.85; p = 0.05), and self-compassion (ES 0.80; p < 0.01) also improved with large effect sizes. At three-months post-MBSR (study endpoint) improvements in perceived stress were diminished to a small effect size (ES 0.26; p = 0.39), were negligible for QOL (ES 0.08; p = 0.71), but were large for mindfulness (ES 1.13; p < 0.001), positive affect (ES 0.90; p = 0.54), self-compassion (ES 0.83; p < 0.05), anxiety (ES 0.82; p = 0.15), and prospective memory (ES 0.81; p < 0.05).

Conclusions

Recruitment, retention, and data collection demonstrate that a RCT of MBSR is feasible for people with MS. Trends towards improved outcomes suggest that a larger definitive RCT may be warranted. However, optimisation changes may be required to render more stable the beneficial treatment effects on stress and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434553/

Improve Multiple Sclerosis Symptoms with Tai Chi

psyjdc Leave a comment

Improve Multiple Sclerosis Symptoms with Tai Chi

 

By John M. de Castro, Ph.D.

 

“The slow, repetitive weight-shifting movements and emphasis on maintaining an erect spine in tai chi help improve balance. People with multiple sclerosis (MS) tend to compensate for dysfunctional body systems by relying heavily on other systems. It’s therefore important to strengthen joint position sense — the sense of how your joints are positioned — and gain muscle control.” – Elizabeth Bowers

 

Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. Tai Chi is a mindfulness practice that is also a gentle exercise. It is gentle enough that it doesn’t increase body temperature which can exacerbate MS symptoms. In addition, Tai Chi  has been shown to reduce pain and improve balance, reducing falls. So, it would seem likely that Tai Chi might be effective in improving the quality of life and lessening fatigue in patients with multiple sclerosis.

 

In today’s Research News article “Tai chi for health benefits in patients with multiple sclerosis: A systematic review.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300172/

Zou and colleagues reviewed the published research literature (10 studies) investigating the effectiveness of Tai Chi practice for patients with Multiple Sclerosis (MS). They found that the published studies provided evidence that Tai Chi practice is safe and beneficial in improving the symptoms of MS. In particular, the literature suggests that Tai Chi practice improves flexibility, leg strength, gait, balance, and quality of life, and reduces pain. Although some evidence exists that it also reduces fatigue, the findings are inconsistent.

 

The research to date appears to support the use of Tai Chi practice to help improve the symptoms of Multiple Sclerosis. An important characteristic of Tai Chi practice is that it is safe, rarely having any adverse consequences. Once learned, it can also be practiced without professional supervision at home or in social groups. This makes it inexpensive and convenient, and perhaps even fun, improving the likelihood of long-term engagement in practice. This is particularly important as MS is a life-long non-fatal disease. Hence, Tai Chi practice would appear to be an excellent mindfulness practice for the improvement of the quality of life of patients with MS.

 

So, improve multiple sclerosis symptoms with tai chi.

 

“Tai Chi posture, has recently been shown in a number of random controlled trials to improve balance, posture, vigour and general well-being in a variety of client groups. These are problems commonly encountered by people with Multiple Sclerosis.  Some studies have suggested that Tai Chi is also beneficial towards managing spasticity.” – MS Unites

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Zou, L., Wang, H., Xiao, Z., Fang, Q., Zhang, M., Li, T., … Liu, Y. (2017). Tai chi for health benefits in patients with multiple sclerosis: A systematic review. PLoS ONE, 12(2), e0170212. http://doi.org/10.1371/journal.pone.0170212

 

Abstract

The aim of this systematic review was to evaluate the existing evidence on the effectiveness and safety of Tai chi, which is critical to provide guidelines for clinicians to improve symptomatic management in patients with multiple sclerosis (MS). After performing electronic and manual searches of many sources, ten relevant peer-reviewed studies that met the inclusion criteria were retrieved. The existing evidence supports the effectiveness of Tai chi on improving quality of life (QOL) and functional balance in MS patients. A small number of these studies also reported the positive effect of Tai chi on flexibility, leg strength, gait, and pain. The effect of Tai chi on fatigue is inconsistent across studies. Although the findings demonstrate beneficial effects on improving outcome measures, especially for functional balance and QOL improvements, a conclusive claim should be made carefully for reasons such as methodological flaws, small sample size, lack of specific-disease instruments, unclear description of Tai chi protocol, unreported safety of Tai chi, and insufficient follow-up as documented by the existing literature. Future research should recruit a larger number of participants and utilize the experimental design with a long-term follow-up to ascertain the benefits of Tai chi for MS patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300172/

 

Improve Quality of Life and Performance with Multiple Sclerosis with Yoga

psyjdc Leave a comment

Improve Quality of Life and Performance with Multiple Sclerosis with Yoga

 

By John M. de Castro, Ph.D.

 

“Studies in multiple sclerosis, these have shown that mindfulness can improve quality of life and help people cope better with their MS. The studies also found that it decreased stress, anxiety and depression.” – Multiple Sclerosis Trust

 

MS is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue. Yoga is a mindfulness practice that has the added feature of exercising and stretching the muscles. It would seem likely that yoga practice might be an ideal treatment for improving the quality of life and lessening symptoms in patients with multiple sclerosis.

 

In today’s Research News article “Feasibility and Impact of an 8-Week Integrative Yoga Program in People with Moderate Multiple Sclerosis–Related Disability: A Pilot Study.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315321/

Cohen and colleagues performed a pilot, single-group study, of the effectiveness of a specially designed yoga program for treating patients with multiple sclerosis. They recruited adult patients with multiple sclerosis with moderate disability and provided them with 8 weeks of twice weekly, 90-minute yoga sessions, including breathing practices, postures, meditation, and deep relaxation. The patients were encouraged to also practice at home. They assessed the feasibility of widespread implementation of such a program with budget utilization, recruitment rates, retention rates, attendance rates, and safety. They also assessed the patients’ quality of life, walking ability, extremity function, respiration, attention, and concentration, prior to and after the 8-week program and also 8-weeks later.

 

They found that the program was feasible, as it was implemented with acceptable costs, high participation rates and low drop-out rates, no unexpected adverse effects, and all participants reported home yoga practice. Importantly they found that after the intervention the patients were significantly improved on overall health status, quality of life issues, including bladder control, perceived deficits, and fatigue, standing, walking ability, motor control of both hands, hearing, and seeing. Many of these improvements continued to be significant at the 8-week follow-up.

 

Hence, this pilot study demonstrated the feasibility and potential benefits of yoga for patients with multiple sclerosis. This study did not contain a control condition, so any conclusions must be tempered and recognized as preliminary. Any exercise program might have produced similar benefits. A randomized controlled clinical trial is needed and warranted. But, the results were impressive and suggest that yoga for patients with multiple sclerosis can improve their quality of life and physical and mental ability and well-being. Since, multiple sclerosis produces a life-long disability, and yoga was shown to be both safe and effective, can be practiced at home, and substantially improves quality of life and motor ability, it would seem to be ideal to improve the lives of these patients.

 

So, improve quality of life and performance with multiple sclerosis with yoga.

 

“Mind-body therapies like yoga are also a practical therapeutic approach in MS because of their low risk of physical or emotional stress. The exercise of yoga also allows people with MS to engage in their treatment in a very active and engaged manner. there appears to be benefit in MS from participation in any regular physical activity like yoga. yoga may additionally improve cognitive ability by exercising one’s attention on focused breathing and positioning techniques and by generally improving mood and reducing stress.” – Edward Kim

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Cohen, E. T., Kietrys, D., Fogerite, S. G., Silva, M., Logan, K., Barone, D. A., & Parrott, J. S. (2017). Feasibility and Impact of an 8-Week Integrative Yoga Program in People with Moderate Multiple Sclerosis–Related Disability: A Pilot Study. International Journal of MS Care, 19(1), 30–39. http://doi.org/10.7224/1537-2073.2015-046

 

Abstract

Background:

This pilot study determined the feasibility of a specifically designed 8-week yoga program for people with moderate multiple sclerosis (MS)–related disability. We explored the program’s effect on quality of life (QOL) and physical and mental performance.

Methods:

We used a single-group design with repeated measurements at baseline, postintervention, and 8-week follow-up. Feasibility was examined through cost, recruitment, retention, attendance, and safety. Outcomes included the Multiple Sclerosis Quality of Life Inventory (MSQLI), 12-item Multiple Sclerosis Walking Scale (MSWS-12), Timed 25-Foot Walk test (T25FW), 6-Minute Walk Test (6MWT), Nine-Hole Peg Test (NHPT), Five-Times Sit-to-Stand Test (FTSTS), Multidirectional Reach Test (MDRT), maximum expiratory pressure, and Paced Auditory Serial Addition Test-3″ (PASAT-3″).

Results:

Fourteen participants completed the study. The program was feasible. There were significant main effects on the 36-item Short Form Health Status Survey Mental Component Summary (SF-36 MCS), Modified Fatigue Impact Scale (MFIS), Bladder Control Scale (BLCS), Perceived Deficits Questionnaire (PDQ), Mental Health Inventory (MHI), MSWS-12, T25FW, NHPT, PASAT-3″, 6MWT, FTSTS, and MDRT-Back. Improvements were found on the SF-36 MCS, MFIS, BLCS, PDQ, MHI, and MSWS-12 between baseline and postintervention. The effect on PDQ persisted at follow-up. Improvements were found on the T25FW, NHPT, 6MWT, FTSTS, and MDRT-Back between baseline and postintervention that persisted at follow-up. The PASAT-3″ did not change between baseline and postintervention but did between postintervention and follow-up.

Conclusions:

The yoga program was safe and feasible. Improvements in certain measures of QOL and performance were seen at postintervention and follow-up.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315321/

 

Improve Multiple Sclerosis Symptoms with Mindfulness

psyjdc Leave a comment

Improve Multiple Sclerosis Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness can be conceptualized as a facilitator of transition, enabling people to adapt to living with a long-term condition, and that this transition is associated with improved, self-directed management, important to both people with long-term conditions and healthcare providers.” – Daniela Semedo

 

MS is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.

 

Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life. Since mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, emotion regulation, and fatigue, it would seem likely that mindfulness practice might be effective in improving the quality of life and lessening fatigue in patients with multiple sclerosis.

 

In today’s Research News article “The effect of group mindfulness-based stress reduction and consciousness yoga program on quality of life and fatigue severity in patients with MS.” See  summary below or view the full text of the study at http://journals.tbzmed.ac.ir/JCS/Manuscript/JCS-5-325.pdf

Nejati and colleagues recruited patients with multiple sclerosis, aged 20-45 years, who did not practice meditation or yoga, and randomly assigned them to receive either an 8-week program of meditation and yoga practice or treatment as usual (control). Training in meditation and yoga occurred in 8 weekly 2-hour sessions with home practice. Both groups were measured before and after treatment for multiple sclerosis quality of life, psychiatric diseases, and fatigue.

 

They found that the meditation and yoga practice produced significant improvements in the multiple sclerosis quality of life subscales including physical health, role limitations due to physical and emotional problems, energy, emotional well-being, health distress, health perception, and satisfaction with sexual function, overall quality of life, and fatigue severity. There was no improvement found in overall health.

 

It should be noted that this was a quasi-experimental design as the control group did not receive any active additional treatment. Hence, various confounding factors such as placebo effects, attentional effects, etc. could have been responsible for the results. In addition, since the intervention contained both meditation and yoga practice, it cannot be determined which one or both were responsible for the improvements.

 

Nevertheless, the results are encouraging and suggest the mindfulness training might be effective in relieving fatigue and improving the quality of life in patients with multiple sclerosis. Since these patients will likely be spending the rest of their lives coping with the disease, making it easier for them to function and improving the quality of their lives is vitally important to their ling-term well-being.

 

So, improve multiple sclerosis symptoms with mindfulness.

 

“Living with the pain, discomfort, and the uncertainties of MS can lead to feelings of frustration, anger, anxiety, and depression. These feelings can lead to physiological changes such as increased fatigue and muscle pain, impaired memory and concentration, and poor sleep. “By becoming mindful and aware of our thoughts, feelings, and body sensations, we can better control situations, and we have more choices. Mindful awareness helps us to become fully conscious of the world as it is, rather than how we wish it could be.” – Regina Boyle Wheeler

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Nejati S, Rajezi Esfahani S, Rahmani S, Afrookhteh G, Hoveida Sh. The effect of group mindfulness-based stress reduction and consciousness yoga program on quality of life and fatigue severity in patients with MS. J Caring Sci 2016; 5 (4): 325-35. doi:10.15171/jcs.2016.034.

 

Abstract

Introduction: The chronic nature of Multiple Sclerosis (MS), have can leave devastating effects on quality of life and fatigue. The present research aimed to study the effect of group Mindfulness-based Stress Reduction (MBSR) and conscious yoga program on the quality of life and fatigue severity among patients with MS. Methods: This study was quasi-experimental with intervention and control groups. The statistical population included all members to MS Society of Tehran Province, 24 of whom diagnosed with MS were selected as the sample based on the inclusion criteria. The subjects were randomly assigned into the test group (12 patients) and the control group (12 patients). MS Quality of Life-54 (MSQOL-54) and Fatigue Severity Scale (FSS) were used for data collection. Subjects in the test group underwent a MBSR and conscious yoga program in 8 two-hour sessions. The data were analyzed using the SPSS ver.13 software. Results: The study findings showed that there was a significant difference between subjects in the experimental and control groups in terms of mean score of some subscales of quality of life including physical health, role limitations due to physical and emotional problems, energy, emotional well-being, health distress, health perception, and satisfaction with sexual function, overall quality of life, and fatigue severity. Conclusion: The results show that the program is effective in reduction of fatigue severity and improving some subscales of quality of life in MS patients. Hence, this supportive method can be used as an effective way for improving quality of life and relieving fatigue in MS patients.

http://journals.tbzmed.ac.ir/JCS/Manuscript/JCS-5-325.pdf

 

Improve Emotions in MS with Mindfulness

psyjdc Leave a comment

By Dr. John M. de Castro

 

“Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” – Amit Sood

 

“Multiple sclerosis (MS) is the most widespread disabling neurological condition of young adults around the world. more than 400,000 people in the United States and about 2.5 million people around the world have MS. About 200 new cases are diagnosed each week in the United States. The most common early symptoms of MS are: fatigue vision problems tingling and numbness vertigo and dizziness muscle weakness and spasms problems with balance and coordination.” – Healthline

 

MS is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It is most commonly diagnosed in people between the ages of 20 and 50 years.  Unfortunately, there is no cure for multiple sclerosis.  There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms. Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life.

 

Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. But, the emotional symptoms are the most problematic with clinically significant depression present in 50% of MS sufferers and anxiety in about a third of MS sufferers. Since mindfulness has been previously shown to improve depression, sleep quality, cognitive impairments, and emotion regulation, it would seem likely that mindfulness would affect the quality of life in MS patients.

 

In today’s Research News article “Effect of Mindfulness-Based Stress Reduction on Anxiety, Depression and Stress in Women with Multiple Sclerosis”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1179736912050233/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733502/

Kolahkaj and Zargar compared MS patients who were randomly assigned to receive either Mindfulness Based Stress Reduction (MBSR) or treatment as usual. They were compared prior to the intervention, after and two months later. They found that MBSR produced clinically significant reductions in depression, anxiety, and stress that were maintained two months after the end of active treatment.

 

The size and endurance of the effectiveness of MBSR is striking. But, it should be remembered that the control condition did not receive any active intervention, only receiving treatment as usual. Hence, the effectiveness of MBSR could be due to a number of contaminants including expectancy effects, experimenter bias effects, attention effects, etc. or social effects as MBSR is conducted in groups. It remains for future research to compare MBSR to other active interventions. In addition, Mindfulness Based Stress Reduction (MBSR) involves meditation, body scan, and Hatha yoga. It is a potent combination. But, it leaves the question open as to which of the components is effective against the various symptoms of MS. Once again, future research is needed to begin to separate out effective from ineffective components.

 

MBSR is known to reduce the psychological and physiological responses to stress. Since MS produces considerable stress in the sufferers, reducing the responses to stress may be a very important component of MBSR’s effectiveness for depression and anxiety. Also the yoga component of MBSR may be helpful in helping the MS sufferers to better deal with the effects of MS on motor movements and this may reduce stress, anxiety, and depression. Both meditation and yoga are known to improve emotion regulation, allowing the patient to better experience their emotions, yet respond to them adaptively and positively. This could markedly reduce anxiety, depression, and in turn, stress.

 

Regardless of the mechanism, it is clear that Mindfulness Based Stress Reduction (MBSR) produces marked improvement in the levels of anxiety, depression, and stress of MS patients. So, improve emotions in MS with mindfulness.

 

“I dissolved into a spiral of negative thinking. But since I started to practise mindfulness, I can control my negative thoughts and fears about the future. My stress levels are the lowest they’ve ever been and I’m back at work full-time.

I think mindfulness is even having a physical effect on the progression of the disease – my disability progression continues to be slow, even though I’ve been diagnosed for five years now.” – Gareth Walker

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Improve MS Quality of Life with Mindfulness

psyjdc Leave a comment

111111

 

“Multiple sclerosis (MS) can be an overwhelming challenge. One day you can feel strong and resilient, but the next day you can feel helpless and isolated. On these days, getting an extra push or boost from others just like you can make all the difference. ‘A positive attitude is the best medicine.’” – MS patient Lorri Lowe Peterson

“Multiple sclerosis (MS) is the most widespread disabling neurological condition of young adults around the world. more than 400,000 people in the United States and about 2.5 million people around the world have MS. About 200 new cases are diagnosed each week in the United States. The most common early symptoms of MS are: fatigue vision problems tingling and numbness vertigo and dizziness muscle weakness and spasms problems with balance and coordination.” – Healthline http://www.healthline.com/health/multiple-sclerosis/facts-statistics-infographic.

 

MS is most commonly diagnosed in people between the ages of 20 and 50 years with an average age between 30 and 35 years.  There is no cure for multiple sclerosis.  There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms. MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. There is a thus a critical need for safe and effective methods to help relieve the symptoms of MS and improve quality of life.

 

Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. But, depressive symptoms are the most problematic with clinically significant depression present in 50% of MS sufferers. Since mindfulness has been previously shown to improve depression (see http://contemplative-studies.org/wp/index.php/category/research-news/depression/) sleep quality (see http://contemplative-studies.org/wp/index.php/2015/07/17/mindfulness-is-a-snooze/), cognitive impairments (see http://contemplative-studies.org/wp/index.php/category/research-news/cognition/), and emotion regulation (see http://contemplative-studies.org/wp/index.php/category/research-news/emotions/, it would seem likely that mindfulness would affect the quality of life in MS patients.

 

In today’s Research News article “Examining trait mindfulness, emotion dysregulation, and quality of life in multiple sclerosis”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1148798548477403/?type=3&theater

Schirda and colleagues investigated the relationship of trait mindfulness with the quality of life and its associated symptoms in MS patients. They found that the higher the levels of trait mindfulness the lower the levels of depression and emotion dysregulation and the higher the quality of life in the patients. They also found that the reduction in emotion dysregulation was partially responsible for the positive relationship between mindfulness and quality of life. In addition, the higher the depression level the larger the impact of mindfulness’ association with emotion dysregulation on quality of life.

 

So, as predicted, mindfulness played an important role in mitigating the effects of MS on quality of life and its associated symptoms. These relationships in MS patients parallel the effects of mindfulness on healthy individuals and so would seem to be universal regardless of the disease state. That emotion regulation appears to be central is very interesting. Mindfulness is known to allow the individual to fully experience emotions but to respond to them in a positive and constructive way. The results of the study then suggest that this may be the critical effect of mindfulness for the patient to experience a high quality of life

 

It should be kept in mind that Schirda and colleagues’ study did not manipulate mindfulness, rather simply looking at existing levels of trait mindfulness and their relationships with quality of life. Hence, it can’t be concluded that mindfulness causes quality of life improvements in MS. For example, it could be that people who have a high quality of life with MS become more mindful. It will take future manipulative research to establish mindfulness’ effectiveness in treating MS patients.

 

But, we can tentatively recommend to improve MS quality of life with mindfulness.

 

“I want America to know that you can still have a full, exciting and productive life even if you or your loved one is battling a debilitating, chronic disease such as MS.” – Michaele Salahi

 

CMCS – Center for Mindfulness and Contemplative Studies