Exercise and Stretch Thread Nov. 2016

[Sunshine]

I nearly ran down the boardwalk so I could snap the sunrise for you guys :) took my flip phone and it did a great job.

[Virginia]

Great pics BBS!

Well, absolutely to activity for me today. That is the way it is - if I go one day I can't the next day or two. Exasperating!

[Sunshine]

Yes, it's interesting isn't it? It's like the battery completely wears down super fast and it takes a while to recharge it. It's like my iPad battery. If you don't close your mail, your FB, and other apps, they run in the background and the Battery wears down very fast. Same idea. The body has all these other apps going to try to re route messages through less faulty nerves and is spending lots of energy trying to repair or patch the damaged wires.

[Howie]

I always explain it this way. People with MS have X amount of energy each day. Go over that amount, and it will be deducted from the next days amount of energy. It takes some time to be able to stay in the middle so you begin to feel "good" each day.

[agate]

I found this on MedPage Today (November 23). It's a small study but sponsored by the National MS Society. It's about a paper presented at the Society for Neuroscience meeting held this month in San Diego.

[Society for Neuroscience]: Ballet Improves Ataxia in MS

Dance program improved movement in pilot study

by Kristina Fiore
Associate Editor, MedPage Today
November 16, 2016

SAN DIEGO -- A rehabilitative dance program based on classical ballet improved ataxia among multiple sclerosis (MS) patients in a pilot study, researchers reported here.

Among the six patients enrolled in the program, all had significant improvements on most measures of the International Cooperative Ataxia Rating Scale (ICARS), Citlali Lopez-Ortiz, PhD, of the University of Illinois at Urbana-Champaign, and colleagues reported at the Society for Neuroscience meeting here.

"Animal models have shown that exercise increases myelination," Lopez-Ortiz told MedPage Today. "We think this sort of more heavily loaded, whole body exercise might be pushing some of the mechanisms that are improving conduction in MS so that we see improved coordination and reduction in ataxia."

The benefit of exercise and rehabilitation has been established, but there has been little focus on improving agility and smoothness of movement in exercise interventions for those with MS, the researchers said.

So they developed a targeted exercise intervention based on classical ballet training with the goal of improving agility, balance, ataxia, and smoothness of movement in MS. The program relies on knowledge about the nature of motor impairment and sensory processing as well as on the whole body movement associated with conservatory training in classical ballet, Lopez-Ortiz said.

"We think dance is important because it uses music, and research has identified that there is an effect of entrainment facilitation of movement when a rhythm is given to you. Dance couples music and movement intrinsically. Also, classical ballet has a high cognitive demand, involving the entire body all the time. Of all possible forms of dance, it is the most demanding, but it creates the most dexterous people on the planet. It's a technique that has been developed over 500 years, and over that time people have been able to identify what really works in training the motor system."

The researchers enrolled six patients with MS, ages 49 to 65, with Expanded Disability Status Scale (EDSS) scores ranging from 4.5 to 6.5 -- indicating walking impairment -- into the 16 week pilot study that involved two hour-long classes per week.

The primary investigator, who has a Bolshoi Ballet Academy Teacher Certification and neuromuscular rehabilitation expertise, led the classes.

Balance was assessed using the Mini-BESTest, and ataxia was measured on the International Cooperative Ataxia Rating Scale.

Smoothness of gait was measured by calculating s-indexes of 29 reflective markers placed on anatomical landmarks of the body in a 5 meter walk test.

Overall, the researchers found that gait smoothness significantly improved on all measures at all locations, including the upper arm, elbow, upper leg, and knee.
Patients also had a significant, 42%, improvement on the Mini-BESTest, which Lopez-Ortiz noted far surpassed results in the literature for other exercise interventions.

"Previous literature on exercise interventions in MS shows improvements of about 10% to 15% in balance and walking ability in early-stage disease," she told MedPage Today. "In this study, although it's a pilot and we're still collecting data, we see improvement of 42% in balance and walking ability combined."

The team also found a benefit for ataxia, with significant improvement on all measures of ICARS (including posture and gait and kinetic), with the exception of the oculomotor test.

Lopez-Ortiz noted that dance provides motivation, social interactions, emotional expression, music, and targeted physical tasks in a single program centered on movement rehabilitation. Also, the cost of dance is a fraction of that of traditional pharmacological interventions for MS, she pointed out.

Next steps include doing a larger clinical trial, as well as digging further into the potential mechanisms behind the benefits.

Lopez-Ortiz said that the team has also tested this dance program in children with cerebral palsy and adults with Parkinson's disease, and has seen improvements in movement quality as well as clinical improvements "that make a difference in peoples' lives. Most commonly, it improves balance, but it also improves measures of coordination and movement in general."

_________________________
The study was supported by the National Multiple Sclerosis Society.

Lopez-Ortiz disclosed no financial relationships with industry.

Primary Source:
Society for Neuroscience Meeting
Source Reference: Lopez-Ortiz C, et al "Ataxia rehabilitation in multiple sclerosis through a targeted dance class" SFN 2016; Abstract 533.

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[QUOTE]

[Sunshine]

Would love to see a study with good controls built in too, to build on the findings here.

Example, what if any movement is coupled with an upbeat song and tempo and in a social setting like a class. Locally, there is aquacise in an 80 degree heated outdoor pool. They play fun oldies songs and they use the tempo for water based stretching and movement therapies with a leader and a class ranging from 8 to 30 participants, thrice weekly.

Maybe it isn't the ballet specifically, but music and tempo based movement in a social setting?

Personally, ballet would do me in.

[Howie]

Me too. Can't you see Howie in a tutu?

[SuzE-Q]

Me too. Can't you see Howie in a tutu?

Yes, please, Howie.

I vote to see that.

[agate]

Even Howie in a leotard would be a--different sight.

Compared to the usual thong, I mean.

BBS, I wondered if the movements in ballet aren't somewhat like the movements needed for surfing but it sounds as if it's not similar at all. Different muscles being "challenged"?

[Howie]

I feel pretty, oh so pretty..........

[Sunshine]

Not being a ballet person, I suspect it's different. Other athletes have told me that they're in terrific shape from other forms of exercise and sports, but it didn't translate at all to surfing.

I used to swim a mile daily. Then ai took my first surf lesson. Afterwards, all I could do was lie down and stare at the ceiling the rest of the day. Same with a healthy friend.

Perhaps it's the combination of intense adrenaline combined with a full body work out with surfing, that does it?

[Sunshine]

Refrained from swimming today. It just seemed risky. Maybe tomorrow....But did walk outside for ten minutes, did six flights, did laundry, cooking, and ran into a store to pick up socks for the MS legs. So, I am satisfied with those victories.

[agate]

Some whirling dervishes around here!

I did--um, what did I do? Ironing! I'm getting around to the hair washing I was going to do a couple of days ago.

I've done my usual exercises. I never skip them. Sometimes I'll postpone some of the M-W-F ones till the next day.

[Virginia]

I use to love to dance. Now if I try to put anything to music my feet are so clumsy I just fall over my own self. I tried holding onto the handle of the refrigerator and doing something to music. It was pathetic.

Second day of no activity. Friday did it for me. Hope to get back to doing something in the house soon.

[Sunshine]

I swam a half mile today. Not my normal mile, but it felt terrific to do it. I don't dare do more. I could feel the MS the rest of the day, will skip swimming tomorrow likely.

I love reading everyone's comments, Virginia I hope you can get back to where you were,