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Exploring Wellness Interventions in Progressive Multiple Sclerosis: an Evidence-Based Review

  • Multiple Sclerosis and Related Disorders (J Graves, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review

There has been recent interest in the role of lifestyle and wellness-based approaches in the treatment and management of multiple sclerosis (MS). These approaches may be particularly relevant for patients with progressive MS, considering limited therapeutic options currently available. The purpose of this review is to examine the role of wellness-based interventions including exercise training, emotional well-being therapies, and dietary modification in patients with progressive MS.

Recent findings

We conducted a literature search on the efficacy of wellness-based interventions in patients with progressive MS published between 1985 and July 2017. The level of evidence for each trial was evaluated using the American Academy of Neurology criteria. Overall, 21 articles reporting on 16 wellness-based interventions were identified: ten trials involved exercise training, three involved emotional wellness therapies, two involved dietary modification, and one was a combined wellness intervention.

Summary

There is level C evidence (possibly effective; one class II study) for the efficacy of aerobic exercise training on cardiorespiratory fitness in patients with progressive MS. There is level B evidence (probably effective; one class I study) for the efficacy of mindfulness training on psychological distress, depression, anxiety, pain, and quality of life in patients with progressive MS. There is inadequate evidence (level U) for efficacy of dietary modification (one class III study and one class IV study) and combined wellness interventions involving exercise training, meditation, and dietary modification (one class IV study). High-quality research is needed to provide evidence-based recommendations for wellness behaviors and lifestyle change in patients with progressive MS.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada

    Myriam Venasse BSc

  2. School of Human Kinetics, University of Ottawa, Ottawa, Canada

    Thomas Edwards BKin, MSc

  3. Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada

    Lara A. Pilutti PhD

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  1. Myriam Venasse BSc
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  2. Thomas Edwards BKin, MSc
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  3. Lara A. Pilutti PhD
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Correspondence to Lara A. Pilutti PhD.

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Myriam Venasse and Thomas Edwards declare no conflict of interest. Lara A. Pilutti reports receiving research grants from the National Multiple Sclerosis Society and the Consortium of Multiple Sclerosis Centers outside of this work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Multiple Sclerosis and Related Disorders

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Venasse, M., Edwards, T. & Pilutti, L.A. Exploring Wellness Interventions in Progressive Multiple Sclerosis: an Evidence-Based Review. Curr Treat Options Neurol 20, 13 (2018). https://doi.org/10.1007/s11940-018-0497-2

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