Physical activity linked to reduced paediatric MS burden

By Shreeya Nanda, Senior medwireNews Reporter

A cross-sectional study has found an association between moderate or strenuous physical activity and reduced fatigue, lesion volumes and relapse rates in children and adolescents with multiple sclerosis (MS).

Among 31 MS paediatric patients, higher levels of self-reported moderate physical activity metabolic equivalents, as assessed by the Godin Leisure-Time Exercise Questionnaire (GLTEQ), were associated with lower sleep/rest and general fatigue symptoms. And the converse was true as well – the higher the sleep/rest and general scores on the PedsQL Multidimensional Fatigue Scale, the lower the level of moderate physical activity.

Magnetic resonance imaging data, available for 13 patients, showed a significant correlation between higher strenuous physical activity and lower T2 lesion volumes and annualised relapse rate. Specifically, the median lesion volume was 0.46 cm³ for the six participants who reported strenuous activity and 3.40 cm³ for the seven who did not. The corresponding median values for the relapse rate were 0.5 per year and 1.0 per year.

These findings suggest “a potential protective effect of strenuous [physical activity] in this population”, write researcher E Ann Yeh (SickKids Research Institute, Toronto, Ontario, Canada) and co-authors in Neurology.

They note, however, that MS patients reported significantly less strenuous and total physical activity than 79 patients with monophasic acquired demyelinating syndrome (mono-ADS), at 0.0 versus 27.0 metabolic equivalents and 40.0 versus 54.0 metabolic equivalents, respectively. And a significantly lower proportion of MS patients than their mono-ADS counterparts reported participation in any strenuous activity, at 45.2% and 82.3%, respectively.

Yeh et al say that the reasons underlying this difference between MS and mono-ADS patients remain “unclear”, but could be attributed to “ongoing disease activity, perceived limitations, or symptoms such as depression or fatigue”. They note that the levels of fatigue and depression were significantly higher in MS than in mono-ADS patients in their study.

Highlighting the cross-sectional nature of the study, the authors conclude that “[f]uture studies should focus on establishing the causal nature of this relationship by investigating interventions to improve [physical activity] and examining associated consequences in this population.

“These future interventions have the potential to improve quality of life by attenuating symptoms such as depression and fatigue and potentially reducing the rate of disease progression.”

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