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Upper-lower limb and breathing exercise program for improving sleep quality and psychological status in multiple sclerosis: a pilot randomized controlled trial

Published online by Cambridge University Press:  01 October 2021

Tanja Grubić Kezele Open the ORCID record for Tanja Grubić Kezele [Opens in a new window] ,
Zrinka Trope ,
Valentina Ahel ,
Natali Ružić ,
Hrvoje Omrčen Open the ORCID record for Hrvoje Omrčen [Opens in a new window] ,
Luka Đudarić  and
Ariana Fužinac-Smojver
Tanja Grubić Kezele*
Affiliation:
Department of Physiology and Immunology, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
Zrinka Trope
Affiliation:
University of Rijeka Faculty of Health Studies, Rijeka, Croatia
Valentina Ahel
Affiliation:
University of Rijeka Faculty of Health Studies, Rijeka, Croatia
Natali Ružić
Affiliation:
University of Rijeka Faculty of Health Studies, Rijeka, Croatia
Hrvoje Omrčen
Affiliation:
Department of Anatomy, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
Luka Đudarić
Affiliation:
Department of Radiology, General Hospital Pula, Pula, Croatia
Ariana Fužinac-Smojver
Affiliation:
Department of Basic Sciences, University of Rijeka, Faculty of Health Studies, Rijeka, Croatia
*
*Corresponding author. E-mail: tanja.grubic@medri.uniri.hr
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Abstract

Purpose:

To examine the feasibility and possible effect of an 8-week exercise program on sleep quality, insomnia and psychological distress in individuals with multiple sclerosis (MS).

Methods:

Twenty-four individuals with MS were recruited into a controlled pre-post feasibility study and divided into 2 groups: exercise (n = 13; Expanded Disability Status Scale (EDSS): 1.0–7.5) and a related control group with no exercise (n = 11; EDSS: 1.0–7.0). The exercise group performed combined upper limb, lower limb and breathing exercises in a controlled group (2d/week, 60 min/session) for 8 weeks. Participants were administered measures to evaluate sleep quality (Pittsburgh Sleep Quality Index, PSQI), insomnia severity (Insomnia Severity Index, ISI), psychological distress (Clinical Outcomes in Routine Evaluation–Outcome Measure, CORE-OM) and additionally impact of fatigue (Modified Fatigue Impact Scale, MFIS) after 8-weeks.

Results:

Insomnia severity measured with ISI (F(1;22)=5.95, p = 0.023, ηp2 = 0.213, 90% CI = 0.02–0.42) and psychological distress measured with the CORE-OM (F(1;22)=4.82, p = 0.039, ηp2 = 0.179, 90% CI = 0.01–0.40) showed statistically significant group-by-time interaction. Sleep quality measured with the PSQI showed statistically significant group-by-time interaction only in an aspect of daytime sleep dysfunction (F(1;22)=5.33, p = 0.031, ηp2 = 0.195, 90% CI = 0.01–0.40). The fatigue impact measured with the MFIS showed statistically significant group-by-time interaction in physical (F(1;22)=6.80, p = 0.016, ηp2 = 0.236, 90% CI = 0.02–0.44) and cognitive aspects (F(1;22)=9.12, p = 0.006, ηp2 = 0.293, 90% CI = 0.05–0.49), and total score (F(1;22)=11.29, p = 0.003, ηp2 = 0.339, 90% CI = 0.08–0.52).

Conclusions:

Our 8-week program reduced insomnia severity, psychological distress and some aspects of fatigue (physical; cognitive; total), and improved sleep quality in an aspect of daytime sleep dysfunction in a small group of individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.

Keywords

insomniamultiple sclerosissleep qualitypsychological distressquality of lifefatigue
Type
Original Article
Information
Brain Impairment , Volume 24 , Issue 1 , March 2023 , pp. 86 - 102
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

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