April 12, 2017 /
J
Am Coll Nutr. 2017 Apr
10:1-19. doi: 10.1080/07315724.2016.1255160. [Epub ahead of print]
Am Coll Nutr. 2017 Apr
10:1-19. doi: 10.1080/07315724.2016.1255160. [Epub ahead of print]
Author
information
Abstract
OBJECTIVE:
The objective of this study was to examine
whether participation in a 12-month multimodal intervention would improve mood
and cognitive function in adults with progressive multiple sclerosis (MS).
whether participation in a 12-month multimodal intervention would improve mood
and cognitive function in adults with progressive multiple sclerosis (MS).
METHODS:
In this one-arm, open-label feasibility trial,
participants were prescribed a home-based multimodal intervention, including
(1) a modified Paleolithic diet; (2) an exercise program (stretching and
strengthening of the trunk and lower limb muscles); (3) neuromuscular
electrical stimulation (EStim) of trunk and lower limb muscles; and (4) stress
management (meditation and self-massage). Individuals completed measures of
mood (Beck Anxiety and Depression Inventories) and cognitive (Cognitive
Stability Index, Cognitive Screening Test, Delis-Kaplan Executive Function
System) and executive function (Wechsler Adult Intelligence Scale) at baseline
and 3, 6, 9, and 12 months after the start of the intervention. Dosage of
the multimodal intervention was assessed at 3, 6, 9, and 12 months.
participants were prescribed a home-based multimodal intervention, including
(1) a modified Paleolithic diet; (2) an exercise program (stretching and
strengthening of the trunk and lower limb muscles); (3) neuromuscular
electrical stimulation (EStim) of trunk and lower limb muscles; and (4) stress
management (meditation and self-massage). Individuals completed measures of
mood (Beck Anxiety and Depression Inventories) and cognitive (Cognitive
Stability Index, Cognitive Screening Test, Delis-Kaplan Executive Function
System) and executive function (Wechsler Adult Intelligence Scale) at baseline
and 3, 6, 9, and 12 months after the start of the intervention. Dosage of
the multimodal intervention was assessed at 3, 6, 9, and 12 months.
RESULTS:
The more individuals participated in the
intervention activities, the greater improvements they had from baseline to
12 months on self-report measures of anxiety (Beck Anxiety Inventory
[BAI]; ps = 0.001 to 0.02), depression (Beck Depression Inventory [BDI]; ps =
<0.0001 to 0.09), cognitive function (Cognitive Stability Index [CSI/T],
Delis-Kaplan Executive Function System [DKEFS]; ps = 0.001 to 0.06), and
executive function (Wechsler Adult Intelligence Scale [WAIS]; ps = <0.0001
to 0.09). Mood and cognitive improvements were more closely related to a higher
intake of the modified Paleolithic diet than to exercise and stress management
dosage. Anxiety and depression changes were evident after just a few months,
whereas changes in cognitive function were generally not observed until later
in the intervention period. Mood and cognitive function changes from baseline
to 12 months were significantly associated with fatigue improvements (ps =
<0.0001 to 0.03).
intervention activities, the greater improvements they had from baseline to
12 months on self-report measures of anxiety (Beck Anxiety Inventory
[BAI]; ps = 0.001 to 0.02), depression (Beck Depression Inventory [BDI]; ps =
<0.0001 to 0.09), cognitive function (Cognitive Stability Index [CSI/T],
Delis-Kaplan Executive Function System [DKEFS]; ps = 0.001 to 0.06), and
executive function (Wechsler Adult Intelligence Scale [WAIS]; ps = <0.0001
to 0.09). Mood and cognitive improvements were more closely related to a higher
intake of the modified Paleolithic diet than to exercise and stress management
dosage. Anxiety and depression changes were evident after just a few months,
whereas changes in cognitive function were generally not observed until later
in the intervention period. Mood and cognitive function changes from baseline
to 12 months were significantly associated with fatigue improvements (ps =
<0.0001 to 0.03).
CONCLUSIONS:
A modified Paleolithic diet, exercise, EStim,
and stress management intervention like this one has the potential to improve
the mood and cognitive symptoms that can lead to considerable suffering in
people with MS, potentially improving quality of life and function for people
with progressive MS.
and stress management intervention like this one has the potential to improve
the mood and cognitive symptoms that can lead to considerable suffering in
people with MS, potentially improving quality of life and function for people
with progressive MS.
KEYWORDS:
Multiple sclerosis; Wahl’s Protocol; anxiety; cognitive function;
depression; diet; electrical stimulation; exercise; mood; non-pharmacologic
depression; diet; electrical stimulation; exercise; mood; non-pharmacologic
PMID: 28394724
Terry Wahls, MD, MBA, IFMCP
Clinical Professor of Medicine
Department of Medicine
Carver College of Medicine
University of Iowa
200 Hawkins Drive
Iowa City, Iowa 52240
Secretary
319-356-4421
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