RESUMEN
BACKGROUND: Multiple sclerosis (MS) is a chronic, progressive, and neurodegenerative central nervous system disorder. MS usually causes disability, cognitive deficiency, fatigue, and depression symptoms. OBJECTIVES: To assess cognitive functions of people with MS (pwMS) and investigate the impact of depression, fatigue, and disability on cognitive functions. METHODS: We administered the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery to assess 200 pwMS. The Expanded Disability Status Scale (EDSS) was used to evaluate disability levels. Fatigue Severity Scale (FSS) and the Beck Depression Inventory (BDI) were used, respectively, for fatigue and depression levels. RESULTS: EDSS and FSS scores were significantly higher in those with a disease duration of 5 years or more. Those with the EDSS ≥ 4 were found to have lower BICAMS performances and higher FSS scores. There was a significant difference in Symbol Digit Modalities Test (SDMT) performances between the groups with and without fatigue (FSS ≥ 4 and FSS < 4, respectively). When depression and fatigue symptoms concur or in the existence of just one of them or none of them, significant differences in terms of SDMT performances have been shown. CONCLUSION: The level of disability and fatigue adversely affects the cognitive functions of pwMS; depression has no significant effect. BICAMS that is specific for MS can be beneficial to assess the cognitive state of pwMS.
Asunto(s)
Esclerosis Múltiple , Cognición , Depresión/etiología , Fatiga/etiología , Humanos , Esclerosis Múltiple/complicaciones , Pruebas NeuropsicológicasRESUMEN
CONTEXT: To the best of our knowledge, there has been no study on yoga that includes both persons with multiple sclerosis (MS) and their family members. Because yoga has therapeutic effects in both persons with MS and healthy persons, we hypothesized that it would be an effective method to improve not only the physical and psychosocial status but also the time persons with MS and their family members spend together. OBJECTIVE: To examine the feasibility of a 6-month (long-term) yoga program to improve the physical and psychosocial status of persons with MS and their family members. DESIGN: Uncontrolled clinical trial. SETTING: The protocol was developed at the Department of Neurology, Faculty of Medicine, and School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey. PARTICIPANTS: Persons with MS and healthy family members. MAIN OUTCOME MEASURES: Walking, balance, fatigue, health-related quality of life, depression, pain, and kinesiophobia. INTERVENTIONS: Yoga training was given once a week (at least 1h) for 6 months. The same assessors who assessed at baseline also performed the same assessments immediately after the end of the training (i.e., after 6 months). RESULTS: In total, 44 participants (27 persons with MS and 17 healthy family members) participated in the study. Twelve persons with MS and three healthy family members completed the 6-month yoga intervention. The completion rate for persons with MS and healthy subjects was 44.4% and 17.6%, respectively. In persons with MS, the mental dimension of health-related quality of life, walking speed, fatigue, and depression levels significantly improved after the yoga program (p < .05). However, there was no significant change in the self-reported walking impact, balance, pain, physical dimension of health-related quality of life, and kinesiophobia levels in the persons with MS (p > .05). This study suggests that a 6-month yoga program can improve the mental dimension of health-related quality of life, walking speed, fatigue, and depression in the persons with MS. However, the 6-month yoga program does not appear to be a feasible method to increase the time that persons with MS spend together with their family members.