984501301

Program#/Poster#: 253.06/Y21

Presentation Title:

Location: Presentation time: Authors:

Abstract:

Disclosures:

Keyword(s):

Support:

EfFects of intensive directed nutrition, progressive exercise program and neuromuscular electrical stimulation on secondary progressive multiple sclerosis

Hall A-C

Sunday, Nov 13, 2011, 2:00 PM - 3:00 PM

*B. BISHT¹, W. DARLING¹. E. SHIVAPOUR³, S. LUTGENDORF². L. SNETSELAAR⁶. M. HALL⁴, T. WAHLS⁵;

¹Hlth. and Humań PhysioL, ²Dept. of Psychology. Univ. of Iowa. Iowa City, IA: ²Dept. of Neuorology. ⁴VA Iowa City. Dept. of Psychiatry, ^SVA Iowa City, Dept. of Intrnl. Med., Ul Can/er Col. of Med., Iowa City, IA; ⁶Dept. of Epidemiology. Ul Col. of Publ. Hlth., Iowa City. IA

Secondary progressive multiple sclerosis (SPMS) is characterized by progressive muscle weakness. fatigue and deterioration of cognitive functions. Effectiveness of drugs and inten/entions such as strength training. neuromuscular electrical stimulation (NMES) and diet in treatment of MS has been reported. However, reversal of deterioration of symptoms in SPMS patients is rarely seen. In a case report of a patient (TW) with SPMS, dramatic improvement in gait (transition from scooter dependence to mild gait disability) was reported following a combination of inten/entions including neuromuscular electrical stimulation (NMES). a progressive home exercise program (PEP) consisting of stretching and strengthening exercises. and intensive directed nutrition (IDN) consisting of modified Paleolithic diet and nutritional supplements. Thus. we investigated whether individuals with SPMS can tolerate a similar combined inten/ention including NMES. PEP and IDN and how this inten/ention affects their fatigue. transfers and gait.

Eleven subjects were recruited into a run-in phase which included IDN and PEP To enroll in the Main Study, subjects had to fully comply with IDN and PEP Ninę subjects were enrolled into the main study. with 8 showing very good compliance with each of the inten/entions (IDN. PEP. and NMES) and one with fair compliance. We have outcome data for 6 months on 3 subjects and 3 months on 5 subjects. One subject had a relapse during the 3^rd month into the study and could not complete 25 foot walk and get up and go tests at that time. Thus, in this preliminary analysis data of only 4 subjects are presented. Characteristics at baseline (mean, rangę): Age and sex (51.25. 45-54 years. all female). years sińce MS diagnosis (11.75.

3-20). EDSS (6.1, 6-6.5). At 3 months, outcome measures improved from baseline as follows: Fatigue Severity Scalę by 34.2%, Timed 25 foot walk by 16.6%. Get up and go test by 20.7%. average speed during 25 foot walk test by 20.35% and total Multiple Sclerosis Spasticity Scalę (MSSS-88) by 16.3%. At 6 month average improvement of first 3 subjects were as follows: Fatigue Severity Scalę by 31.4%, Timed 25 foot walk by 14.4%, Get up and go test by 27.1%. average speed during 25 foot walk test by 17.5% and total MSSS-88 by 26.5%. No significant adverse events were reported. In conclusion, individuals with SPMS are willing to complete a complex behavioral change involving intensive directed nutrition. neuromuscular electrical stimulation and progressive exercise program. Preliminary results indicate beneficial effects of this combined inten/ention on fatigue and gait in subjects with a progressive disease who are not expected to show improvement.

T. Wahls: Ownership Interest; Minding My Mitochondria. TZ press, L.L.C. provided to subject free of cost.. LOCOMOTION ELECTRICAL STIMULATION DIET

Direct MS Charity of Canada