Background: People with multiple sclerosis (MS) frequently use cannabis to manage symptoms such as pain, spasticity, and sleep disturbance. During abstinence, withdrawal symptoms may overlap with MS-related complaints, complicating cessation. This study examined whether cannabis withdrawal trajectories differ by sex during monitored abstinence in people with MS. Method: Nineteen frequent cannabis users with MS (11 women) completed 28 days of monitored abstinence. Withdrawal symptoms were assessed using the Cannabis Withdrawal Questionnaire (CWQ) at baseline and weekly through day 28. Abstinence was verified using creatinine-adjusted urinary THC-COOH ratios. Mood was assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline and day 28. A repeated-measures analysis of covariance examined time × sex effects, adjusting for demographic, disability, and cannabis-use covariates. Results: At baseline (preabstinence), women reported higher CWQ scores than men. On day 28, women again showed higher scores. A significant time × sex interaction (Pillai trace = .784; P = .018; partial η² = .784) indicated distinct symptom trajectories across abstinence. Women reported greater irritability, sleep disturbance, physical tension, nausea, and headaches. HADS scores remained stable and within normal limits for both sexes. Conclusions: Women with MS demonstrated a more pronounced and sustained increase in CWQ symptom burden over the abstinence period than men. These findings likely reflect both withdrawal-related effects and the unmasking of underlying MS-related symptoms. Cannabis cessation appears psychologically tolerable in people with MS, though women may require closer monitoring and targeted support during abstinence.
Worldwide, the average age of people with multiple sclerosis (MS) has increased significantly over the past several decades. Findings from natural history studies reveal that the risk of new relapse and MRI activity diminishes with age. Available since 1993, the use of disease-modifying therapies (DMTs) for MS has expanded dramatically, with many patients using the drugs indefinitely. The participants of most phase 3 clinical trials that have resulted in regulatory approval of MS DMTs have been 55 years or younger at the onset of participation, so there remains a dearth of data as to the benefits and risks of DMT use in older people with MS. Risks associated with DMT use may increase as people age, especially vascular and malignancy comorbidities. Although some people with MS older than 55 years have discontinued DMT, some are reluctant to even consider a trial off DMT. Findings from many observational DMT discontinuation studies and 2 discontinuation randomized controlled trials have confirmed that the greatest risk of recurrent MS disease activity is in younger patients who discontinue DMT. For clinically stable people older than 60 years, the greatest enhanced risk faced by those who discontinue DMT is that of 1 to 2 brain MRI-detected lesions of unclear long-term clinical significance. Thus, although it may be reasonable to consider a personal DMT discontinuation or de-escalation trial, patients, their families, and MS clinicians would benefit from a substantial increase in clinical studies relevant to the risks and benefits of DMT use and nonuse in those older than 55 years.
Background: Supporting effective self-management is essential for successful transition from pediatric to adult care. There is a limited understanding of the experiences, priorities, and challenges faced by youth with multiple sclerosis (MS) during this time, so we investigated youth perspectives on MS self-management and the development of self-management skills during transition. Methods: We conducted a qualitative study with individual interviews using the methodological framework of interpretive description. Participants were recruited from pediatric and adult MS care centers in Toronto, Canada. During interviews, participants described their experiences with self-management during transition. The research team, including youth patient-partners, used constant comparative analysis to identify themes from interviews. Results: Seventeen youth were interviewed (median age 18 years; range, 13-24 years; 12 girls/women). From the interviews, we identified themes about self-management during transition: a need for support and skills regarding MS diagnosis disclosure or concealment, utilization of safety nets, setting expectations, and delegating tasks. We also identified themes on the development of self-management skills: observation, knowledge exchange, explicit guidance and direction, and trial and error. Finally, the interviews highlighted that effective self-management involves self-management of medical, social, and emotional aspects of life, particularly at school and work. Conclusions: In this study, youth with MS identified key self-management and skill development priorities and processes for the transition to adult care. These insights should inform comprehensive health care practices.
Background: Multiple sclerosis (MS) can impair respiratory function due to demyelinating lesions that disrupt neural input to respiratory muscles. This dysfunction may result in muscular weakness, ineffective coughing, and respiratory failure. Early identification and management of respiratory dysfunction can improve long-term outcomes and reduce morbidity and mortality. Factors contributing to early respiratory decline in MS are understudied. This review aims to characterize factors associated with and nonpharmacological interventions for respiratory dysfunction in people with MS. Methods: This review was registered with the Open Science Framework and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A comprehensive search of PubMed, Embase, and Scopus was conducted for articles published in English between 2014 and 2024. Eligible studies assessed respiratory function and evaluated nonpharmacological interventions or associated factors. Peer-reviewed observational and experimental studies were included. Titles, abstracts, and full texts were screened independently by 2 reviewers using Covidence. Results: Findings from 11 observational studies identified factors that influence respiratory function, including disease-related, physical, and psychological factors. Nine studies investigated nonpharmacological interventions such as inspiratory/expiratory muscle training, Pilates, lung volume recruitment, and proprioceptive neuromuscular facilitation; all showed improvements in respiratory outcomes. Conclusions: Although the impact of physiological, functional, psychological, and psychosocial factors has been studied in relation to respiratory dysfunction in MS, other increasingly common factors in MS, such as obesity, have not been studied and warrant further investigation. Nonpharmacological therapies show promise in improving respiratory function in people with MS, but larger trials with longer-duration interventions are needed to confirm the efficacy of these interventions.
Background: Bladder dysfunction and bowel dysfunction impact up to 80% of individuals with multiple sclerosis (MS). Beyond their physical effects, they can reduce quality of life and contribute to emotional distress for people with MS. Exploring the nuanced, lived experiences of people with MS who have bladder and/or bowel dysfunction is critical to better understanding these challenges. The purpose of this meta-synthesis was to answer the following research question: What are the lived experiences of bladder and bowel dysfunction for people with MS and their clinicians? Methods: This qualitative meta-synthesis included a comprehensive literature search of 3 databases. Titles, abstracts, and full texts were reviewed by 2 reviewers. Included articles were critically appraised, and reciprocal translation was used to synthesize novel, representative themes from the primary studies. Results: Systematic searches yielded 3664 articles, of which 14 met the inclusion criteria. Three themes were identified: quality-of-life impacts, barriers to accessing health care (subthemes: clinician-driven access barriers, patient-driven access barriers, opportunities for facilitating access to bladder and/or bowel health care), and symptom management strategies. Conclusions: Findings highlight patient embarrassment surrounding bladder and bowel symptoms, limited clinician engagement, and low awareness of intervention options from both people with MS and their clinicians. More research is needed to improve educational interventions, increase access to specialized health care, and understand the perspectives of people with MS and bladder and bowel dysfunction in differing health care systems.
Background: This study examined group therapy as a treatment modality for people with multiple sclerosis (MS). Specifically, social satisfaction, anxiety, and depression outcomes were explored in relation to treatment modalities. Methods: A retrospective cohort study was conducted to examine the relationship between social satisfaction, anxiety, and depression for people with MS in group vs individual therapy. Inclusion criteria were age of 18 years or older, MS diagnosis, and participation in 3 or more group (intervention) or individual (control) therapy sessions with an MS behavioral medicine clinician. Participants completed the Quality of Life in Neurological Disorders (Neuro-QOL), Patient Health Questionnaire 9-item, and Generalized Anxiety Disorder 7-item scales. Demographic variables and disease characteristics were also examined in the context of treatment modalities and in relation to reported social satisfaction. Multivariable linear regression models were constructed. Results: In covariate-adjusted models, baseline Neuro-QOL social satisfaction t scores were negatively associated with baseline Neuro-QOL anxiety (β = –0.53; 95% CI, –0.68 to –0.37; P < .001) and depression t scores (β = –0.41; 95% CI, –0.57 to –0.25; P < .001). Patient-Determined Disease Steps score, educational status, and race were also associated with social satisfaction. Conclusions: Anxiety and depression are negatively associated with social satisfaction, and treatment type is not associated with differing social satisfaction scores. Given this, patient-reported social satisfaction is an important consideration in the clinical treatment and interdisciplinary management of MS. Additional research is warranted to better understand outcomes relevant to different treatment modalities.
Background: Bowel dysfunction affects 39% to 72% of people with multiple sclerosis (MS) and is associated with significant mental burden, social stigma, and reduced quality of life. Despite its negative impact, bowel dysfunction is underrecognized, resulting in patient distress and failed self-management. This study aimed to investigate the relationship between bowel function satisfaction and well-being in people with MS. Methods: Of the 1872 people with MS from France, Germany, Italy, and the UK who completed an online survey on bladder- and bowel-related issues of living with MS and on well-being, 1322 identified bowel-related issues and were the focus of this study. Logistic regression models assessed the relationship between bowel problems and well-being, adjusting for demographics and proxies for MS progression. Results: Reduced satisfaction with bowel function and longer duration since MS diagnosis were each linked to approximately twice the odds of lower well-being (OR, 2.17; 95% CI, 1.64-2.87 and OR, 2.16; 95% CI, 1.46-3.20, respectively). Additionally, bowel care self-management was associated with 45% higher odds of lower well-being (OR, 1.45; 95% CI, 1.11-1.89). Other significant risk factors for lower well-being included urinary problems and employment status. Conclusions: People with MS experiencing bowel dysfunction have poorer well-being when managing symptoms independently compared with those receiving help. Early identification and support for managing bowel symptoms are crucial for maintaining well-being.
Older adults with multiple sclerosis (MS) face unique issues related to the combined effects of MS and age-related changes, which often present with overlapping symptoms that complicate assessment and treatment decisions. In this review, based on the Consortium of MS Centers’ Aging and MS Consensus Statement committee meeting in 2024, we address the contributions of aging in MS by focusing on direct, biological aging effects on MS pathology and comorbid age-related changes in physical and cognitive function. Features of biological aging include cellular senescence and immune dysregulation, which may drive disease progression in MS through a variety of proinflammatory mediators that may maintain low levels of chronic inflammation in the immune and central nervous system compartments and offset regulatory processes, ultimately impairing remyelination and increasing neurodegeneration. Measuring biological aging in MS may help identify individuals at risk of worse MS outcomes and support gerotherapeutic treatments that target aging mechanisms. Compounding any direct effects of aging on MS pathology, aging-related impairments in neuromuscular function and cognition can worsen functional outcomes in people with MS. Characteristics of cognitive impairments in MS affecting attention and processing speed occur early in the disease course and are distinct from other age-associated neurodegenerative disorders, such as Alzheimer disease, that commonly affect language and executive function domains. As MS clinicians care for growing numbers of older adults with MS, a more comprehensive understanding of the interplay between aging and MS-related changes can improve the timing and modality of treatments to optimize MS neurogeriatric care.
As age increases, the prevalence of comorbidities increases in the general population. In turn, this often leads to an increase in the number of medications administered. This phenomenon creates additional challenges in the management of neurodegenerative disorders such as multiple sclerosis (MS). Higher comorbidity burden is associated with longer diagnostic delays and greater disability at diagnosis. A higher burden of comorbidities in people with MS is associated with higher disability levels and accelerated disability progression. Responses to rehabilitation therapy may also be altered in terms of timing and sustainability of response. Conversely, a diagnosis of MS negatively affects the management and outcomes of some comorbidities, and treatment of certain comorbidities can worsen MS symptoms. Thus, comorbid conditions in people with MS have important implications with respect to MS-specific care and general health care throughout the life course of the disease. Comorbidities must be considered when developing plans of care. Similarly, polypharmacy is common in non-MS populations, even more so in MS populations, and can adversely affect quality of life and worsen underlying disability. In 2023, the Consortium of Multiple Sclerosis Centers needs assessment identified comorbidity and polypharmacy as a core topic relevant to the care of aging adults with MS, and an in-person meeting of experts in 2024 discussed the existing literature. This narrative review discusses how comorbid disease and polypharmacy affect people with MS, strategies to mitigate these negative risks, as well as areas where evidence is lacking and further study is needed to inform optimal treatment strategies for older adults with MS.
Background: Optogenetics is a technique that uses light to manipulate genetically targeted neurons and has a potential role in the treatment of multiple sclerosis (MS). This review aims to examine how findings from current cell and animal studies in optogenetics may inform and advance future research in MS in humans. Methods: We conducted a narrative literature review of in vivo and in vitro animal studies investigating optogenetic applications in MS, focusing on their potential to enhance therapeutic outcomes. Results: Our review generated 58 articles related to our topic, and 9 of them were included. Optogenetics enhances remyelination by promoting the differentiation of oligodendrocyte precursor cells into myelinating cells, thereby easing neural repair in demyelinated regions and restoring normal cognitive function in the animal model of MS. In addition, optogenetics offers valuable insights into MS by enabling the study of specific gene mutations, such as heterogeneous nuclear ribonucleoprotein A1, paving the way for novel therapeutic strategies. Conclusions: This review discusses the future of optogenetics as a potential treatment for MS. This innovative technology may offer an improved approach to managing the disease, offering refined control over drug delivery, remyelination, and gene therapy. Further research should prioritize optimizing these technologies for clinical use and exploring their potential in combination therapies to improve patient outcomes. More research is also needed to reassess any complications or restrictions associated with optogenetics.
Background: Multiple sclerosis (MS) is a chronic, immune-mediated, neurodegenerative disease of the central nervous system with prevalent vascular comorbidities and associated vascular dysfunction involving arterial stiffness. This study examined the difference in arterial stiffness between people with MS and controls and whether the difference was accounted for by anxiety, depression, and walking endurance, variables not usually included in other studies of arterial stiffness in MS. Methods: The sample included 129 people with MS (age, 48.5 [10.8] years; 70.5% female; Expanded Disability Status Scale score median, 4) and 51 controls without MS (age, 48.7 [11.3] years; 78.4% female) who completed arterial stiffness, anxiety, and depression assessments and the 6-Minute Walk Test (6MWT). Results: There were significant differences between groups in arterial stiffness (P = .05; d = –.038), anxiety (P = .009; d = –0.438) and depressive symptoms (P < .001; d = –0.927), and walking endurance (P < .001; d = 1.618). The bivariate correlations were significant between arterial stiffness and age, body mass index (BMI), mean arterial pressure (MAP), and 6MWT distance (all P < .05). The difference in arterial stiffness between groups remained when controlling for age, BMI, MAP, anxiety and depression symptoms, and 6MWT distance. Conclusions: Our results indicate that people with MS have higher levels of arterial stiffness compared with controls, but this difference is not explained by age, BMI, MAP, anxiety, depression, or walking endurance.
Background: Spasticity represents a major symptom of people with multiple sclerosis (MS), frequently causing disability, pain, and abnormal postures. The aim of this study is the evaluation of safety and efficacy of radial extracorporeal shock wave therapy (RESWT) for triceps surae muscle spastic hypertonia in people with MS. Methods: Two centers recruited people 18 years or older with MS and triceps surae muscle hypertonia. People were excluded if they had other neurological conditions; had used anticoagulants; had intrathecal baclofen, botulinum toxin, and/or physiotherapy within the past 8 months; or had oral antispasmodics therapy modification in the past 4 weeks. The participants underwent triceps surae RESWT once a week for 4 weeks. Participants were scored on the Modified Ashworth Scale (MAS), the Numerical Rating Scale for spasticity (NRS-Sp), the Medical Research Council (MRC) scale, the Timed Up and Go (TUG) test, and the Timed 25-Foot Walk (T25-FW) test before RESWT (T0) and immediately after RESWT (T1). Self-perceived effect was evaluated via the Global Perceived Effect (GPE) at T1. Results: Twenty-six people with MS were included (10 women and 16 men; mean age ± SD, 52.46 ± 8.39 years; mean Expanded Disability Status Scale score ± SD, 5.44 ± 1.34; mean disease duration ± SD, 14.88 ± 10.83 years), and 36 triceps surae were treated. MAS and NRS-Sp scores decreased at T1, whereas TUG, T25-FW, and MRC scores were comparable over time. Via the GPE, 73% of participants reported a self-perceived positive effect of RESWT on spasticity. Conclusions: RESWT may be efficacious and safe for treating spasticity in people with MS and does not adversely affect gait, strength, or dynamic balance. Further long-term studies are needed to evaluate the possibility of using RESWT as a treatment for spasticity in people with MS.
Background: Physical activity is well supported as an effective intervention with numerous benefits for people with multiple sclerosis (MS). Recent research has suggested stronger physical activity guidelines for people with MS (PAG-MS). This systematic review and meta-analysis aims to assess the impact of PAG-MS on quality of life (QOL). A secondary aim is the assessment of the number of adverse effects across studies to gauge physical activity safety in people with MS. Methods: A systematic search was conducted from inception to October 2024 in PubMed, Embase, Web of Science, SPORTDiscus, Scopus, and PsycINFO. Two independent reviewers assessed included studies for eligibility, extracted data, and evaluated risk of bias using the Cochrane Revised Tool for Risk of Bias in Randomized Trials. Randomized controlled trials assessing QOL with an intervention meeting PAG-MS were included. Extracted data were analyzed via meta-analysis and compared with clinical significance thresholds where possible. Results: Nineteen studies including 891 people with MS were identified. Meta-analysis revealed significant increases in overall QOL (standardized mean difference [MD], 1.13; 95% CI, 0.40-1.86; P < .01) as well as physical (MD, 12.84; 95% CI, 5.29-20.39; P < .01) and mental (MD, 16.75; 95% CI, 11.9-21.59; P = .04) subscale scores. Physical and mental subscale scores surpassed clinical significance thresholds. The majority of studies were rated to have a high risk of bias. Conclusions: The current PAG-MS appear to be effective in improving QOL in people with MS. Multiple forms of physical activity that met the PAG-MS demonstrated comparable efficacy, supporting the feasibility of individualized physical activity prescriptions based on patient-specific needs and preferences.
Background: The period surrounding the diagnosis of multiple sclerosis (MS) is physically and emotionally challenging. Positive psychology (PP) exercises (ie, systematic activities to cultivate well-being) have been shown to increase positive emotional responses, such as positive affect, and may aid in psychosocial adjustment to MS. Methods: Participants were randomly asigned 1:1 to a 5-week, at-home, self-directed PP intervention or a waitlist control condition. The PP intervention consisted of 5 previously tested PP exercises. Feasibility was defined as the proportion of participants who completed at least 4 of the 5 PP exercises. Acceptability was determined by participant ratings of ease and utility (0-10 scale) reported at the completion of each exercise. The effects of the PP intervention on a battery of patient-reported outcome measures were also examined using linear mixed-effects models. Results: Thirty participants were enrolled in the study, and 70% met the a priori threshold for feasibility. Mean ease scores across the exercises ranged from 7.0 to 7.9 (scale of 0-10), and mean utility scores ranged from 7.0 to 8.1. There were statistically significant increases in positive affect (6.68; 95% CI, 2.58-10.78; P = .003) and optimism (3.03; 95% CI, 0.75-5.31; P = .01) in the intervention group compared with the waitlist control group at 5 weeks. Conclusions: A 5-week at-home self-directed PP intervention was feasible and acceptable to individuals with new diagnoses of MS. Larger trials with longer follow-up are needed to fully understand the benefits of PP training to improve adjustment to MS diagnosis, which may lead to better psychosocial and health outcomes.
Introduction: Being diagnosed with multiple sclerosis (MS) marks a significant turning point in a person’s life, with substantial impact on quality of life. Key aspects of effective treatment include how people with MS are cared for and their adherence to treatment. This study aimed to investigate the lived experiences of people with MS. Methods: The study was guided by a phenomenological and hermeneutic approach. Thirteen semistructured face-to-face interviews were conducted with people diagnosed with MS within the past 5 years who were recruited from 3 Danish MS clinics. A reflexive thematic analysis approach was applied to analyze and interpret the data. Results: The transition from being a healthy person to a person living with an MS diagnosis is challenging. Our analysis revealed that people with MS were particularly vulnerable during the diagnostic process and often shared emotionally impactful experiences. After diagnosis, they adjusted to new priorities and demonstrated resilience, finding ways to navigate life with MS. We identified 3 key themes from the interviews: understanding and proving symptoms, considering treatment and how to disclose MS, and living hopefully with MS. Conclusions: Interviewees living with MS in Denmark frequently mentioned challenging symptoms and diagnostic complexity, as they often felt misunderstood when trying to explain their symptoms. For health care professionals, understanding patients’ experiences from initial symptoms to diagnosis and treatment is crucial. The resilience and adaptation of people with MS highlight the importance of holistic approaches to treatment, which foster their hopes for the future.
Background: To improve the quality and standard of care, considerable resources are invested to produce clinical guidelines for multiple sclerosis (MS) management. We aimed to investigate MS clinicians’ use of guidelines and factors that influence use. Methods: Interview guides were developed using Fisher’s framework to assess factors that influence guideline application (categorized as personal, guideline related, and external). Nurses and neurologists experienced in MS health care were recruited through convenience sampling. Semistructured online interviews were conducted from June 2023 to October 2023, and data were analyzed using inductive and deductive methods. Results: We interviewed 16 MS clinicians (10 nurses, 6 neurologists). Despite most clinicians believing that guidelines can improve consistency, safety, and quality of care, the application of guidelines was highly variable. Participants reported that clinical decision-making in MS management involves integrating guideline recommendations with clinical reasoning while considering patients’ circumstances and preferences, the complex nature of MS, and resource constraints. Personal barriers to guideline application included low awareness and familiarity. Guideline-related barriers included evidence, plausibility, accessibility, layout, and complexity. External barriers included a lack of resources. Facilitators were mostly guideline related, including relevance to local protocols, covering complex treatment or unfamiliar topics, and when guidelines were up to date and credible. Participants suggested various strategies to overcome barriers to guideline use. Conclusions: Australian MS clinicians reported low awareness and high variability in the application of national and/or international MS guidelines. Clinical practice guidelines should be adaptable to local contexts, accessible, and regularly updated. Multifaceted strategies to better distribute and champion guidelines should be employed.
Background: The multiple sclerosis (MS) diagnostic process can be lengthy and result in psychological distress and treatment delays. The 2024 revised McDonald diagnostic criteria incorporate the central vein sign (CVS) and paramagnetic rim lesions (PRL), radiological biomarkers that offer the potential to improve the diagnostic pathway. Methods: The study aims were to: (1) investigate the experiences of people with MS and health care professionals (HCPs) regarding the current diagnostic process, and (2) identify the barriers and facilitators to implementing the revised diagnostic criteria. Semistructured individual interviews and focus groups were conducted with 10 HCPs and 9 people with MS. Framework analysis, applying normalization process theory, was employed. Results: Interviews revealed 4 themes: current challenges for the diagnostic pathway, CVS/PRL implementation barriers, the benefits of CVS/PRL implementation, and suggestions for overcoming implementation barriers and improving the diagnostic pathway. Challenges to implementation include pathway inefficiencies, care delivery inequality, insufficient communication, financial constraints, capacity limitations, and clinician hesitancy with the revised criteria. Suggested strategies for implementation and improvement included HCP training, enhancing interdisciplinary collaboration, evaluating implemented changes, and delivering emotional and practical support during diagnosis. Benefits for CVS/PRL implementation included reduced reliance on lumbar punctures, improved patient experience, cost-effectiveness, and enhanced diagnostic accuracy. Conclusions: Despite patient enthusiasm, implementing the revised diagnostic criteria will be challenging and possibly delayed unless HCP concerns are appropriately addressed.
Background: Mississippi is one of the poorest states in the United States, with multiple lagging health indicators. Multiple sclerosis (MS) outcomes can be impacted by social determinants of health (SDOH). Research in locations with high gradients in the SDOH is especially important. Methods: In 2023, 2 focus groups of adults living with MS in the Jackson, Mississippi, metro area were conducted online, hosted by the University of Mississippi Medical Center. Participants completed a survey about the US government’s Healthy People 2030 SDOH list prior to the groups. The focus groups’ transcripts were analyzed using a thematic inductive approach. Results: The 11 participants reported a median of 6 SDOH per person. Participants were mostly female (91%), Black (64%), older (average age 57 years). Most had relapsing MS (82%) with an average disease duration of 17 years. All were educated (100% with a bachelor’s degree or above). Participants scored high (> 50% respondents were affirmative) on a history of incarceration (personal or family member), perceived treatment with “less respect in a medical setting,” and access to MS medications without prohibitive cost. There was job loss (36%) and housing insecurity (36%). Eight SDOH were identified as salient: education; work and occupation; neighborhood and environment; transportation and disability services; water and food; crime, violence, and public safety; social isolation and integration; and race. The time of MS diagnosis was considered the most important period related to SDOH. Additional concerns included access to MS research. Conclusions: The lived experiences of people with MS in Jackson, Mississippi, are reported as foundational work to disaggregate and redress the many SDOH that were considered relevant by people living with MS.
Background: Oceans of Hope is an initiative enabling people with multiple sclerosis (MS) to participate in ocean sailing. Long-term ocean sailing has been hypothesized to promote physical performance and cognitive function in people with MS. However, the effects and feasibility of ocean sailing for rehabilitation purposes remain unexplored. The aim of this study was to evaluate the feasibility of ocean sailing to improve mechanical muscle function, physical capacity, and fine motor control in people with MS. Methods: In this exploratory study, 15 people with MS participated in 10 days of ocean sailing. Mechanical muscle function, gait speed, postural balance, and fine motor control were tested before and after the intervention. No control group was included. Feasibility was evaluated using adverse events, serious adverse events, drop-outs, and adherence. Results: No serious adverse events were reported, but 10 participants experienced mild or moderate seasickness. Adherence was excellent. Manual dexterity improved, and body weight was reduced after the intervention (P< .05). No other statistically significant pre- to postintervention changes were found. Conclusions: Ocean sailing for 10 days is feasible in people with MS, as none of the participants reported serious adverse events, and seasickness was the only adverse event. No deteriorations were observed in physical or cognitive function. Thus, initial evidence suggests ocean sailing may represent a feasible and safe form of physical activity for people with MS.
Background: Exercise is important for people with multiple sclerosis (MS) to manage symptoms and improve quality of life. Tai chi and qigong (TCQ) are mind-body exercises shown to benefit physical, emotional, and cognitive health in many conditions, but research has been limited in people with MS. To understand potential benefits from regular TCQ practice and factors influencing feasibility, acceptability, and sustainability, we conducted a mixed-methods study through a survey and focus groups with people with MS who regularly practice TCQ. Methods: We conducted focus groups with people with MS from across the United States who regularly practice TCQ; the data from these groups were analyzed using reflexive thematic analysis. Participants also completed a brief survey that collected data on demographics, MS health history and symptoms, and TCQ practice (including opinions on content, dosage, and delivery). Results: Thirteen people with MS (85% female, 69% White) participated in the study. Reported TCQ benefits included physical (balance, strength), cognitive (memory), psychological (calming), and social (community building), with a dose-response gain over time. Challenges included learning and remembering movements, physical limitations (strength, endurance, fatigue), and transportation barriers. Adaptations specific to MS included tailoring TCQ content to meet individual needs and symptoms, appropriate pace, online delivery, and safety. Keys to sustainable practice included enjoyment, patience and self-compassion, viewing TCQ as medicine, and scheduling time for practice. Conclusions: Results suggest people with MS who maintain a TCQ practice may experience physical, emotional, cognitive, and social benefits, especially when specific practice details and facilitators are met. Future studies might investigate how these factors influence sustainable practice.
