Exercise Improves Physical Capacity, Cognition, Quality of Life and Promotes Neurotrophic Factors in Patients with Multiple Sclerosis.

Introduction: We aimed to determine the effect of regular exercise on aerobic capacity, strength values, and plasma levels of Nerve Growth Factor (NGF) and Neurotrophin-3 (NT-3) in patients with multiple sclerosis (MS) and investigate its effects on MS symptoms including cognitive impairment, fatigue, balance disorders, and quality of life (QOL). Methods: Forty-three relapsing-remitting MS patients with an Expanded Disability Status Scale (EDSS) score of 4 or less participated in the study. Participants were divided into three groups: aerobic group, strength group, and control group. The patients in the exercise groups had exercise programs three days a week for three months. Aerobic capacity (maximum VO2 value), strength measurements, and balance tests were done, and NGF and NT-3 plasma levels were analyzed in all participants at the beginning and end of the study. Multiple Sclerosis Quality of Life-54 (MSQoL-54), fatigue impact scale, Pittsburgh Sleep Quality Index (PSQI) and, to evaluate cognitive functions, BICAMS scale were applied. Results: Aerobic exercise and strength exercise groups had significant increases in VO2 max, back and leg strength values, and NGF and NT-3 plasma levels (p<0.01). Cognitive functions, fatigue, sleep quality, and QOL significantly improved in the exercise groups (p<0.01). The balance values were also significantly improved in the aerobic group (p<0.01), and althoughimprovement although improvement was observed in the strength group, it was not statistically significant (p>0.05). Conclusions: Our study provides evidence that regular exercise improves quality of life, cognitive functions, fatigue, and sleep quality in MS patients. The levels of NGF and NT-3, which are important factors in neural regeneration and remyelination, were increased post exercise. It can be suggested that exercise may have a potential effect on MS and slow down the disease process with these results.

Electromyostimulation Application on Peroneus Longus Muscle Improves Balance and Strength in American Football Players.

PURPOSE: The aim of this study was to evaluate the effect of 5 weeks of electromyostimulation (EMS) of the peroneus longus muscle on balance and muscle strength in American Football (AmF) players. METHODS: Thirty-two healthy male athletes (4 American Football team training sessions per week, college level) were randomly divided into the EMS and control groups. The EMS applications were conducted on the dominant peroneus longus muscle 3 times per week for 5 weeks, with each application lasting 25 minutes. Before and after the interventions, the strength of ankle dorsiflexion-plantar flexion and foot eversion-inversion was measured with isometric dynamometer and anterior-posterior sway, mediolateral sway, perimeter, and ellipse area were measured with the Technobody Balance System in unilateral stance positions, while eyes were open. RESULTS: Changes between initial and final tests for dorsiflexion and eversion strength, and mediolateral sway for dynamic balance in the groups were significantly different (P = .039, P = .027, P = .030, respectively). CONCLUSION: The EMS application had positive effects on muscle strength and dynamic balance of AmF players. The EMS can be used to improve isometric strength and dynamic balance in AmF players.

The Effects of Virtual Reality Nonphysical Mental Training on Balance Skills and Functional Near-Infrared Spectroscopy Activity in Healthy Adults.

CONTEXT: Athletic skills such as balance are considered physical skills. However, these skills may not just improve by physical training, but also by mental training. The purpose of this study was to investigate the effects of mental training programs on balance skills and hemodynamic responses of the prefrontal cortex. DESIGN: Randomized controlled trial. METHODS: Fifty-seven healthy adults (28 females, 29 males), aged between 18-25 years, participated in this study. Participants were randomly assigned to 3 groups: virtual reality mental training (VRMT) group, conventional mental training (CMT) group, and control group. The training program included action observation and motor imagery practices with balance exercise videos. The VRMT group trained with a VR head-mounted display, while the CMT group trained with a non-immersive computer screen, for 30 minutes, 3 days per week for 4 weeks. At baseline and after 4 weeks of training, balance was investigated with stabilometry and Star Excursion Balance Test (SEBT). Balance tests were performed with simultaneous functional near-infrared spectroscopy (fNIRS) imaging to measure prefrontal cortex oxygenation. RESULTS: For the stabilometry test, at least 1 variable improved significantly in both VRMT and CMT groups but not in the control group. For SEBT, composite reach distance significantly increased in both VRMT and CMT groups but significantly decreased in the control group. For separate directional scores, reach distance was significantly increased in both mental training groups for nondominant leg posterolateral and posteromedial directions, and dominant leg posterolateral direction, while nondominant posteromedial score was significantly increased only in the VRMT group. Between-group comparisons showed that dominant leg posteromedial and posterolateral score improvements were significantly higher than control group for both mental training groups, while nondominant leg improvements were significantly higher than control group only for the VRMT group. The fNIRS oxyhemoglobin levels were not significantly changed during stabilometry tests. However, oxyhemoglobin levels significantly reduced only in the control group during SEBT. CONCLUSIONS: Our findings suggest that both mental training interventions can significantly improve balance test results. Additionally, VRMT may have some advantages over CMT. These findings are promising for the use of mental training in prevention and rehabilitation for special populations such as athletes and older adults.