A West Virginia University assistant professor and occupational therapist – and hundreds of professional peers and colleagues around the world – dig deeper into wellness strategies beyond just medication in the treatment and management of multiple sclerosis .
An incurable disease affecting the central nervous system, multiple sclerosis can include an array of symptoms, from numbness and tingling throughout the body to blindness and paralysis. MS can also affect emotional health and cognitive abilities, but recent research is making inroads in restoring and maintaining quality of life for people with the disease.
According to the National Multiple Sclerosis Society, the specific symptoms, progression, and severity of MS vary from individual to individual. It is estimated that one million Americans are living with MS. Most are diagnosed between the ages of 20 and 50, according to the NMSS, with women three times more likely than men to be diagnosed with the disease.
Jacob Greenfield, an assistant professor in the division of occupational therapy at the WVU School of Medicine, works with MS patients and clinicians in Morgantown. He said several strategies are surfacing or resurfacing to treat MS patients.
Reduce depression through mindfulness
“Mindfulness is like an emergent practice. It’s been around for a while, but we’re starting to see it come back a lot more. It’s used quite commonly in the MS population,” Greenfield said.
“It’s not necessarily about getting rid of symptoms,” he said, “but it helps patients cope with common symptoms: pain, depression, anxiety and fatigue. For the newly diagnosed person, MS can be like a big pill to swallow.
Greenfield said mindfulness can produce short-term benefits for pain management, but “based on our research so far, it hasn’t shown much long-term effects. It helps in pain management by helping the individual adapt to their body. It helps them to de-stress, to relax a little.
“Mindfulness is simply relaxing a patient. They feel less pain, less worry, and they don’t feel as depressed. This can be done in a clinic or in a guided way. Now it’s apps that do that, and some doctors will incorporate that into their practice,” he said.
The NMSS reported in mid-February that an eight-week online mindfulness program significantly reduced depression in participants more than their untreated control group cohort. A component of a University of Sydney study that involved 132 people with MS, the program has contributed to increasing evidence that wellness strategies can help relieve symptoms for people with MS.
“Mindfulness,” explains the NMSS, “is a form of meditation aimed at changing a person’s perception and creating moment-to-moment awareness and acceptance of experiences, with the goal of reducing reactions which may worsen pain or emotional distress related to health-related changes.
John Kabat-Zinn defines mindfulness as “paying attention on purpose, without judgment, to the present moment and with a caring and compassionate awareness.”
Kabat-Zinn, professor emeritus of medicine at the University of Massachusetts Medical School, has spent decades writing, teaching, and advocating for mindfulness. In 1979, he founded the Mindfulness-Based Stress Reduction Clinic at UMSM.
The Australian study team developed the program with five 15-minute interactive modules. Topics included stress management, difficult feelings and emotions, mindful communication, self-compassion, and relapse prevention. Participants also received periodic phone calls from a psychologist to help them with the process.
According to the NMSS, the primary goal of the study was to measure the effect of mindfulness practice on depression. Secondary outcomes included pain, fatigue, anxiety, and quality of life, which were measured before the program and for three and six months afterwards.
The results showed that depression was reduced and quality of life improved significantly more among mindfulness program participants. Depression decreased even more in people with a history of recurrent depression, with benefits maintained after six months.
Closer to home, in Momentum, the NMSS’s online magazine and blog, author Aviva Patz cited a similar NMSS-funded study at Ohio State University last year. The four-week study also compared the results of mindfulness training between around 60 subjects with MS and two control groups. The mindfulness training program involved breath awareness, seated meditation, and mental “body scans” (a meditative practice for focusing attention and sensory awareness of various parts of the body). At the end of the study, participants in mindfulness meditation reported having significant improvements in their ability to manage their negative emotions, compared to control groups.
“The results are very encouraging and may improve mood and cognition in people with MS,” said Ruchika Prakash, associate professor of psychology at OSU, co-author of the pilot study. “We can’t say this will apply to everyone,” Prakash said in the article. “But the data is promising evidence that mindfulness training can help MS patients manage their emotions more constructively and positively, and improve some elements of cognition.”
People recently diagnosed with MS are invited to participate in a virtual program, “New to MS: Navigating Your Journey,” from 8-9:15 p.m. on Thursday, April 14. The online program allows participants to connect with others recently diagnosed with MS. and share experiences, questions and concerns with each other and with participating health professionals. Information is provided on MS and its symptoms and on the management of MS.
New to MS: Navigating Your Journey virtual programs are offered on the third Thursday of each month. Other upcoming program dates are May 12 and June 9.
Online programs can be accessed via www.nationalmssociety.org. Registrations usually reach their maximum capacity, so it is advisable to register in good time.
Benefits of Exercise
The mind-body connection is also linked to helping people with MS improve and maintain their quality of life. As for everyone, regular physical activity, a suitable diet and good sleep hygiene promote optimal well-being. Exercise — movement, in general, such as walking at a moderate level — can be particularly beneficial in helping people with MS manage their symptoms.
According to studies, aerobic exercise programs can help improve cardiovascular fitness, bone strength, density and flexibility, as well as bowel and bladder function. Studies add that exercise can also reduce fatigue and improve mood and cognitive abilities in people with MS.
In addition to walking (with or without a dog), other physical activities that can benefit people with MS include gardening, swimming, or even cooking and other daily household chores. Scientists also claim that a regular exercise regimen can slow the progression of MS in some people.
Greenfield agrees with the findings. “When I was in occupational therapy school, exercise was kind of a controversial topic,” he said, “but a study in 2021 showed that aerobic and resistance training had a benefit for MS patients as long as they are physically able Aerobic exercise and conditioning can help relieve symptoms of fatigue, and have been shown to help manage incontinence It increases density bone and contributes to mood and cognitive function.When you strengthen the heart and lungs, you are not as tired.
“We sometimes refer patients to the National MS Society website,” Greenfield said. “They have great videos that show exercises suitable for them and offer home exercises for patients. They have more information at their fingertips than a clinician can provide.
Greenfield also advocates aquatic therapy for people with MS. “You want to make sure you’re not overheating and that you’re going at your own pace,” he cautioned. “I have a background in aquatic therapy; I have worked a lot with this population. Their symptoms are alleviated in the short term, with improvements in cardiovascular endurance and bone density.
Benefits of a balanced diet
“Obviously no diet is going to cure MS,” Greenfield said, “but it’s a big research topic right now on a national basis. The biggest take-home message with the diet is to promote more a healthy lifestyle to reduce other comorbidities.
“Try incorporating these food colorings into your diet. Cut to the veggie aisle, cook more at home, avoid processed foods and too much sugar, and choose whole grains over refined grains.
Let the sun shine too, advised Greenfield.
“There is a lot of research on vitamin D and biotin (vitamin B₇). Even just being in the sun, spending 15 minutes in the sun, doing physical activity can help. It’s like exercising – gardening, planting flowers, doing a little gardening. Vitamin D will help with symptom management.