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Archive for the month “April, 2012”

Trial of Vitamin D Supplementation Recruiting People with Relapsing-Remitting MS

Summary: Investigators at several centers nationwide are recruiting 172 people with relapsing-remitting MS to compare the effectiveness of the current recommended amount of vitamin D supplementation versus high dose vitamin D supplementation at reducing MS disease activity, when added to standard therapy with glatiramer acetate (Copaxone®, Teva Pharmaceutical Industries). The principal investigator is Ellen Mowry, MD, MCR (Johns Hopkins University, Baltimore) and the study is funded by a research grant from the National MS Society, with partial support from the Society’s Greater Delaware Valley Chapter.

Rationale: A number of genetic and environmental factors influence whether a person will get MS. These factors may also impact the severity of the disease. Research is increasingly pointing to a reduced level of vitamin D in the blood as a risk factor for developing MS. In lab mice, vitamin D can reduce the effects of EAE, an MS-like disease, and growing evidence suggests it is time to test whether vitamin D can provide benefits to people who have MS.

Eligibility and Details: Participants should be between the ages of 18 and 50, and diagnosed with relapsing-remitting MS. Participants must be willing to stop taking additional supplemental vitamin D, except as part of a multivitamin, and must be willing to not take cod liver oil. More details on the enrollment criteria are available from the website and contacts below.

Participants will begin standard Copaxone treatment daily and will be randomly assigned to take either 600 IU (the current recommended daily allowance) or 5000 IU of vitamin D. The primary goal of the study is to determine the effects on reducing the proportion of people who experience a relapse. Other outcomes being studied include relapse rate, quality of life, brain tissue volume, disability progression, and excess calcium levels in the blood (a possible side effect of high doses of vitamin D).

Contact: To learn more about the enrollment criteria for this study, and to find out if you are eligible to participate, please see: http://www.clinicaltrials.gov/ct2/show/NCT01490502, or e-mail vitamindtrialms@jhmi.edu.

Sites are active in the following cities, and more may be added; please refer to the above link to the clinicaltrials.gov listing for the latest information:

San Francisco, California
Baltimore, Maryland
St. Louis, Missouri
Portland, Oregon

Download a brochure that discusses issues to think about when considering enrolling in an MS clinical trial (PDF).

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National MS Society-funded study suggests balance/ eye movement training improves fatigue, balance and other symptoms in people with MS

April 3, 2012 at 5:15 pm (Science) · Edit
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 A recent controlled study suggests that a 6-week balance and eye movement-focused exercise program improved balance, reduced fatigue, and reduced disability due to dizziness or disequilibrium in a group of people with MS, lasting for at least 4 weeks following supervised training. Larger and longer studies are needed to determine how long the benefits last, and which people with MS would be most likely to respond to the training program. The study, by Jeffrey Hebert, PT, PhD (University of Colorado, Aurora) and colleagues, was reported in the journal Physical Therapy in August, 2011 and was partially funded by a pilot research grant from the National MS Society.

Background: Fatigue and impaired balance are two common and troublesome symptoms experienced by people with MS. Current treatments vary greatly in effectiveness. This study is the first to examine the effects of an exercise program involving balance and eye movement training – or “vestibular rehabilitation” — in people with MS to see if it improves both fatigue and balance. The study: For this controlled study, 38 people with MS were divided into three groups: one group did not participate in an exercise program and only received normal MS medical care; one group participated in a general exercise program involving endurance and stretching; and one group participated in the vestibular rehabilitation program specifically designed to improve balance. The endurance and stretching exercises included bicycle riding and exercise designed to stretch various muscles.

The vestibular rehabilitation program included balance exercises on various surfaces (firm surface, foam cushion, trampoline, tiltboard), arm movements while kneeling, head movements on a trampoline and while fixating on different objects, ball catching while walking. The vestibular rehabilitation program also included 3 types of eye movement exercises. Both exercise programs were performed for 60 minutes twice a week in the clinic. A daily home exercise program, consisting of a subset of exercises performed in the clinic, was also assigned to each participant. The exercise training programs lasted for 6 weeks.

Effects on balance, fatigue, dizziness/equilibrium, depression, and walking ability were examined at the end of the 6 weeks and also 4 weeks after the exercise program had ended. At the end of the 6-week period, the group that underwent the vestibular rehabilitation program showed improved balance, reduced fatigue, and reduced disability due to dizziness or disequilibrium. Depression and walking ability were minimally improved. Neither of the control groups showed improvement in balance, fatigue, or dizziness/disequilibrium disability. Four weeks after the exercise program ended, those in the vestibular rehabilitation program group continued to show benefit.

It should be noted that in this study, the bicycle riding was not designed as an aerobic exercise, and thus these findings do not counter prior research studies that have shown benefits of aerobic exercise on MS fatigue. In their paper, the researchers suggest that the vestibular rehabilitation program reteaches the brain how to maintain balance when performing activities during standing or walking, after such abilities are impaired by MS, leading to improved balance, fatigue and dizziness.

Future studies should include more participants and a longer follow-up to determine how long the benefit lasts and which people with MS would most likely respond to this program. Proposals for these investigations are underway.

Based on these preliminary results, balance and eye movement training may help people with MS who are experiencing fatigue and balance problems. Those wishing to explore this option should consult with their neurologists, local rehabilitation facilities or hospitals to see whether this type of training is available.

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