Research: Measuring Activity

R
Sandroff et al. Accelerometer output and its association with energy expenditure in persons with multiple sclerosis. J Rehabil Res Dev. 2012 49:467-76.

Background: Limited data support the strong association between rates of accelerometer activity counts and energy expenditure during dynamic activity MSers. 


Aims: This study examined the association between rates of activity counts and energy expenditure during walking by using two models of accelerometers and generated cut-points representing moderate-to-vigorous physical activity (MVPA) in MSers. 

Methods: Participants were 43 MSers and 43 controls who undertook 5 min of seated rest and up to five 6 min periods of walking at five different speeds on a treadmill. While walking, participants wore two models of accelerometers and a mouthpiece in-line with an open-circuit spirometry system for measuring energy expenditure (rate of oxygen consumption). Strong linear associations were found between accelerometer activity counts and energy expenditure, and the magnitude did not differ between MSers and controls for both accelerometer models. The mean slopes of the linear relationships were steeper in MSers than controls and resulted in distinct cut-points for MVPA based on accelerometer counts for MSers and controls. 

Conclusion: The strong linear relationship between activity counts and energy expenditure and cut-points for quantifying time spent in MVPA should allow for better understanding of physical activity and examination of its predictors and consequences when using accelerometers in MS.

“This is good news; MSers behave in the same way as normal subjects when it comes to energy expenditure from exercise or physical activity. This is not surprising as there is no evidence that MSers peripheral energy usage and requirements are different to normals. However, I would expect different results for cognitive activities; it is clear that MSers use up more energy than controls for a given cognitive task.”

“One issue that was not addressed in this study is the ability of MSers to perform physical activity. A lot of MSers suffer from fatigue and their physical impairments and disabilities prevent them from performing physical activity. This in my opinion is the biggest problem that MSers face.”

“Deconditioning, the medical word for being unfit, is also a problem. It is a bit of a vicious cycle. If you are unable to exercise you get unfit, the more unfit you are the harder it is to exercise and the less exercise you do, the less exercise you do the more unfit you get. This is a downward spiral. This is why we try an encourage all MSers to try and exercise regularly. Exercise has many advantages  that go beyond physical fitness; exercise improves your mental health and well-being. Exercise releases endorphins, chemicals that make you feel good, in the brain that are mood elevating. Exercise improves sleep, which helps with reducing day-time fatigue, Exercise increases your strength and reduces your weight making it easier to do physical chores.”

“Do you exercise?”

Other posts of interest:

07 Jun 2012
Purpose: The evidence base to support therapeutic exercise for MSers is improving; however few studies have considered the MSers’ perspective. This study aimed to explore the experiences and views of people moderately 
15 Jun 2012
Objective: Our aim was to evaluate the effects of a Nintendo Wii Fit® balance exercise programme on balance function and walking ability in people with multiple sclerosis (MS). Methods: A multi-centre, randomised, controlled 
01 Jun 2012
RESULTS: Findings are based on 21 patients (10 from exercise and 11 controls) who had data available on outcomes. There was no significant difference between the two groups at the baseline. MSers in the aquatic exercise 
30 Jun 2012
I agree with Anon – the importance of diet, exercise/physio perhaps vitD/sun and care in mind and body ie exercise everything – should be a crucial part of any holistic approach and it is probably the neuro who should try to 
11 Apr 2011
The effect of exercise therapy on fatigue in multiple sclerosis. Exercise therapy may have a positive effect on MS-related fatigue, however, the findings of a systematic review show the impact of exercise can be highly variable.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

7 comments

  • Yes I exercise – I swim twice a week but am aware that is not weight bearing, or buildingup/maintaining my 'walking' muscles. I am very motivated but even so it is a great effort. I have a cycle machine 'stored'int he corner of a room … must use it even if it is for a short time, plus do yoga/pilates etc floor exercises. Yes I agree, it is a huge challenge to try to maintain fitness.

  • I excercise thrice weekly, but I do get tired. I have progressive MS aNd excercise is getting harder because I still want to push myself and try and do everything I used to do. Thing is even my sister says to me that if I wasn't excercising the way I do I'd probably have been in a wheelchair by now.

    I wish science could meet me halfway because ot feels like all the effort is coming from me right now.

  • I, too, try to do a least something like bike riding a couple of times a week and I try to walk even if it's getting off the bus a stop earlier. I wish I could start to swim again but the temperatures are either too high or too cold and I am bit afraid of water. But, yeah, it's a bit rough if I suffer from stiffness or vertigo to excercise which is a shame because I still could do it – so symptom relief drugs that work would be great.

  • I did start going to the gym around three years ago.

    The staff were friendly and helpful but I felt really initimidated by the attitude of the other gym users who openly sniggered and made comments about me walking on the treadmill or doing a short stint on the bikes.

    I gave up after six weeks. I don't have space at home to have a static bike or rowing machine so have got into the vicious cycle of losing fitness / relapsing and losing more fitnees etc.

    It does feel daunting about how to get back into exercise for all the reasons in the article

  • Re: "losing fitness / relapsing and losing more fitnees etc."

    You need to speak to your neurologist about getting you relapse free; you may need DMTs or your DMTs escalated. A physiotherapist wull be able to help you with a fitness programme. Please don't give up and do nothing.

  • Do you think exercise is likely to improve muscle fatigue (where after you've been active for a while you can do less and less)? This makes it hard for me to exercise, but maybe I would try harder if I thought it would pay off eventually.

  • Re: "Do you think exercise is likely to improve muscle fatigue (where after you've been active for a while you can do less and less)? This makes it hard for me to exercise, but maybe I would try harder if I thought it would pay off eventually."

    MS-related fatigue is complex and not due to one factor. Physical fatigue in MS is mainly due to conduction block and not the muscles. However, saying that if you decondition your muscles this will contribute to the fatigue.

By Prof G

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