MS impairs your ability to safely cross the road; particularly if you are distracted. #MSBlog #MSResearch #ClinicSPpeak #BrainHealth
“The hidden dangers and consequences of having MS are enormous. The majority of MSers have reduced brain reserve, which potentially gets worse with time and age. As a result of this MSers find it very difficult multi-tasking and if they do multitask they tend to under perform. The study below shows that MSers have a reduced ability to cross the road, particularly when distracted (phone conversation). This study was done using a virtual street. These findings have major implications for MSers in that they need to be vigilant about performing tasks that expose them to danger. This study is another example of why it is so important for MSers to take the treatment of their MS seriously; it is as much your responsibility to maximise your brain health as it is the responsibility of your healthcare professional (HCP). Maintaining brain and neuronal reserve is what will protect you when crossing the street and protect you from age-related cognitive decline. At ECTRIMS I will be co-chairing a teaching session on brain health to activate HCPs to the importance of the holistic management of MS; i.e. ‘time is brain‘. As soon as the teaching course is completed I will post the materials online, including a Podcast for you consume, digest and reflect on.”
“Please note we can reduce, and hopefully prevent, the ravages of MS, but at present we can’t repair the nervous system. The recovery of function that occurs in MSers treated with DMTs probably involved endogenous (self) repair mechanisms that are linked to reserve and age. The ability to recover therefore drops off as MS progresses and with ageing. The underlying message therefore is early effective treatment. Please read the following document that explains how you can optimise your treatment and hopefully your brain health.”
Stratton et al. Virtual street-crossing performance in persons with multiple sclerosis: Feasibility and task performance characteristics. Traffic Inj Prev. 2016 Sep 7:1-9.
OBJECTIVES: Multiple sclerosis (MS) is a neurological disease that commonly results in physical and cognitive dysfunction. Accordingly, MS might impact the ability to safely cross the street. The purpose of this study was to examine the feasibility of a simulated street-crossing task in persons with MS and to determine differences in street-crossing performance between persons with MS and non-MS controls.
METHODS: 26 participants with MS (median Expanded Disability Status Scale [EDSS] score = 3.5) and 19 controls completed 40 trials of a virtual street-crossing task. There were 2 crossing conditions (i.e., no distraction and phone conversation), and participants performed 20 trials per condition. Participants were instructed that the goal of the task was to cross the street successfully (i.e., without being hit be a vehicle). The primary outcome was task feasibility, assessed as completion and adverse events. Secondary outcomes were measures of street-crossing performance.
RESULTS: Overall, the simulated street-crossing task was feasible (i.e., 90% completion, no adverse events) in participants with MS. Participants with MS waited longer and were less attentive to traffic before entering the street compared with controls (all P < .05). Participants with MS also took longer to cross the street and were closer to oncoming vehicles when exiting the street compared to controls (all P < .05). When distracted, all participants took longer to initiate crossing, took longer to cross the street, and made more head turns while crossing (all P < .05). There were no significant group by condition interaction effects (all P > .05).
CONCLUSIONS: A virtual street-crossing task is feasible for studying street-crossing behavior in persons with mild MS and most individuals with moderate MS. Virtual street-crossing performance is impaired in persons with MS compared to controls; however, persons with MS do not appear to be more vulnerable to a distracting condition. The virtual reality environment presents a safe and useful setting for understanding pedestrian behavior in persons with MS.