Clinical screening of autonomic dysfunction in multiple sclerosis.

Area of Science:

• Neurology
• Cardiology
• Exercise Physiology

Background:

• Multiple sclerosis (MS) can impact the autonomic nervous system, potentially affecting cardiovascular responses to physical activity.
• Individuals with MS and autonomic dysfunction may exhibit atypical heart rate patterns during exercise.

Purpose of the Study:

• To investigate differences in heart rate response during a simple cycle test among individuals with MS.
• To compare participants with MS and autonomic dysfunction against controls and MS participants without autonomic involvement.

Main Methods:

• A controlled cohort study involving 31 adults with MS and 31 age-matched healthy controls.
• Autonomic function was assessed using various tests, including deep breathing, Valsalva maneuver, postural change, and a cycle test.
• Continuous heart rate and blood pressure were monitored during testing.

Main Results:

• No significant differences in age, height, or weight were found between the MS and control groups.
• Sixteen percent (5/31) of participants with MS demonstrated abnormal autonomic function in laboratory tests.
• Two individuals with MS and abnormal autonomic function showed an atypical heart rate response during the cycle test.

Conclusions:

• Physiotherapists should monitor heart rate responses during dynamic exercise tests in individuals with MS before prescribing exercise programs.
• A delayed or attenuated heart rate response may indicate the need for formal autonomic laboratory testing to ensure patient safety.