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Upper-lower limb and breathing exercise program for improving sleep quality and psychological status in multiple
Tanja Grubić Kezele1, Zrinka Trope2, Valentina Ahel2
1Department of Physiology and Immunology, University of Rijeka, Faculty of Medicine, Rijeka, Croatia.
Purpose:
To examine the feasibility and possible effect of an 8-week exercise program on sleep quality, insomnia and psychological distress in individuals with multiple sclerosis (MS).
Methods:
Twenty-four individuals with MS were recruited into a controlled pre-post feasibility study and divided into 2 groups: exercise (n = 13; Expanded Disability Status Scale (EDSS): 1.0-7.5) and a related control group with no exercise (n = 11; EDSS: 1.0-7.0). The exercise group performed combined upper limb, lower limb and breathing exercises in a controlled group (2d/week, 60 min/session) for 8 weeks. Participants were administered measures to evaluate sleep quality (Pittsburgh Sleep Quality Index, PSQI), insomnia severity (Insomnia Severity Index, ISI), psychological distress (Clinical Outcomes in Routine Evaluation-Outcome Measure, CORE-OM) and additionally impact of fatigue (Modified Fatigue Impact Scale, MFIS) after 8-weeks.
Results:
Insomnia severity measured with ISI (F(1;22)=5.95, p = 0.023, η 2 = 0.213, 90% CI = 0.02-0.42) and psychological distress measured with the CORE-OM (F(1;22)=4.82, p = 0.039, η 2 = 0.179, 90% CI = 0.01-0.40) showed statistically significant group-by-time interaction. Sleep quality measured with the PSQI showed statistically significant group-by-time interaction only in an aspect of daytime sleep dysfunction (F(1;22)=5.33, p = 0.031, η 2 = 0.195, 90% CI = 0.01-0.40). The fatigue impact measured with the MFIS showed statistically significant group-by-time interaction in physical (F(1;22)=6.80, p = 0.016, η 2 = 0.236, 90% CI = 0.02-0.44) and cognitive aspects (F(1;22)=9.12, p = 0.006, η 2 = 0.293, 90% CI = 0.05-0.49), and total score (F(1;22)=11.29, p = 0.003, η 2 = 0.339, 90% CI = 0.08-0.52).
Conclusions:
Our 8-week program reduced insomnia severity, psychological distress and some aspects of fatigue (physical; cognitive; total), and improved sleep quality in an aspect of daytime sleep dysfunction in a small group of individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.
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