Kognitive Funktion als Ziel der Bewegungstherapie bei Multiple Sklerose

Zusammenfassung

Eine reduzierte kognitive Funktion tritt häufig bei Personen mit Multiple Sklerose auf und beeinflusst die Lebensqualität der Betroffenen stark. Körperliche Aktivität zeigt ein hohes Potenzial, um auf nicht-medikamentöser Ebene die kognitive Funktion zu beeinflussen. Neben der Verbesserung der motorischen Leistungsfähigkeit sollte daher ebenfalls die Verbesserung der kognitiven Funktion in der Bewegungstherapie fokussiert werden. Individuell gesteuerte Trainingsprogramme von Ausdauer-, Kraft- und Koordinationseinheiten stellen dabei einen wesentlichen Schwerpunkt dar.

Summary

Reduced cognitive performance is a common symptom in Multiple Sclerosis that has profound impact on persons’ quality of life. Physical activity reveals high potential as a non-pharmacological treatment to beneficially impact cognitive performance. Besides the improvement of physical performance and motor control, cognitive performance should be a targeted outcome of exercise therapy. Thereby, individualized programs for aerobic-, resistance and coordination-exercises are emphasized.

Stichworte

Multiple Sklerose - kognitive Funktion - körperliche Aktivität - Ausdauertraining, Krafttraining.

Key words

Multiple sclerosis - cognitive function - physical activity - endurance training - strength training

• Literatur

• 1 Compston A, Coles A. Multiple sclerosis. The Lancet 2008; 372: 1502-1517. doi:https://doi.org/10.1016/S0140-6736(08)61620-7
• 2 Motl RW, Sandroff BM, Kwakkel G. et al. Exercise in patients with multiple sclerosis. The Lancet Neurology 2017; 16: 848-856. doi:10.1016/s1474-4422(17) 30281-8
• 3 Marrie RA, Reider N, Cohen J. et al. A systematic review of the incidence and prevalence of cardiac, cerebrovascular, and peripheral vascular disease in multiple sclerosis. Multiple sclerosis 2015; 21: 318-331. doi:10.1177/1352458514564485
• 4 Dalgas U, Langeskov-Christensen M, Stenager E. et al. Exercise as Medicine in Multiple Sclerosis—Time for a Paradigm Shift: Preventive, Symptomatic, and Disease-Modifying Aspects and Perspectives. Current Neurology and Neuroscience Reports 2019; 19: 88. doi:10.1007/s11910-019-1002-3
• 5 Sutherland G, Andersen MB. Exercise and multiple sclerosis: physiological, psychological, and quality of life issues. The Journal of sports medicine and physical fitness 2001; 41: 421-432
• 6 Langdon DW, Amato MP, Boringa J. et al. Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Multiple sclerosis 2012; 18: 891-898. doi:10.1177/1352458511431076
• 7 Pflugshaupt T, Geisseler O, Nyffeler T. et al. Cognitive Impairment in Multiple Sclerosis: Clinical Manifestation, Neuroimaging Correlates, and Treatment. Seminars in neurology 2016 36. 203-211.
• 8 Haselkorn JK, Hughes C, Rae-Grant A. et al. Summary of comprehensive systematic review: Rehabilitation in multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2015 85. 1896–1903.
• 9 Zimmer P, Bansi J, Rademacher A. et al. Exercise-neuroimmunology – from bench to bedside. Deutsche Zeitschrift für Sportmedizin 2019; 70: 227-234. doi:10.5960/dzsm.2019.392
• 10 Sandroff BM, Motl RW, Scudder MR. et al. Systematic, Evidence-Based Review of Exercise, Physical Activity, and Physical Fitness Effects on Cognition in Persons with Multiple Sclerosis. Neuropsychology review 2016; 26: 271-294. doi:10.1007/s11065-016-9324-2
• 11 Wasserman K. Principles of exercise testing and interpretation. 5. ed. . Aufl. Philadelphia, Pa.: Kluwer / Lippincott Williams & Wilkins; 2012
• 12 Eriksen L, Curtis T, Gronbaek M. et al. The association between physical activity, cardiorespiratory fitness and self-rated health. Preventive medicine 2013; 57: 900-902. doi:10.1016/j.ypmed.2013.09.024
• 13 Motl RW, Sandroff BM, Benedict RH. Cognitive dysfunction and multiple sclerosis: developing a rationale for considering the efficacy of exercise training. Multiple sclerosis 2011; 17: 1034-1040. doi:10.1177/1352458511409612
• 14 Zimmer P, Bloch W, Schenk A. et al. High-intensity interval exercise improves cognitive performance and reduces matrix metalloproteinases-2 serum levels in persons with multiple sclerosis: A randomized controlled trial. Multiple sclerosis 2018; 24: 1635-1644.
• 15 Mazzetti SA, Kraemer WJ, Volek JS. et al. The influence of direct supervision of resistance training on strength performance. Medicine and science in sports and exercise 2000; 32: 1175-16184. doi:10.1097/00005768-200006000-00023
• 16 Collett J, Dawes H, Meaney A. et al. Exercise for multiple sclerosis: a single-blind randomized trial comparing three exercise intensities. Multiple sclerosis 2011; 17: 594-603. doi:10.1177/1352458510391836
• 17 Kalron A, Allali G. Gait and cognitive impairments in multiple sclerosis: the specific contribution of falls and fear of falling. Journal of neural transmission 2017; 124: 1407-1416. doi:10.1007/s00702-017-1765-0
• 18 Prosperini L, Castelli L, Sellitto G. et al. Investigating the phenomenon of “cognitive-motor interference” in multiple sclerosis by means of dual-task posturography. Gait & posture 2015; 41: 780-785. doi:10.1016/j.gaitpost.2015.02.002
• 19 Cameron MH, Lord S. Postural control in multiple sclerosis: implications for fall prevention. Curr Neurol Neurosci Rep 2010; 10: 407-412. doi:10.1007/s11910-010-0128-0
• 20 Sirhan B, Frid L, Kalron A. Is the dual-task cost of walking and texting unique in people with multiple sclerosis?. Journal of neural transmission 2018; 125: 1829-1835. doi:10.1007/s00702-018-1939-4
• 21 Massot C, Simoneau-Buessinger E, Agnani O. et al. Anticipatory postural adjustment during gait initiation in multiple sclerosis patients: A systematic review. Gait & posture 2019; 73:: 180-188. doi:10.1016/j.gaitpost.2019.07.253