The impact of physical functions on depressive symptoms in people with multiple sclerosis

ABSTRACT

Background: Multiple sclerosis (MS) is an immune-mediated disease that affects the central nervous system. The impact of MS transcends physical functions and extends to psychological impairment. Approximately 50% of people with MS develop depressive symptoms during their lifetime and depressive symptoms may predict impairment of physical functions. However, prediction of depressive symptoms based on objective measures of physical functions is still necessary. Objective: To compare physical functions between people with MS presenting depressive symptoms or not and to identify predictors of depressive symptoms using objective measures of physical functions. Methods: Cross-sectional study including 26 people with MS. Anxiety and/or depressive symptoms were assessed by the Beck Depression Inventory-II (BDI-II) and by the Hospital Anxiety and Depression Scale (HADS). Outcomes of physical functions included: the Nnnine-hole Ppeg Ttest (NHPT), knee muscle strength, balance control, the Timed Up and Go Test (TUG), and the 6-minute walk test (6MWT). Perceived exertion was measured using the Borg scale. Results: The frequency of depressive symptoms was 42% in people with MS. Balance control during a more challenging task was impaired in people with MS who presented depressive symptoms. Balance could explain 21-24% of the variance in depressive symptoms. 6MWT and TUG presented a trend of significance explaining 16% of the variance in the BDI-II score. Conclusions: Impairment in physical functions consists in a potential predictor of depressive symptoms in people with MS. Exercise interventions aiming at the improvement of physical functions, together with the treatment of depressive symptoms and conventional medical treatment, are suggested.

RESUMO

Introdução: A esclerose múltipla (EM) é uma doença imunomediada que afeta o sistema nervoso central. O impacto da doença transcende as funções físicas e se estende a comprometimento psicológico. Aproximadamente 50% das pessoas com EM desenvolvem sintomas depressivos e estes podem predizer o comprometimento das funções físicas. No entanto, a previsão de sintomas depressivos com base em medidas objetivas das funções físicas ainda é necessária. Objetivos: Comparar funções físicas entre pessoas com EM que apresentam ou não sintomas depressivos e identificar preditores de sintomas depressivos usando medidas objetivas de funções físicas. Métodos: Estudo transversal incluindo 26 pessoas com EM. A ansiedade e/ou sintomas depressivos foram avaliadas pelo Inventário de Depressão de Beck-II (Beck Depression Inventory - BDI-II) e pela Escala Hospitalar de Ansiedade e Depressão. Os resultados das funções físicas incluíram: teste de PEG de nove buracos, força muscular do joelho, controle de equilíbrio, teste Timed Up and Go (TUG) e teste da caminhada de seis minutos (TC6M). A fadiga percebida foi medida usando a escala de Borg. Resultados: A frequência de sintomas depressivos na amostra foi de 42%. O controle do equilíbrio durante tarefa desafiadora foi prejudicado em pessoas com EM e sintomas depressivos. O equilíbrio pode explicar 21-24% da variação nos sintomas depressivos. O TC6M e o TUG apresentaram tendência de significância que explica 16% da variância no escore do BDI-II. Conclusões: O comprometimento das funções físicas é potencial preditor de sintomas depressivos em pessoas com EM. São sugeridas intervenções de exercícios físicos visando melhora das funções físicas, juntamente com o tratamento médico convencional e dos sintomas depressivos.

Keywords:

Multiple Sclerosis - Depression - Physical Fitness - Walking

Palavras-chave:

Esclerose Múltipla - Depressão - Habilidade Física - Caminhada

Authors’ contributions:

CBT, RC, LMBS and LSN contributed substantially to the conception or design of the study; CBT, CR, EB and FMS collection, analysis, or interpretation of data; CBT, CR, FVG and LSN writing or critical review of the manuscript; CBT, JRAAG, AD, COB, LMBS, LSN project administration or funding acquisition; and all authors - final approval of the version to be published.

Publikationsverlauf

Eingereicht: 18. Januar 2020

Angenommen: 11. Juni 2020

Artikel online veröffentlicht:
01. Juni 2023

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