Valutazione dell'efficacia dell'intervento sullo stile di vita in pazienti affetti da sclerosi multipla: risultati preliminari

Background. Multiple Sclerosis is an autoimmune condition in which the immune system attacks the CNS, leading to demyelization. MS was first described in 1835 by Jean Martin Charcot. Disease onset usually occurs in young adults, is more common in women. It may cause numerous physical and mental symptoms, and often progresses to physical and cognitive disability. The main symptoms are muscle weakness, abnormal muscle spasms, or difficulty in moving; difficulties with coordination and balance (ataxia); problems in speech (dysarthria) or swallowing (dysphagia), visual problems (nistagmus, optic neuritis, or diplopia), fatique, depression, anxiety disorder.
Multiple sclerosis (MS) and its treatment have broad-ranging effect in quality of life. This article effort to asses the impact of lifestyle intervention on multiple sclerosis patients daily living.

Objective. To evaluate the effects of a lifestyle intervention (structured exercise intervention on physical activity and dietary intervention) in multiple sclerosis patients quality of life.

Method. Participants (n=100) were enclosed in the study. Participants (n=60) randomly assigned to a structured lifestyle intervention (n=30), consisting of six monthly supervised sessions. Results were compared with a control group (n=30). Psychological status was measured with self-report questionnaires before the start (pre-test), at the end (6 months, post-test), and after 1 year (follow-up): IES-R (Impact of Event Scale for test post-traumatic stress disorder), CMDI (Chicago Multiscale Depression Inventory) and FAMS (Functional Assessment in Multiple Sclerosis).
 IES-R: the scale consisted of twenty-two items. Seven items described episodes of intrusion, seven described episodes of iperarousal and eight described episode of avoidance.
 The CMDI is a 50-item, self-reporting questionnaire. A total score and three separate 14-item subscale scores are produced. The subscales assess mood (dysphoria), vegetative symptoms (physical malfunctioning) and evaluative symptoms (self-criticism). Participants rate how well items describe their own experience over the past week on a Likert rating scale, ranging from 1 (not at all) to 5 (extremely).
 The FAMS quality of life instrument is a 58-itemes multidimensional index of health related scale quality of life for used with people diagnosed with MS.
Physical activity was measured with monopodalic Stabilometric Test and monopodalic Static Riva’s Test with Vertical Controller Sensor before the start (pre-test), at the end (6 months, post-test), and after 1 year (follow-up).

Results. At the moment there are not a significant results, because the simple is not reliable.

Conclusions. Researchers hope one year after the intervention the lifestyle group will maintain a significant increase in physical activity, which highlights the potential of lifestyle programs in the battle against inactivity and depressed mood in MS people.


Key-word: lifestyle intervention, quality of life, multiple sclerosis