Venasse Myriam, Edwards Thomas, Pilutti Lara A
Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada.
School of Human Kinetics, University of Ottawa, Ottawa, Canada.
Curr Treat Options Neurol. 2018 Apr 10;20(5):13. doi: 10.1007/s11940-018-0497-2.
There has been recent interest in the role of lifestyle and wellness-based approaches in the treatment and management of multiple sclerosis (MS). These approaches may be particularly relevant for patients with progressive MS, considering limited therapeutic options currently available. The purpose of this review is to examine the role of wellness-based interventions including exercise training, emotional well-being therapies, and dietary modification in patients with progressive MS.
We conducted a literature search on the efficacy of wellness-based interventions in patients with progressive MS published between 1985 and July 2017. The level of evidence for each trial was evaluated using the American Academy of Neurology criteria. Overall, 21 articles reporting on 16 wellness-based interventions were identified: ten trials involved exercise training, three involved emotional wellness therapies, two involved dietary modification, and one was a combined wellness intervention. There is level C evidence (possibly effective; one class II study) for the efficacy of aerobic exercise training on cardiorespiratory fitness in patients with progressive MS. There is level B evidence (probably effective; one class I study) for the efficacy of mindfulness training on psychological distress, depression, anxiety, pain, and quality of life in patients with progressive MS. There is inadequate evidence (level U) for efficacy of dietary modification (one class III study and one class IV study) and combined wellness interventions involving exercise training, meditation, and dietary modification (one class IV study). High-quality research is needed to provide evidence-based recommendations for wellness behaviors and lifestyle change in patients with progressive MS.
近期，生活方式和基于健康的方法在多发性硬化症（MS）治疗与管理中的作用受到了关注。鉴于目前可用的治疗选择有限，这些方法可能对进展型MS患者尤为重要。本综述的目的是探讨基于健康的干预措施，包括运动训练、情绪健康疗法和饮食调整在进展型MS患者中的作用。
我们对1985年至2017年7月期间发表的关于基于健康的干预措施对进展型MS患者疗效的文献进行了检索。每项试验的证据水平均按照美国神经病学学会的标准进行评估。总体而言，共识别出21篇报道16项基于健康的干预措施的文章：10项试验涉及运动训练，3项涉及情绪健康疗法，2项涉及饮食调整，1项为综合健康干预。有C级证据（可能有效；一项II类研究）表明有氧运动训练对进展型MS患者的心肺适能有疗效。有B级证据（可能有效；一项I类研究）表明正念训练对进展型MS患者的心理困扰、抑郁、焦虑、疼痛和生活质量有疗效。饮食调整（一项III类研究和一项IV类研究）以及涉及运动训练、冥想和饮食调整的综合健康干预（一项IV类研究）的疗效证据不足（U级）。需要高质量的研究来为进展型MS患者的健康行为和生活方式改变提供循证建议。
