Impact of pre-cooling therapy on the physical performance and functional capacity of multiple sclerosis patients: A systematic review.

Patients with multiple sclerosis experience many complications that gradually lead them to comorbidity and disability. Exercise could prevent and ameliorate the symptoms that comorbidity or inactivity generate. However, until recently it was suggested that multiple sclerosis patients should not participate in exercise training programs because these patients are characterized by thermoregulatory failure and the heat stress due to physical work could exacerbate the disease symptoms. Furthermore, taken into account that 60-80% of the multiple sclerosis patients present adverse clinical symptoms when their body temperature is increased (not only due to physical working but even when immerse in hot water or by exposure to infrared lamps or to the sun), the need for the development of treatment strategies to overcome the thermoregulatory problem in these patients is crucial. Given that pre-cooling has been proposed as an effective method, the aim of this systematic review is to discuss the current knowledge for the effects of cooling therapy on the functional capacity of multiple sclerosis patients. The relevant literature includes many articles, but only a handful of studies published thus far have used a cooling intervention in multiple sclerosis patients and have examined the effects of pre-cooling on functional capacity. These studies used active cooling methods, namely garments or other material that are cooled by circulating liquid through a tube, as well as passive, cooling methods. Passive cooling methods include passive cooling garments or other material namely garments that have ice or gel packs inside them. Overall, the results of all the studies analysed in this review demonstrated that pre-cooling therapy can prevent the symptom worsening due to increased body temperature in multiple sclerosis patients without causing adverse effects. Therefore, such strategies could serve as a complimentary therapeutic approach in multiple sclerosis patients.