MSWA Bulletin Magazine Spring 2021

HERE WE PROVIDE SUMMARIES OF RESEARCH SOURCED FROM WEBSITES IN AUSTRALIA AND AROUND THE
WORLD; WE HOPE IT’S OF INTEREST TO YOU.
READ MORE AT MSWA.ORG.AU/RESEARCHUPDATE
Tremors are one of the most
common symptoms of MS,
affecting 25% to 58% of patients,
being severe in 3%–15% of cases.
The arms, legs, head, trunk, and
vocal cords are the most commonly
affected. For many people with MS,
tremors can be debilitating enough
to severely impair quality of life and
are challenging to treat.
DBS is approved, and successful, for
Parkinson’s disease and essential
tremor, and has also been used
for the treatment of severe MSassociated
tremors when other
treatments have failed. Electrodes
are surgically implanted in the brain
to stimulate the thalamus — an
area involved in motor function —
with electric impulses. The amount
of stimulation is controlled by a
pacemaker-like device placed
under the skin, near the collarbone.
A team of researchers in Iran
systematically reviewed studies
published up to March 2021 that
investigated the effects of DBS on
MS-related tremors. From a total of
1,663 studies, 17 — covering 162 MS
patients — were included in the
meta-analysis.
Results showed that the pooled rate
of tremor reduction was 73% (range
of 22%–100%) and that DBS led to
a significant reduction in tremor
scores, by a mean of -2.9 points.
One study reported improvements
in quality of life among patients
showing tremor reductions
following DBS.
“The result of this systematic review
and meta-analysis demonstrates
that MS-related tremor improves
after DBS,” the researchers wrote.
But given the high variability
between studies in terms of
follow-up duration and tremor
assessment, as well as the low
number of included patients,
larger studies using standardised
measures are needed to better
assess the intervention’s benefits in
this patient population, they added.
FROM BMC NEUROLOGY
Read more at: biomedcentral.com
Longitudinal observational study
of boxing therapy in Parkinson’s
disease, including adverse impacts
of the COVID-19 lockdown; Craig
Horbinski, et al.
Parkinson’s Disease (PD) is a highly
prevalent neurodegenerative
disease whose incidence
is increasing with an aging
population. One of the most serious
manifestations is gait instability,
leading to falls and subsequent
complications that can be
debilitating, even fatal.
Boxing therapy (BT) uses gait
and balance exercises to improve
ambulation in people with PD,
though its efficacy has not yet been
fully proven.
In the current longitudinal
observational study, 98 participants
with idiopathic PD underwent
twice-weekly BT sessions. Primary
outcome was self-reported falls per
month; secondary outcomes were
quantitative and semi-quantitative
gait and balance performance
evaluations.
Twice per week, each participant
worked with their trainer on specific
boxing-related exercises aimed
at improving overall coordination,
gait, and balance. The program
consists of hundreds of exercises/
skill sets, broken down into three
main phases. At the beginning of
each month, including before the
very first session, each participant
was asked to estimate how many
falls they had experienced the prior
month.
The average number of self-reported
falls per month per participant
decreased by 87%, during BT.
During the lockdown imposed by
COVID-19, this increased per month.
Females and those > 65 years old
reported the greatest increase in
falls during the lockdown period.
Post-lockdown resumption of BT
resulted in another decline in falls.
Quantitative performance metrics,
including standing from a seated
position and standing on one leg,
largely mirrored the pattern of falls
pre-and post-lockdown; concluding
that BT may be an effective option
for many PD patients.
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