Ballroom Dance Improves Heart Rate Variability and Depression in Persons with Multiple Sclerosis

Abstract

Multiple Sclerosis is a neurodegenerative disease of the central nervous system. Symptoms include fatigue, depression, gait disturbances, and cognitive changes, all which affect quality of life (QOL). Heart Rate Variability (HRV), an indication of cardiac autonomic balance, can be altered in persons with Multiple Sclerosis (PwMS) and has been associated with depression and other health risks in other populations. In turn, depression as well as HRV, can be improved with aerobic exercise. The relationships between depression, QOL, and other self-reported measures to HRV in PwMS are largely unknown. We previously showed that ballroom dance (BD) may improve physical fitness, cognition, fatigue, depression and QOL in PwMS. PURPOSE: The purpose of this study was to investigate the relationship of depression with HRV in PwMS and test whether BD can improve HRV concurrent with depression. METHODS: Thirteen PwMS participated in an 8-week BD program (MSD). Twelve PwMS served as a control group (C). BD classes were 1 hour/day, 2x/week and taught by a professional BD instructor. Each MSD subject was paired with a non-MS partner. All subjects were ambulatory, independent to modified independent. Patient Determined Disease Steps (PDDS) did not differ between groups (MSD=2.0(1.9), C=1.4(1.8)). Pre- and post- measures included QOL (PROMIS Global Well Being), Fatigue Impact Scale (FIS), Beck Depression Inventory (BDI), Heart Rate Variability (HRV), and 6-minute walk test (6MWT). Nonparametric and parametric statistics were used with p≤0.05. Data are mean (SD) or md (Q1,Q3) for self-report measures. RESULTS: In both MSD and C groups prior to BD, QOL correlated with FIS (rs = -0.63) and BDI (rs = -0.70). FIS correlated with BDI (rs = 0.72). HRV correlated with QOL (rs= 0.47) and BDI (rs = -0.56) but not with FIS. (rs = -0.32). No variables correlated with 6MWT. For the MSD group, HRV (pre = 31 (19) post = 38 (19) ms, p = 0.03) and 6MWT (pre = 432 (114) post = 462 (126) m, p = 0.03) increased. Of the self-report outcomes, BDI improved (pre= 9 (5,15) post = 4 (0,10), p = 0.04). There were no changes in any measured outcome for the C group. CONCLUSION: BD can lead to significant improvements in HRV and depression. Further, HRV but not 6MWT might mediate improvements in QOL through depression in pwMS. This study was supported by the Greater Milwaukee Foundation.