Stability of Mental Toughness, Sleep Disturbances, and Physical Activity in Patients With Multiple Sclerosis (MS)-A Longitudinal and Pilot Study.

Dena Sadeghi Bahmani,Juerg Kesselring,Markus Gerber,Vahid Shaygannejad,Serge Brand,Undine E Lang,Leila Esmaeili,Edith Holsboer-Trachsler

doi:10.3389/fpsyt.2018.00182

Abstract

Background: Previous research of patients with multiple sclerosis (MS) focused prevalently on fatigue, depression, and cognitive dysfunction during the clinical course. By contrast, research on the longer-term characteristics of physical activity (PA), psychological functioning, and sleep problems is scarce. The aims of the present study were therefore to examine changes in PA, mental toughness (MT) as a proxy of psychological functioning, and sleep disturbances over a 2-year period of time after disease onset.Methods: A total of 18 patients with diagnosed MS (mean age: M = 34.29 years) took part in this longitudinal study. First, 1–4 weeks after the first symptoms, a neurologist diagnosed the MS. Second, they completed a series of questionnaires covering socio-demographic data, PA, MT, and sleep disturbances. Third, the same questionnaires were completed again 2 years later (follow-up). Last, a neurologist assessed the degree of disability with the Expanded Disability Status Scale (EDSS).Results: Two years after MS onset, patients had lower levels of vigorous PA, but no statistically significant changes in moderate PA were observed. Further, walking time increased and sedentary time decreased. Patients with sleep disturbances at disease onset also reported poor sleep 2 years later. MT scores remained stable over time. EDSS scores worsened, though, change in EDSS was not associated with PA, MT, or sleep.Conclusions: Two years after disease onset, patients with MS reported similar MT levels and sleep disturbances. PA shifted from vigorous PA toward walking and a less sedentary lifestyle, while moderate PA remained unchanged. The pattern of results of the present pilot study suggests that at the early stage of the MS course, there is no obstacle for being physically active, nor did sleep and MT as a proxy of psychological functioning decrease in a substantial way.

Highlights

Multiple sclerosis (MS) is an autoimmune, chronic, inflammatory, and demyelinating neurodegenerative disease [1,2,3], and as with all neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, or Huntington’s disease, physical and psychological functioning are at high risk to be impaired
With regard to mental toughness, a significant decrease was observed in the Commitment dimension and a descriptive increase was observed in Confidence Interpersonal
The present pattern of the results expands upon previous research in that we showed that physical activity (PA), mental toughness (MT), and sleep remained stable over 2 years after disease onset

Summary

Introduction

Multiple sclerosis (MS) is an autoimmune, chronic, inflammatory, and demyelinating neurodegenerative disease [1,2,3], and as with all neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, or Huntington’s disease, physical and psychological functioning are at high risk to be impaired. Patients with MS often report sleep disturbances [9,10,11,12], fatigue [13,14,15], and paraesthesia [1, 3], all of which may contribute to decreased quality of life Patients, their relatives, and their health care providers are interested in knowing more about the outlook of PA, psychological functioning and sleep as observable and detectable signals of quality of life. In the present study, we focused on the question how PA, mental toughness as a proxy of psychological functioning and sleep developed over time from disease onset until 2 years later. The aims of the present study were to examine changes in PA, mental toughness (MT) as a proxy of psychological functioning, and sleep disturbances over a 2-year period of time after disease onset

Objectives

Methods

Results

Discussion

Conclusion