Abstract
Short-arm human centrifugation (SAHC) is proposed as a robust countermeasure to treat deconditioning and prevent progressive disability in a case of secondary progressive multiple sclerosis. Based on long-term physiological knowledge derived from space medicine and missions, artificial gravity training seems to be a promising physical rehabilitation approach toward the prevention of musculoskeletal decrement due to confinement and inactivity. So, the present study proposes a novel infrastructure based on SAHC to investigate the hypothesis that artificial gravity ameliorates the degree of disability. The patient was submitted to a 4-week training programme including three weekly sessions of 30 min of intermittent centrifugation at 1.5–2 g. During sessions, cardiovascular, muscle oxygen saturation (SmO2) and electroencephalographic (EEG) responses were monitored, whereas neurological and physical performance tests were carried out before and after the intervention. Cardiovascular parameters improved in a way reminiscent of adaptations to aerobic exercise. SmO2 decreased during sessions concomitant with increased g load, and, as training progressed, SmO2 of the suffering limb dropped, both effects suggesting increased oxygen use, similar to that seen during hard exercise. EEG showed increased slow and decreased fast brain waves, with brain reorganization/plasticity evidenced through functional connectivity alterations. Multiple-sclerosis-related disability and balance capacity also improved. Overall, this study provides novel evidence supporting SAHC as a promising therapeutic strategy in multiple sclerosis, based on mechanical loading, thereby setting the basis for future randomized controlled trials.
Highlights
Multiple sclerosis (MS) is a multifactorial and often disabling disease of the central nervous system, frequently with unpredictable progression, due to inflammation-induced demyelination and axonal damage [1], leading to inactivity, deconditioning and physical disability [2]
Based on the outcomes of the present case study, we propose a rehabilitation intervention strategy on a Short-arm human centrifugation (SAHC) device suitable to counter deconditioning, which may play a crucial role in changing the course of the disease
Since the intervention evaluation was performed three times, we focused on those cortical regions whose energy of rhythmic activity followed either a linear increase or a linear decrease pattern
Summary
Multiple sclerosis (MS) is a multifactorial and often disabling disease of the central nervous system, frequently with unpredictable progression, due to inflammation-induced demyelination and axonal damage [1], leading to inactivity, deconditioning and physical disability [2]. By acting on the immune system that is dysregulated in multiple sclerosis, those medications partially control central nervous system inflammation, preventing the occurrence of relapses and new inflammatory lesions. They focus on slowing the disease progression and alleviating the symptoms, steering the researchers’ attention toward neuroprotective and repairpromoting strategies [3] like exercise [4]. Alternative exercise training strategies, capable of better managing physical disability, emerge as a need
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