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Head Pre-Cooling Improves Symptoms of Heat-Sensitive Multiple Sclerosis Patients

Published online by Cambridge University Press:  02 December 2014

Luke F. Reynolds ,
Christine A. Short ,
David A. Westwood  and
Stephen S. Cheung
Luke F. Reynolds
Affiliation:
School of Health and Human Performance, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia
Christine A. Short
Affiliation:
Department of Physical Medicine and Rehabilitation, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia
David A. Westwood
Affiliation:
School of Health and Human Performance, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia
Stephen S. Cheung*
Affiliation:
School of Health and Human Performance, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia Department of Physical Education and Kinesiology, Brock University, St. Catharines, Ontario, Canada
*
Department of Physical Education and Kinesiology, Brock University, 500 Glenridge Avenue, St. Catharines, Ontario, L2S 3A1, Canada
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Abstract:

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Background:

Damage to the central nervous system by Multiple Sclerosis (MS) leads to multiple symptoms, including weakness, ambulatory dysfunction, visual disturbances and fatigue. Heat can exacerbate the symptoms of MS whereas cooling can provide symptomatic relief. Since the head and neck areas are particularly sensitive to cold and cooling interventions, we investigated the effects of cooling the head and neck for 60 minutes on the symptoms of MS.

Methods:

We used a double blinded, placebo controlled, cross-over study design to evaluate the effects of head and neck cooling on six heat-sensitive, stable, ambulatory females with MS (Extended Disability Status Scale 2.5-6.5). To isolate the effects of perceived versus physiological cooling, a sham cooling condition was incorporated, where subjects perceived the sensation of being cooled without any actual physiological cooling. Participants visited the clinic three times for 60 minutes of true, sham, or no cooling using a custom head and neck cooling hood, followed by evaluation of ambulation, visual acuity, and muscle strength. Rectal and skin temperature, heart rate, and thermal sensation were measured throughout cooling and testing.

Results:

Both the true and sham cooling elicited significant sensations of thermal cooling, but only the true cooling condition decreased core temperature by 0.37°C (36.97±0.21 to 36.60±0.23°C). True cooling improved performance in the six minute walk test and the timed up-and-go test but not visual acuity or hand grip strength.

Conclusions:

Head and neck cooling may be an effective tool in increasing ambulatory capacity in individuals with MS and heat sensitivity.

Résumé:

Résumé:Contexte:

Le dommage au système nerveux central causé par la sclérose en plaques (SP) est responsable d'une multitude de symptômes dont de la faiblesse, une dysfonction ambulatoire, des troubles visuels et de la fatigue. La chaleur peut exacerber les symptômes de SP alors que le refroidissement peut en améliorer les symptômes. Comme la région de la tête et du cou sont particulièrement sensibles au froid et aux interventions refroidissantes, nous avons étudié les effets d'un refroidissement de 60 minutes de la tête et du cou sur les symptômes de la SP.

Méthodes:

Nous avons utilisé un plan d'étude à double insu, contrôlé par placebo et avec permutation, pour évaluer les effets d'un refroidissement de la tête et du cou chez six femmes atteintes de SP (EDSS 2,5 à 6,5) sensibles à la chaleur, capables de marcher et dont l'état était stable. Nous avons créé une situation de refroidissement factice pendant laquelle les sujets percevaient la sensation de refroidissement sans qu'il y ait de refroidissement physiologique réel afin d'isoler les effets d'un refroidissement perçu par rapport à un refroidissement réel. L'étude comportait 3 visites de 60 minutes à la clinique pendant lesquelles un refroidissement réel, factice ou aucun refroidissement n'était appliqué au moyen du port d'un capuchon refroidissant personnalisé de la tête et du cou, suivi par une évaluation de la marche, de l'acuité visuelle et de la force musculaire. La température rectale et cutanée, le rythme cardiaque et la sensation thermique étaient mesurés pendant toute la durée du refroidissement et de l'évaluation.

Résultats:

Le refroidissement réel et le refroidissement factice ont provoqué des sensations significatives de refroidissement, mais seul le refroidissement réel a diminué la température centrale de 0,37°C (36,97 ± 0,21 à 36,60 ± 0,23°C). Le refroidissement réel a amélioré l'exécution du test de la marche de 6 minutes et du test minuté up-and-go, mais pas l'acuité visuelle ou la force de préhension de la main.

Conclusions:

Le refroidissement de la tête et du cou peut être un outil efficace pour augmenter la capacité ambulatoire chez les patients atteints de SP qui sont sensibles à la chaleur.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 1 , January 2011 , pp. 106 - 111
Copyright
Copyright © Canadian Neurological Sciences Federation 2011

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