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Multiple Sclerosis: HELP
Articles by Martin Langeskov-Christensen
Based on 6 articles published since 2009
(Why 6 articles?)
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Between 2009 and 2019, M. Langeskov-Christensen wrote the following 6 articles about Multiple Sclerosis.
 
+ Citations + Abstracts
1 Review Potential pathophysiological pathways that can explain the positive effects of exercise on fatigue in multiple sclerosis: A scoping review. 2017

Langeskov-Christensen, Martin / Bisson, Etienne J / Finlayson, Marcia L / Dalgas, Ulrik. ·Section of Sport Science, Department of Public Health, Aarhus University, Aarhus C, Denmark. Electronic address: mach@ph.au.dk. · School of Rehabilitation Therapy, Queen's University, Kingston, Canada. · Section of Sport Science, Department of Public Health, Aarhus University, Aarhus C, Denmark. ·J Neurol Sci · Pubmed #28131211.

ABSTRACT: BACKGROUND: Fatigue is one of the most common and most disabling symptoms of multiple sclerosis (MS). It is a multidimensional and complex symptom with multifaceted origins, involving both central and peripheral fatigue mechanisms. Exercise has proven to be safe for people with MS, with cumulating evidence supporting significant reductions in fatigue. However, the potential pathophysiological pathways that can explain the positive effects of exercise on fatigue in MS remain elusive. OBJECTIVES: The objectives were, in PwMS (1) to update the knowledge on the pathophysiology underlying primary and secondary fatigue, and (2) to discuss potential pathophysiological pathways that can explain the positive effects of exercise on MS fatigue. METHODS: A comprehensive literature search of six databases (PubMed, Embase, Cochrane Library, PEDro, CINAHL and SPORTDiscus) was performed. To be included, the study had to 1) enroll participants with definite MS according to defined criteria, 2) assess explicit pathophysiological mechanisms related to MS fatigue, 3) be available in English, Danish or French, and 4) had undergone peer-review. RESULTS: A total of 234 studies fulfilled the inclusion criteria. Primary MS fatigue mainly originated from a dysfunction of central nervous system neuronal circuits secondary to increased inflammation, reduced glucose metabolism, brain atrophy and diffuse demyelination and axonal lesions. Secondary MS fatigue was linked with sleep disturbances, depression, cognitive impairments, and deconditioning. Cardiovascular, immunologic, neuroendocrine, and neurotrophic changes associated with exercise may alleviate primary MS fatigue while exercise may improve secondary MS fatigue through symptomatic improvement of deconditioning, sleep disorders, and depression. CONCLUSIONS: >30 primary and secondary pathophysiological fatigue pathways were identified underlining the multidimensionality and complexity of MS fatigue. Though the underlying key cellular and molecular cascades still have to be fully elucidated, exercise holds the potential to alleviate MS fatigue, through both primary and secondary fatigue pathways.

2 Review Aerobic capacity in persons with multiple sclerosis: a systematic review and meta-analysis. 2015

Langeskov-Christensen, Martin / Heine, Martin / Kwakkel, Gert / Dalgas, Ulrik. ·Section of Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus C, Denmark, mach@ph.au.dk. ·Sports Med · Pubmed #25739555.

ABSTRACT: BACKGROUND: Aerobic capacity (VO2max) is a strong health and performance predictor and is regarded as a key physiological measure in the healthy population and in persons with multiple sclerosis (PwMS). However, no studies have tried to synthesize the existing knowledge regarding VO2max in PwMS. OBJECTIVES: The objectives of this study were to (1) systematically review the psychometric properties of the VO2max test; (2) systematically review the literature on VO2max compared with healthy populations; (3) summarize correlates of VO2max; and (4) to review and conduct a meta-analysis of longitudinal exercise studies evaluating training-induced effects on VO2max in PwMS. DATA SOURCES AND STUDY SELECTION: A systematic literature search of six databases (PubMed, EMBASE, Cochrane Library, PEDro, CINAHL and SPORTDiscus) was performed. To be included, the study had to (1) enrol participants with definite MS according to defined criteria; (2) assess aerobic capacity (VO2max) by means of a graded exercise test to voluntary exhaustion; (3) had undergone peer review; and (4) be available in English, Danish or Dutch. STUDY APPRAISAL AND SYNTHESIS METHODS: The psychometric properties of the VO2max test in PwMS were reviewed with respect to reliability, validity and responsiveness. Simple Pearson correlation analysis was used to assess the relation between key study characteristics and the reported mean VO2max. The methodological quality of the intervention studies was evaluated using the original 11-item Physiotherapy Evidence Database (PEDro) scale. A random coefficient model was used to summarize individual, weighted, standardized effects of studies that assessed the effects of exercise on aerobic capacity in PwMS. RESULTS: A total of 40 studies, covering 165 healthy controls and 1,137 PwMS, fulfilled the inclusion criteria. VO2max testing in PwMS can be considered a valid measure of aerobic capacity, at least in PwMS having low-to-mild disability, and an ∼10% change between two tests performed on separate days can be considered the smallest reliable change (with 95% certainty) in VO2max in PwMS. The average body-weight-adjusted VO2max was significantly lower in PwMS (25.5 ± 5.2 mL·kg(-1)·min(-1)) compared with healthy controls (30.9 ± 5.4 mL·kg(-1)·min(-1)). The analysis of VO2max correlates revealed associations with a variety of outcomes covering all levels of the International Classification of Functioning, Disability and Health (ICF) model. The meta-analysis showed that aerobic training in PwMS may improve VO2max by as much as 3.5 mL·kg(-1)·min(-1). CONCLUSIONS: A valid and reliable test can be performed, in at least ambulant PwMS, by the gold standard whole-body maximal exercise test. Aerobic capacity in PwMS is impaired compared with healthy people, and is significantly associated with factors on all levels of the ICF model, including disease severity. Aerobic training can improve aerobic capacity in PwMS to a degree that is associated with secondary health benefits.

3 Article Is the impact of fatigue related to walking capacity and perceived ability in persons with multiple sclerosis? A multicenter study. 2018

Dalgas, U / Langeskov-Christensen, M / Skjerbæk, A / Jensen, E / Baert, I / Romberg, A / Santoyo Medina, C / Gebara, B / Maertens de Noordhout, B / Knuts, K / Béthoux, F / Rasova, K / Severijns, D / Bibby, B M / Kalron, A / Norman, B / Van Geel, F / Wens, I / Feys, P. ·Section of Sport Science, Dep. of Public Health, Aarhus University, Denmark. Electronic address: dalgas@ph.au.dk. · Section of Sport Science, Dep. of Public Health, Aarhus University, Denmark. · The Danish MS Hospitals in Ry and Haslev, Denmark. · REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences,Hasselt University, Diepenbeek, Belgium. · Masku Neurological Rehabilitation Center, Masku, Finland. · Hospital de Dia de Barcelona CEMCat, Spain or MS Center of Catalonia (Cemcat), Vall Hebron University Hospital, Universitat Autònoma de Barcelona, Spain. · National MS Center, Melsbroek, Belgium. · Center Neurologique et de Réadaptation Fonctionelle, Fraiture-en-Condroz, Belgium. · Rehabilitation and MS Center Overpelt, Belgium. · The Mellen Center for Multiple Sclerosis Treatment and Research, The Cleveland Clinic, Cleveland, OH, USA. · Department of Rehabilitation, Third Faculty of Medicine, Charles University, Czech Republic. · Section of Biostatistics, Department of Public Health, Aarhus University, Denmark. · Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. · Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Physiotherapy, Nordland Hospital Trust, Bodø, Norway. ·J Neurol Sci · Pubmed #29571860.

ABSTRACT: BACKGROUND: The relationship between fatigue impact and walking capacity and perceived ability in patients with multiple sclerosis (MS) is inconclusive in the existing literature. A better understanding might guide new treatment avenues for fatigue and/or walking capacity in patients with MS. OBJECTIVE: To investigate the relationship between the subjective impact of fatigue and objective walking capacity as well as subjective walking ability in MS patients. METHODS: A cross-sectional multicenter study design was applied. Ambulatory MS patients (n = 189, age: 47.6 ± 10.5 years; gender: 115/74 women/men; Expanded Disability Status Scale (EDSS): 4.1 ± 1.8 [range: 0-6.5]) were tested at 11 sites. Objective tests of walking capacity included short walking tests (Timed 25-Foot Walk (T25FW), 10-Metre Walk Test (10mWT) at usual and fastest speed and the timed up and go (TUG)), and long walking tests (2- and 6-Minute Walk Tests (MWT). Subjective walking ability was tested applying the Multiple Sclerosis Walking Scale-12 (MSWS-12). Fatigue impact was measured by the self-reported modified fatigue impact scale (MFIS) consisting of a total score (MFIS RESULTS: MFIS CONCLUSIONS: The physical impact of fatigue is weakly related to objective walking capacity, while general, physical, cognitive and psychosocial fatigue impact are weakly to moderately related to subjective walking ability, when analysed in a large heterogeneous sample of MS patients.

4 Article Can aerobic exercise alleviate flu-like symptoms following interferon beta-1a injections in patients with multiple sclerosis? 2016

Langeskov-Christensen, Martin / Kjølhede, Tue / Stenager, Egon / Jensen, Henrik Boye / Dalgas, Ulrik. ·Department of Public Health, Section for Sport Science, Aarhus University, Aarhus, Denmark. Electronic address: mach@ph.au.dk. · Department of Public Health, Section for Sport Science, Aarhus University, Aarhus, Denmark. · MS-Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Department of Neurology, Hospital of Southern Denmark, Sønderborg, Denmark. · MS-Clinic of Southern Jutland (Sønderborg, Vejle, Esbjerg), Department of Neurology, Hospital of Southern Denmark, Sønderborg, Denmark; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark. ·J Neurol Sci · Pubmed #27206886.

ABSTRACT: BACKGROUND: Flu-like symptoms (FLS) are common side effects of interferon beta (IFNß) treatment, and may affect the willingness to initiate therapy, the long-term acceptability, and the adherence to the treatment. Case reports suggest that aerobic exercise is able to markedly reduce FLS following IFNß-1a injections in persons with multiple sclerosis (PwMS). OBJECTIVE: To test the hypothesis that aerobic exercise can alleviate FLS following IFNß-1a injections in PwMS, and secondarily to examine whether or not fluctuations in circulating cytokines provide a mechanism that can explain a potential positive effect. METHODS: Seventeen PwMS who frequently experience FLS following IFNß-1a injections completed four days of testing. On two of the testing days they completed 35min of aerobic exercise on a bicycle-ergometer following IFNß-1a injection. On the two other testing days, no intervention took place following the injection. FLS were assessed pre-injection and 3h, 5h, 12h and 24h post-injection. Blood samples were taken pre-injection and 1h and 3h post-injection to determine levels of circulating interleukin 6 and 17 and IFNγ. The primary study endpoint was the comparison of the change in FLS severity from pre-injection to 5h post-injection between days with injection alone and days with injection followed by aerobic exercise. RESULTS: FLS severity change was significantly lower on days with exercise compared to days with rest. IL6 was significantly increased 3h following IFNß-1a injection and exercise compared to 1h post and pre and when compared to the resting condition. Participants reported no adverse events in addition to FLS during the study period. CONCLUSION: Data from this study suggest that moderate intensity aerobic exercise following IFNß-1a injections is safe and can alleviate the FLS severity in PwMS. Based on these results, 35min of aerobic exercise should be encouraged for PwMS who often experience FLS following IFNß-1a injections.

5 Article Cardiopulmonary fitness is related to disease severity in multiple sclerosis. 2016

Heine, Martin / Wens, Inez / Langeskov-Christensen, Martin / Verschuren, Olaf / Eijnde, Bert O / Kwakkel, Gert / Dalgas, Ulrik. ·Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands m.heine@dehoogstraat.nl. · Rehabilitation Research Center (REVAL), Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium. · Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark. · Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands. · Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Neurorehabilitation, Centre of Rehabilitation and Rheumatology READE, Amsterdam, The Netherlands. ·Mult Scler · Pubmed #26014607.

ABSTRACT: BACKGROUND: In persons with MS (pwMS), a lower cardiopulmonary fitness has been associated with a higher risk for secondary disorders, decreased functional capacity, symptom worsening and reduced health-related quality of life. OBJECTIVE: To investigate the association between disease severity and cardiopulmonary fitness. METHODS: Data from cardiopulmonary exercise tests, previously conducted in three different countries, were pooled. The association between disease severity (Expanded Disability Status Scale (EDSS)) and cardiopulmonary fitness (peak oxygen uptake (VO2peak)) was adjusted for age, sex and the country of origin. RESULTS: The combined sample comprised 116 ambulant pwMS having a mean (± SD) EDSS score of 2.7 ± 1.3. There was a significant correlation (r = -0.418, p < .01) between VO2peak and EDSS. A multiple regression model (R(2) = 0.520, p < .01) was constructed to describe VO2peak (mL∙kg(-1)∙min(-1)); VO2peak = 36.622 - 5.433 (Sex (1=men)) - 0.124 (Age) - 2.082 (EDSS) + 2.737 (Belgium) + 8.674 (Denmark). CONCLUSION: There was a significant association between disease severity and cardiopulmonary fitness. The close relation between cardiopulmonary fitness and chronic conditions associated with physical inactivity, suggest a progressive increase in risk of secondary health conditions in pwMS.

6 Article Validity and reliability of VO₂-max measurements in persons with multiple sclerosis. 2014

Langeskov-Christensen, Martin / Langeskov-Christensen, Daniel / Overgaard, Kristian / Møller, Andreas Buch / Dalgas, Ulrik. ·Department of Public Health, Section of Sport Science, Aarhus University, Dalgas Avenue 4, DK-8000 Aarhus C, Denmark. Electronic address: mach@adm.au.dk. · Department of Public Health, Section of Sport Science, Aarhus University, Dalgas Avenue 4, DK-8000 Aarhus C, Denmark. · Department of Clinical Medicine, Research Laboratory for Biochemical Pathology, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark. ·J Neurol Sci · Pubmed #24825731.

ABSTRACT: BACKGROUND: Direct measurement of whole body maximal oxygen consumption (VO2-max test) is considered the gold standard when assessing cardiorespiratory fitness. Nonetheless, the validity and reliability of the test have not been examined in persons with multiple sclerosis (PwMS). OBJECTIVE: To investigate the validity and reliability of VO2-max measurements in PwMS, and additionally to compare these measures to those of healthy controls. METHODS: Twenty PwMS completed two incremental VO2-max tests on a leg cycling ergometer. Test validity was analyzed based on the first VO2-max test in the total sample and in patient subgroups based on Expanded Disability Status Scale (EDSS) scores (EDSS≤2.5, n=10 and EDSS≥3.0, n=10) by evaluation of the primary VO2 plateau criterion and four common secondary validity criteria. Data from 20 age- and gender-matched healthy controls were used for comparison. The second VO2-max test was used to establish day-to-day reliability. RESULTS: In PwMS 40% were able to achieve the primary validity criterion for VO2-max measurements, while 65-95% were able to achieve the secondary criteria. This corresponded to the age-matched healthy controls. Strong correlations were found between measurements of VO2-max and between the validity criteria from test 1 compared to test 2 in PwMS. MS disability level did not influence criteria attainment. The variability analysis exhibited a 95% prediction interval of -238 to 201 mL·min(-1) (-9.8 to 8.1%) for the difference between the two measurements of VO2-max. CONCLUSION: In mild to moderately impaired PwMS less than half achieve the primary validity criterion when performing a VO2-max test, but the high reliability and the better achievement of the secondary criteria implies that a valid test of VO2-max can be performed, at a level corresponding to that of healthy controls. The day-to-day variation implies that a change of more than 10% in VO2-max is required to be interpreted as a real change.