Physical Activity and Exercise in People with Multiple Sclerosis and Generalized Anxiety Disorder

Clinical anxiety symptoms are prevalent, yet poorly managed in multiple sclerosis (MS), a neuroinflammatory disease of the central nervous system. Anxiety disorders occur in 22% of people with MS, and anxiety is associated with poorer outcomes across clinical and quality of life domains. GAD is the most prevalent anxiety disorder in MS (18.6%). Currently, there are no established evidence-based treatment guidelines for anxiety in MS and GAD. The evidence of efficacy of treatments used in the general population (pharmacotherapy and psychotherapy) is limited in people with MS and GAD. Physical activity and exercise training are promising novel treatment options for anxiety in MS and GAD based on the wealth of evidence from the general population with GAD. This dissertation presents three studies that aimed to provide foundational understanding for development of physical activity and exercise training interventions to manage anxiety in MS and GAD. First study reviewed the available literature on anxiety in MS, focusing on the predictors, outcomes, and current treatments of anxiety in MS. The review also presented the case for exercise training as treatment of anxiety in MS, particularly in people with MS and GAD. The second study examined the effects of an acute bout of moderate-intensity walking exercise on state anxiety and mood in people with MS prescreened for GAD. This randomized, counter-balanced, crossover experimental study reported significant, large reductions in state anxiety and improvements in mood following the exercise bout, but not the control condition. The third study examined the physical activity rates, and the association between physical activity and anxiety symptoms, among women with MS and GAD, compared to women with MS without GAD. The final study reported no significant differences in physical activity rates between the GAD groups, and no significant associations between overall physical activity and anxiety symptoms in women with MS and GAD. Overall, the results of the three studies indicate that there is a need for better treatment of anxiety and GAD in MS, and that physical activity, particularly moderate-intensity walking exercise, may be an effective approach for reducing anxiety in MS and GAD.

Author dc:creator

• Petra Silic (24399509)

• Exercise science

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.32993948.v1

OAI identifier oai:identifier

oai:figshare.com:article/32993948