Falls are a serious concern for patients with multiple sclerosis (MS), an autoimmune disease of the central nervous system, in which the body’s immune system attacks the protective covering or sheath surrounding nerve fibers. The risk for serious head and extremity injuries can increase with the duration of the disease.
As disruption of balance is both a common and debilitating symptom of MS, initiatives to reduce the incidence of falls would be welcomed by patients and medical providers.
In fact, some medications that MS patients take actually can make balance worse, with no current MS medications actually helping to maintain or prevent worsening of balance. One technique, physical rehabilitation, using exercises that promote balance, has been suggested as a way to improve balance in these patients.
According to new study published online in the Journal, Radiology, a balance board accessory for a popular Nintendovideo game console–when used as part of a physical rehabilitation program–can help persons with MS reduce their risk of falls.
“Wii Balance Board” Nintendo Wii Fit (Photo credit: Wikipedia)
Magnetic resonance imaging (MRI) scans in the study demonstrated that use of the Nintendo Wii Balance Board system led to growth and development of brain connections that are linked to both movement and balance.
Since physical rehabilitation is typically recommended to improve and preserve balance, the Wii Balance Board System, a battery-powered device about the size and shape of a bathroom scale, has been suggested as a way to improve balance in patients with MS.
Users of the Wii stand on a specialized board and shift their weight as they follow the action on a television screen during games including tennis, snowboarding or skiing. Wii balance board rehabilitation has been seen as beneficial in patients with MS, but little data is available regarding the physiological explanation for improvements in balance.
In the study, investigators evaluated changes in the brains of 27 MS patients who took part in a 12-week intervention using Wii balance board-based visual feedback training by using a specialized MRI technique called diffusion tensor imaging (DTI). DTI is a specialized MRI technique that provides data regarding white matter tracts. These tracts help to conduct neurologic signals through the brain and body.
MRI scans in the MS patients in the study demonstrated significant growth of nerve tracts which are integral in movement as well as balance. It turns out that the changes seen on MRI correlated with improvements in balance as measured by an assessment technique called posturography.
These brain changes in MS patients are likely a manifestation of neural plasticity, or the ability of the brain to adapt and form new connections throughout life, said lead author Luca Prosperini, M.D., Ph.D., from Sapienza University in Rome, Italy. ”The most important finding in this study is that a task-oriented and repetitive training aimed at managing a specific symptom is highly effective and induces brain plasticity.”
“More specifically, the improvements promoted by the Wii balance board can reduce the risk of accidental falls in patients with MS, thereby reducing the risk of fall-related comorbidities like trauma and fractures,” added Prosperini.
Although the specific mechanism contributing to this process are still not clear, Prosperini explains that similar “plasticity” has been identified in those playing video games.
He believes that the changes may be related to myelination, whereby a protective covering is generated surrounding the nerves. It is important to know that the Wii- associated improvements did not persist after the patients stopped using the protocol. One explanation, according to Prosperini, is that continuous training is necessary in order to promote ongoing and lasting changes in the brain.
“This finding should have an important impact on the rehabilitation process of patients, suggesting that they need ongoing exercises to maintain good performance in daily living activities,” said Prosperini.
Landmark study funded by National Institute of Health yields dramatic results
By Miriam Raftery
August 26, 2014 (San Diego’s East County)--Arguments in favor of medical marijuana just got a big shot in the arm.
A new study in the prestigious Journal of Internal Medicine, which is published by the Journal of the American Medical Association, has found that in 13 states where medical marijuana is legal, fatal overdoses from prescription pain medications dropped dramatically.
Overall, opioid overdose deaths dropped nearly 20% in the first year after a state legalized medical marijuana, rising to 33.7 percent – a full third—five years after legalization. Overall, death from opioid overdose fell 25% across the 13 states when patients had access to medical cannabis.
About 60 percent of all deaths from opioid overdoses nationwide occur in patients with legitimate prescriptions. Moreover, the number of patients who are prescribed opioids for non-cancer pain has nearly doubled over the last decade—and deaths from prescription pain killers rose 118% from 1999 to 2011, according to the Centers for Disease Control. Every day, 113 people in the U.S. die of these overdoses and 6,700 land in emergency rooms—so reducing overdoses has the potential to save not only lives, but money as wlel.
The researchers at some of America’s top medical institutions now conclude that medical marijuana appears far safer than opioid prescription pain killers, such as oxycontin and vicodin.
The lead author, Dr. Marcus A. Bachhuber, MD at the Robert Wood Johnson Foundation Clinical Scholar at the University of Pennsylvania’s Penn Center and the Philadelphia VA Medical Center said the study suggests that people taking prescription opiods may also find that they can supplement with medical marijuana and be able to lower their painkiller dose, thus lowering their risk of overdose.”
The National Institute for Health supported this study, along with other prominent health institutions participating, including the John Hopkins Bloomberg School of Public Health, Perelman School of Medicine, Albert Einstein College of Medicine and Center for Aids Research .
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