Benefits of Physical Activity for Depression and Fatigue in Multiple Sclerosis: A Longitudinal Analysis

Samantha Stephens; Shahriar Shams; Joshua Lee; Stephanie A Grover; Giulia Longoni; Tara Berenbaum; Marcia Finlayson; Robert W Motl; E Ann Yeh

doi:10.1016/j.jpeds.2019.01.040

Benefits of Physical Activity for Depression and Fatigue in Multiple Sclerosis: A Longitudinal Analysis

J Pediatr. 2019 Jun:209:226-232.e2. doi: 10.1016/j.jpeds.2019.01.040. Epub 2019 Mar 14.

Authors

Samantha Stephens¹, Shahriar Shams², Joshua Lee³, Stephanie A Grover¹, Giulia Longoni⁴, Tara Berenbaum¹, Marcia Finlayson⁵, Robert W Motl⁶, E Ann Yeh⁷

Affiliations

¹ Division of Neurosciences and Mental Health, SickKids Research Institute, Division Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ Faculty of Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
⁴ Division of Neurosciences and Mental Health, SickKids Research Institute, Division Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada; Faculty of Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
⁵ Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
⁶ Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL.
⁷ Division of Neurosciences and Mental Health, SickKids Research Institute, Division Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada; Faculty of Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. Electronic address: ann.yeh@sickkids.ca.

PMID: 30878208
DOI: 10.1016/j.jpeds.2019.01.040

Abstract

Objectives: To examine the longitudinal relationship between physical activity and fatigue and depression among youth with demyelinating conditions.

Study design: From September 2013 to March 2017, we performed a longitudinal study of consecutive youth diagnosed at their first visit with pediatric onset multiple sclerosis (POMS) or monophasic acquired demyelinating syndromes (mono-ADS) at a neuroinflammatory disorders clinic in a tertiary children's hospital. Fatigue was determined at each visit by the Pediatric Quality of Life Multidimensional Fatigue Scale, depressive symptoms by the Center of Epidemiologic Studies Depression Children Rating Scale, and physical activity level by the Godin Leisure Time Exercise Questionnaire. Mixed linear models were used to examine the associations of moderate-to-vigorous physical activity (MVPA) with fatigue and depression over time, adjusting for age, time from incident demyelination, sex, number of relapses, relapse within 30 days, and disability.

Results: In 182 patients (48 POMS, age 15 ± 1.7 years, 35 female; and 134 mono-ADS, age 12 ± 3.6 years 67 female) with 538 visits (mean follow-up 3.6 ± 2.7 years and 4.2 ± 3.3 years, respectively), a trajectory of increased fatigue over time was observed in POMS (2.28 points/year, P = .008) and mono-ADS (1.33 points/year, P = .007) patients. Youth with POMS had more depressive symptoms (estimate = 11.4 points, P < .002) than mono-ADS. Depressive symptoms increased over time in female patients with POMS (estimate = 1.4 points/year, P < .02). MVPA was associated with lower depression (-0.09, P < .001) and general fatigue (0.13, P = .02) over time in POMS.

Conclusions: Youth with POMS who have higher levels of MVPA demonstrate lesser depressive symptoms and lower fatigue over time. Our results may inform future interventions to manage mood and fatigue in POMS.

Keywords: exercise; multiple sclerosis; pediatric; psychosocial outcomes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Depression / etiology*
Depression / prevention & control*
Exercise*
Fatigue / etiology*
Fatigue / prevention & control*
Female
Humans
Longitudinal Studies
Male
Multiple Sclerosis / complications*