HEAT related FATIGUE in Multiple Sclerosis
B
Temperature Sensitivity, such that a rise in temperature of as little as
0.5°C above normal, will cause Conduction failure in some Axons.
It is this Fiber Fatigue that accounts for the problem many MSers have,
in walking more than short distances, or extended physical activity, and
causes heat sensitivity.
When Fiber Fatigue occurs and Axons stop conducting, the legs simply
will not move, until the Axons are rested enough and begin conducting
again.
Nerve Fiber Fatigue is worst during the early stages of recovery, from
an attack.
You may only be able to make a particular movement once or twice
initially; but over the next several days, you will be able to repeat
the movement more and more often, often returning to near normal
function but some MSers are left with
Permanent Loss of Function.
Fiber Fatigue is often physically limiting and is markedly influenced by
body core temperature; a cool environment may help, particularly during
physical activity.
Studies show that individuals can exercise longer with appropriate
cooling, most find a cold swim enables better functioning for hours.
It lowers the core temperature and causes cooling and VasoConstriction
in the extremities, which serve as heat sinks, keeping your body
temperature lower for some time.
Bren's Multiple Sclerosis Forum-
http://pub57.ezboard.com/bbrensfriendlymultiplesclerosisforum
I am a part of the Cool Suit program below, out of Little Rock, Ark.
that was originally started in Hot Springs, Ark. but is now based in
Little Rock.
NASA SPACE AGENCY AND MSAA
It is commonly accepted that heat sensitive Multiple Sclerosis patients
(HSMS) are impaired by warm environments and exercise. Typical acute
physiologic, motor, and self-perceived hyperthermic stress among these
HSMS include:
1) worsening of existing neurologic signs and symptoms,
2) the development of new signs and symptoms, and
3) lassitude and increased fatigue.
These HSMS patients often improve after the ambient environmental
temperature decreases or upon lowering of their body temperature.
Anecdotal evidence suggests that artificially cooling HSMS can improve
their physical strength, endurance, motor control (balance) and
self-perceived energy and exertion.
Several methods are currently employed in thermal conditioning and
cooling of MS patients. These include hypothermic rooms, administration
of ice baths, cold pool therapy, ingestion of cold fluids, and personal
cooling systems. Many of the personal cooling systems currently being
used by MS patients are based upon the liquid cooling garment technology
developed by NASA for aerospace environments.
On May 23, 1994 the National Aeronautics and Space Administration (NASA)
signed a Memorandum of Understanding (MOU) with the Multiple Sclerosis
Association of America (MSAA) whereby both groups would cooperate in the
application and assessment of NASA's "cool suit" technology for the
benefit of multiple sclerosis patients. Since that time this program has
become a national focal point for many investigators involved in basic
and clinical research of MS. The MOU was extended in June 1997, and
Lockheed Martin became a contributing commercial partner.
MSAA Advances Cooling Therapy
In early 1992, MSAA embarked on a pioneering mission to fund
scientific research on the clinical effects of cooling and multiple
sclerosis. The MSAA funded several clinical research studies on cooling
and MS. These studies were conducted at clinics across the nation,
including UCLA Medical Center, National Rehabilitation Hospital,
Fairview Medical Center, and the University of Washington Medical Center
in Seattle.
Summary of Clinical Studies on Cooling and MS
In recent years, there has been renewed interest in cooling as
a symptomatic therapy for MS. This is due in part to the availability of
liquid cooled garments and advances in evaluation techniques. The
following research studies and summary quotes are some examples of the
many clinical trials that have involved cooling.
Effect of Cooling on Physical Performance in Multiple Sclerosis Dr.
George Kraft, P. I.: and Alan Alquist, Research Scientist, University of
Washington MS Clinical & Research Center, Seattle, WA Completed: Spring,
1996.
Summary Quote "Subjectively and objectively, we noticed remarkable
gains in Heat Sensitive MS (person's) ability to perform repetitive
activities. We believe this may be an important finding for MS patients
for it is repetitive motor tasks that elicit extreme local and central
fatigue in MS patients." Enhancement of cognitive processing by
multiple sclerosis patients using liquid cooling technology: A case
study L. D. Montgomery, R. W. Montgomery, Y. E. Ku, Lockheed Martin
Engineering & Sciences Company, NASA Ames Research Center, Moffett
Field, CA Completed: 1997
Summary Quote "This case study indicates that 'cooling therapy' may
be used to temporarily improve the cognitive processing of MS
patients."Temporary Improvement of Motor Function in Patients with
Multiple Sclerosis after Treatment with a Cooling Suit Jergen Kinnman,
MD, PhD, Ulf Anderson, MD, PhD, Ylva Kinnman, MD, and Lil Wetterqvist,
Department of Neurology, L(nssjukhuset,
Halmstead, Sweden, J Neuro Rehab 1997;11:109-114
Summary Quote
"After cooling, ten out of fourteen ambulatory patients and all six
wheelchair patients were improved in at least one motor test."
Apart from these studies, there is a notable collection of
data by the Institute for Neurology and Neuroscience
Research, Hot Springs, AR, which has followed persons with MS using cool
suits for up to five years. In some of these cases, persons have shown a
significant increase in various motor functions.
How active cool suits are used
The first step to safe cooling is establishing a baseline
temperature. This is an average of temperatures over at least seven
days. This is important because it is generally considered that a safe
maximum cooling temperature is 2°F from a person's baseline. Next,
choose a room with a stable and moderate room temperature
(70°-75°F). Room temperature plays a vital role in effective
cooling. If the room is too cool, the body will react against the
cooling. If the room is too warm, the cooling suit will be
ineffective.
Active suits are always started at a setting that will produce
less cooling, then the temperature is slowly reduced. Most in-home
cooling sessions last one hour.
They may be repeated with or without physician recommended exercise up
to three times per day (with at least two hours between each session).
These units can also be used with a battery pack, enabling persons who
are heat intolerant to once again enjoy the outdoors.
This system has been evaluated by NASA Ames Research Center in
conjunction with the MSAA, and been found to be the most effective
active unit available to date.
Passive cooling
So far, this booklet has dealt with active cooling systems,
but there is another form of cooling for persons with MS. Passive
cooling means that there is no "active" cooling mechanism, such as a
pump at work. Passive cooling can be accomplished through a simple
transfer of heat by wearing a garment containing a cooling source.
New Technologies
The MSAA is continuing its efforts to hasten the development
of more effective cooling units. MSAA staff are regularly called upon by
manufacturers to provide expert advice and relate client experiences.
The MSAA continues to evaluate the effectiveness of new cooling
equipment, as it becomes available.
MSAA Cooling Program
In keeping with our philosophy of delivering quality client
services and programs to those with MS, the MSAA Cooling Program offers
the free use of active or passive cooling suits to MSAA members, based
on suit availability and program guidelines. Physicians and clinics may
also apply for the free loan of cooling equipment, providing it is used
in free patient care or research programs.
As part of the MSAA's commitment to the scientific evaluation
of cooling therapy, cool suit recipients may be asked to provide
detailed accounts of cool suit usage and resulting symptom conditions.
For more information on this program, call 1-800-LEARN MS. For
more details about cooling therapy and research, call 1-877-677-6884.
============================
Bren
Bren's Friendly Multiple Sclerosis Forum-
http://pub57.ezboard.com/bbrensfriendlymultiplesclerosisforum