Full Title: Physical Activity, Quality of Life, and Disease Outcomes in Youth with Multiple Sclerosis: The Atomic (Active Teens Multiple Sclerosis) Physical Activity Research Program

Increased physical activity (PA) has the potential to improve brain tissue integrity, mental health outcomes, and quality of life in youth with multiple sclerosis (MS). We have demonstrated associations between lower levels of PA and higher levels of depressive symptoms and fatigue in these youth over time. Furthermore, we have demonstrated an association between higher levels of PA and lower levels of disease activity in youth with MS. Finally, extensive work in adults with MS supports the role of PA in reducing disease activity and symptoms, resulting in improved quality of life in adults with MS. Importantly, our preliminary work shows that youth with MS have very low levels of PA. Increasing PA, therefore, has the potential to have both disease-modifying and psychosocial benefits in youth with MS. Other research has shown that group-based exercise classes while increasing PA at the time of the intervention, do not lead to sustained increases in levels of everyday living PA. Any intervention oriented towards sustained increases in PA must address barriers and facilitators to behaviour change.

We have developed a user-driven app to address these issues: through it, we will be able to deliver MS-specific PA information via a mobile app platform, overcoming the barriers of patient engagement and distance. We propose to test the feasibility of implementing a mobile app-based physical activity intervention in youth with MS and to examine the extent to which the intervention can change physical activity levels in this population. Secondary and exploratory outcomes will be to evaluate improvement in regional brain volumes, mood, and quality of life in youth with MS.

For more information and participation, please contact Hareem Ilyas.

Full Title: Disrupting lives: Social networks and mental health among children and adolescents with chronic illness in the age of the COVID-19 pandemic -- a collaboration of the Mental Health Strategy for COVID team

This research study is being done to understand the relationship of health equity and social networks to mental health outcomes and behaviours in children and adolescents with a neuroinflammatory condition during the COVID-19 pandemic. We hope to find out the effects of COVID-19-related societal changes on health behaviours and mental health outcomes in children and adolescents with neuroinflammatory conditions.

For more information and participation, please contact Mina Ly.

Image by Gerd Altmann from Pixabay


Physical Activity, Depression, and Fatigue in Paediatric MS

Full Title: Benefits of Moderate- to Vigorous Physical Activity on Depression and Fatigue in Pediatric MS

Cross-sectional studies have demonstrated an association between higher levels of moderate to vigorous physical activity (MVPA) and less fatigue and depression among children with multiple sclerosis (MS) and monophasic demyelinating disorders (mono-ADS). While inferences of causality are not possible with cross-sectional studies, time-varying relationships can be examined with longitudinal studies.

The objectives of this study are to examine the relationship between MVPA and symptoms of fatigue and depression among youth with demyelinating conditions over time. Standardized fatigue, depression, and MVPA questionnaires are collected at each visit from youth with MS and mono-ADS attending a Neuroinflammatory Clinic (2013-2017). The associations of MVPA with fatigue and depression will be examined over time, controlling for age and time from disease onset, sex, relapse rate, depression, and disability. Read our publication

Sleep, Physical Activity and MS Symptoms in Paediatric MS

Full Title: Sleep, Physical Activity and MS Symptoms in Paediatric MS

Most youth with multiple sclerosis (MS) experience symptoms such as depression and fatigue. In addition, cognitive issues, especially with attention and memory occur frequently. However, little is known about interventions that might work to improve these symptoms. In other work, we have shown that higher levels of physical activity are associated with lower levels of depression and fatigue. Others have shown that sleep may reduce fatigue and depression while improving attention and memory in the adult MS population and other pediatric populations. Importantly, sleep problems are frequently encountered in youth with MS and were seen in 60% of surveyed youth with MS in our preliminary work. Whether sleep plays an important role in symptoms in youth with MS, and the relationship between sleep and physical activity in youth with MS is unknown and may differ from the relationship seen in otherwise healthy individuals due to consequences of the disease process. Describing and identifying problems and disturbances with sleep, and examining their relationship to physical activity and MS-related symptoms is the first step towards developing effective interventions for these problems.

Our preliminary findings suggest that sleep problems occur in over half of youth with MS. However, it is not clear how these sleep problems might affect these youth. Furthermore, there has been no research to date using objective measures to document the rate of sleep problems in this population. Modifying sleep habits may also have an effect on physical activity levels in these youth. Finding ways to increase physical activity levels is important, as we have shown that increased physical activity is related to improved disease symptom status. This research will address these issues. Our goal is to understand sleep problems in youth with MS. We will also study how sleep habits, physical activity, and disease symptoms are related to one another in these youth. We will do this by evaluating the sleep habits using questionnaires and an objective measure of sleep activity, a wrist-based activity monitor (ActiWatch). In addition, we will measure physical activity in all participants objectively using a wearable activity monitor (accelerometry). Finally, we will assess levels of disease activity, fatigue and depression in order to understand how these disease symptoms are related to sleep and physical activity.

Physical Activity Barriers and Facilitators

This study’s objective is to better understand the levels of physical activity youth with neuroinflammatory disorders engage in and how fit they are. This research study  is designed to learn about the amount and type of physical activities that are done by youth with neuroinflammation and also by healthy youth. We would like to know how fit these youth are and would like to ask about things that get in the way of taking part in physical activity.  We also want to know what helps youth to take part in physical activity.  Finally, we hope that this research helps us give better advice on the best ways to be physically active in youth with neuroinflammation.