Physical Activity During Pregnancy Among People with Multiple Sclerosis

• Author / Creator

  Kimber, Miranda

• It is well established that physical activity confers numerous health benefits for both mother and fetus in the vast majority of pregnant individuals. Yet, significant knowledge gaps remain. Of the 12 systematic reviews which informed the Society of Obstetricians and Gynecologists of Canada/Canadian Society for Exercise Physiology 2019 Canadian Guideline for Physical Activity during Pregnancy, not a single study included pregnant people with impairments. As a result, the Steering Committee put out an urgent call to action to initiate research in this area. In response, we conducted a study examining the physiological responses to a single bout of moderate intensity physical activity within pregnant people with Multiple Sclerosis (MS).
  We recruited six pregnant people with MS, and six pregnant people without MS >12 weeks gestation to participate in our research study. Participants completed a 20-minute submaximal exercise test instrumented with a Polar H6 heart rate monitor and Freestyle Libre Pro continuous glucose monitor. Acute measurements of fatigue and energy were recorded prior-to, immediately following, 30-minutes and 60-minutes following exercise using the Visual Analog Scale to Evaluated Fatigue Severity (VAS-F). Following exercise, participants wore Actigraph and ActivPAL accelerometers for seven full days. They also completed the International Physical Activity Questionnaire (IPAQ) and Barriers to Physical Activity for Individuals with Mobility Impairments (BPAQ-MI) questionnaire.
  Although rating of perceived exertion was not different between groups, mean heart rate during exercise was lower in participants with MS (p = 0.005) as all participants with MS spent less time in the 60-70% heart rate reserve (HRR) zone throughout exercise (p = 0.008). Participants with MS reported lower levels of acute energy immediately following exercise (p = 0.04), but no differences in acute fatigue or glucose prior-to, 30 minutes and 60 minutes following exercise were observed. Spearman correlational analyses demonstrated a significant moderate positive correlation between acute fatigue scores and glucose across exercise among participants with MS (r = 0.63, p = 0.03), but no correlation was found among participants without MS (r = -0.22, p = 0.35). Chronic physical activity and sedentary measures were not different between groups and individuals with MS listed a greater number of barriers to physical activity compared to individuals without MS. Daily glucose patterns (fasting, 24 hour, peak, nadir, time spent in hyper- and hypoglycemia) were not different between groups, and we observed no correlation between day-to-day fatigue scores via the Modified Fatigue Impact Scale (MFIS), and fasting (r = -0.37) or 24 hour glucose values (r = -0.33).
  These data suggest the physiological responses to an acute bout of exercise with the same subjective perception of exertion differ between pregnant individuals with and without MS. Further, our results demonstrate pregnant people with MS engage in smaller amounts of weekly MVPA that may be related to increased barriers to physical activity and fatigue.

• Subjects / Keywords

  • Pregnancy
  • Multiple Sclerosis
  • Physical Activity

• Graduation date

  Spring 2022

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-4pmr-fg86

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.