Date of Award

2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cooling therapy improves functional mobility in heat-sensitive adults diagnosed with MS.

STUDY DESIGN: Systematic review of three randomized controlled trials published between 2007 and 2011, all in the English language.

DATA SOURCES: Three randomized controlled trials were found using the PubMed/MEDLINE database.

OUTCOMES MEASURED: Functional mobility as measured by the Multiple Sclerosis Functional Composite (MSFC), postural control, exercise duration, walking speed, and timed up and go examinations.

RESULTS: In one study, MeyerHeim, et al. demonstrated significant improvements with the experimental intervention on the 25-foot walk, 9-hole peg test, as well as the total MSFC, and no significant different on tests of postural sway and knee spasticity. In terms of exercise duration, Grahn, et al. found a significant improvement of 33% increase with cooling therapy. Finally, the study by Reynolds, et al. showed an improvement on the 6-minute walk test when comparing true cooling to the other tested conditions; on the 25-foot walk test and the timed up and go, true cooling was not associated with a significant improvement with regard to the other conditions.

CONCLUSIONS: The reviewed studies, representing the best evidence currently available, suggest the efficacy of cooling therapy as a well-tolerated method for improving functional mobility in heat-sensitive adults diagnosed with multiple sclerosis.

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