Index > Vol. 39/2007 > Iss. 7/September > pp. 554-559 > Abstract
Original report | Neuromuscular diseases

Patients with neuromuscular diseases benefit from treatment in a warm climate

doi: 10.2340/16501977-0088

Abstract:

Objective: Several studies have shown positive effects of treatment of chronic diseases in a warm climate. The aim of this study was to evaluate the long-term effect of a 4-week rehabilitation programme in a warm climate for patients with neuromuscular diseases.
Design: A randomized controlled trial with a cross-over design. One period of intervention and one period of “life as usual”.
Patients: A total of 60 persons with a neuromuscular diagnosis.
Methods: Long-term effects were defined as changes in physical and psychological functions persisting after 3 months. Several scales were used according to the World Health Organization’s classification of functioning.
Results: A comparison of the changes in the 2 periods showed significantly better results for all primary outcome scales in favour of the intervention. Mean difference in changes in pain (VAS scale), 6-min walking test and “timed up and go” were 9.0 (SD 28.8) units, 52 (75) m and 1.0 (2.3) sec, p = 0, 03, < 0.01 and 0.01, respectively. Median difference in changes in “Fatigue Severity Scale” and “Life Satisfaction Scale” were 0.4 (–0.5, 1.7) and 0.0 (0.0, 1.0), p = < 0.01 and 0.01, respectively.
Conclusion: This study shows positive long-term effects on different dimensions of health after a 4-week rehabilitation programme in a warm climate for patients with neuromuscular diseases. This effect might be due to the programme, the warm climate, or a combination of both.

Authors:

Petra A. Nordby, Yndis A. Staalesen Strumse, Kathrine F. Frøslie and Johan K. Stanghelle

Key words:

neuromuscular disease, climate, rehabilitation, comparative study, treatment outcome.

References

  1. Bindoff L, Gilhus NE. The genetic basis of muscle disease. [Arvelige muskelsykdommer] Tidsskrift for Den Norske Laegeforening 2003; 23: 2588–2592 (in Norwegian).
  2. Brooke M, editor. A clinician’s view of neuromuscular diseases. Baltimore: Williams and Wilkins; 1986.
  3. Harper PS. The myotonic disorders. In: Walton J, editor. Disorders of voluntary muscle. 5th edn. Edinburgh: Churchill Livingstone; 1988, p. 569–587.
  4. Mellgren SI, Vedeler C. Hereditary neuropathies. [Hereditære nevropatier]. Tidsskr Nor Lægeforen 2003; 123: 2585–2587 (in Norwegian).
  5. Skre H. Genetic and clinical aspects of Charcot-Marie-Tooth’s disease. Clin Genet 1974; 6: 98–118.
  6. Walton J, Gardner-Medwin D. The muscular dystrophies. In: Walton J, editor. Disorders of voluntary muscle. 5th edn. Edinburgh: Churchill Livingstone; 1988, p. 519–568.
  7. Wenneberg S, Gunnarsson LG, Ahlstrom G. Using a novel exercise programme for patients with muscular dystrophy. Part II: a quantitative study. Disabil Rehabil 2004; 26: 595–602.
  8. Wenneberg S, Gunnarsson LG, Ahlstrom G. Using a novel exercise programme for patients with muscular dystrophy. Part I: a qualitative study. Disabil Rehabil 2004; 26: 586–594.
  9. Gran JT. [Treatment Abroad- An Official Norwegian Report ] Behandlingsreiser til utlandet et offentlig ansvar? Sosialdepartementet NOU 2000: 2. Oslo: Statens forvaltningstjeneste, Informasjonsforvaltning; 2000. 
.
  10. Vardeberg K, Kolsrud M, Laberg T. The Sunnaas Index of ADL. World Federation of Occupational Therapy Bulletin 1991; 24: 30–35.
  11. World Health Organization. International Classification of Functioning, Disability and Health: ICF. Geneva: WHO; 2001.
  12. Carlsson AM. Assessment of chronic pain. Aspects of the reliability and validity of the visual analogue scale. Pain 1983; 16: 87–101. Link to article
  13. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 1989; 46: 1121–1123.
  14. Lerdal A, Wahl A, Rustoen T, Hanestad BR, Moum T. Fatigue in the general population: a translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale. Scand J Public Health 2005; 33: 123–130.
  15. Finch E, Brooks D, Statford PW, Mayo NE, editors. Physical rehabilitation outcome measures: a guide to enhanced clinical decision-making. Canada: Lippincott, Williams and Wilkins; 2002. 
.
  16. Wade D, editor. Measurement in neurological rehabilitation. Oxford: Oxford University Press; 1992.
  17. Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142–148.
  18. Fugl-Meyer AR, Bränholm I-B, Fugl-Meyer KS. Happiness and domain specific life satisfaction in adult northern Swedes. Clin Rehabil 1991; 5: 25–33. Link to article
  19. Fugl-Meyer AR, Melin R, Fugl-Meyer KS. Life satisfaction in 18- to 64-year-old Swedes: in relation to gender, age, partner and immigrant status. J Rehabil Med 2002; 34: 239–246.
  20. Mc Nair DM, Lorr M, Dropplemann LF, editors. Profile of mood states manual. San Diego: Education and Testing Service; 1992.
  21. Eriksen H, Ihlebæk C, Ursin H. A scoring system for subjective health complaints (SHC): original article. Scand J Publ Health 1999; 27: 63–72.
  22. Altman D. Practical statistics for medical research. London: 
Chapman and Hall/CRC; 1997.
  23. Strumse YAS, Stanghelle JK, Utne L, Ahlvin P, Svendsby EK. Treatment of patients with postpolio syndrome in a warm climate. Disabil Rehabil 2003; 25: 77–84.
  24. Kelly AM. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J 2001; 18: 205–207.
  25. Kelly AM. Does the clinically significant difference in visual analog scale pain scores vary with gender, age, or cause of pain? Acad Emerg Med 1998; 5: 1086–1090.
  26. Guyatt GH, Townsend M, Pugsley SO, Keller JL, Short HD, Taylor DW, et al. Bronchodilators in chronic air-flow limitation. Effects on airway function, exercise capacity, and quality of life. Am Rev Respir Dis 1987; 135: 1069–1074.
  27. Lacasse Y, Wong E, Guyatt GH, King D, Cook DJ, Goldstein RS. Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. Lancet 1996; 348: 1115–1119. Link to article
  28. Enright PL. The six-minute walk test. Respir Care 2003; 48: 783–785.
  29. De Amici D, Klersy C, Ramajoli F, Brustia L, Politi P. Impact of the Hawthorne effect in a longitudinal clinical study: the case of anesthesia. Controlled clinical trials 2000; 21: 103–114.
  30. Kilmer DD. The role of exercise in neuromuscular disease. Phys Med Rehabil Clin N Am 1998; 9: 115–125, vi.
  31. Phillips BA, Mastaglia FL. Exercise therapy in patients with myopathy. Curr Opin Neurol 2000; 13: 547–552.
  32. Taivassalo NDS. Short-term aerobic training response in chronic myopathies. Muscle & Nerve 1999; 22: 1239–1243.
  33. Wright NC, Kilmer DD, McCrory MA, Aitkens SG, Holcomb BJ, Bernauer EM. Aerobic walking in slowly progressive neuromuscular disease: effect of a 12-week program. Arch Phys Med Rehabil 1996; 77: 64–69. Link to article
  34. Dahl A, Skjeldal OH, Simensen A, Dalen HE, Bråthen T, Ahlvin P, et al. Treatment of patients with neuromuscular disease in a warm climate. [Behandling i varmt klima for pasienter med neuromuskulaere sykdomer]. Tidsskr Nor Laegeforen 2004; 124: 1795–1798 (in Norwegian).
  35. Nätterlund B, Sjöden PO, Ahlström G. The illness experience of adult persons with muscular dystrophy. Disabil Rehabil 2001; 23: 788–798.