Dallas researchers are investigating whether the summer heat can be especially dangerous to people with Multiple Sclerosis.
The study, funded by the National Multiple Sclerosis Foundation, is being conducted by scientists at the Institute for Exercise and Environmental Medicine (IEEM) at Texas Health Presbyterian Hospital Dallas. The researchers, led by Craig Crandall, PhD, director of the IEEM’s Thermal and Vascular Physiology Laboratory, are investigating whether hot weather and higher body temperatures might put people with MS at increased risk of falling.
“We know that people with MS experience increases in the frequency of their symptoms during heat exposure, but we want to learn more,” Crandall said. “It remains unknown whether heat exposure further compromises balance in MS patients and would put them at more risk for falling.”
Even without temperature changes, MS patients often have poor balance and are at an overall increased risk of falls due to the effects of the neurological disease, which causes communication misfires between nerves in the brain, spinal cord and eyes. Several factors caused by the breakdown of nerves contribute to the falls: muscle weakness, spasticity (stiffness and reduced ability to maintain smooth, controlled movements of limbs), loss of balance, dizziness, sensory problems and tremor.
In fact, studies have shown that about half of middle-aged and older people with MS fall at least once every six months. This can lead to bruises, broken bones, and head injuries.
Heat, though, tends to make these problems worse. Even a very slight increase in body temperature can temporarily worsen MS symptoms. An increase in temperature may result from illness-related fever, from exercise or from the kind of hot weather and high humidity that hits North Texas every summer.
“This question is important because if heat exposure impairs balance in MS patients, there might be ways to mitigate the problem,” Crandall said. “So part of our investigation will look at the other angle: whether skin cooling, by fanning, during heat exposure improves MS patients’ balance.”
During the research project, study subjects undergo a series of static stand tests in an environmental chamber – a 120 square foot room in which temperature and humidity are tightly controlled. A highly sensitive force platform quantifies foot forces and movements in three axes, measuring postural sway. As the temperature is slowly increased in the chamber, the subjects are asked to stand as still as possible in a series of balance tests, some with their eyes closed.
During the tests, researchers stand next to the subjects, and a padded floor mat is next to them to protect from possible falls. Core temperature, skin temperature, heart rate, and blood pressure are monitored throughout the tests.
The temperature in the heated chamber is raised to 104 degrees Fahrenheit.
Tips for a safe home environment, according to the National MS Society:
- Check entryways, thresholds and doors to identify slippery or uneven surfaces.
- Place reflective or contrasting, non-skid strips on stairs and steps.
- Use rails on both sides of the stairs to provide good support as you enter; railings should extend beyond the first and last steps.
- Install a ramp or threshold ramp to avoid falls on steps or on a doorway lip.
- Ensure doorways are clear and wide enough for you to move through them without tripping or bumping into anything.
- Install level door handle hardware that will allow you to open a door within minimal strength and dexterity, and with one hand.
About the Institute for Exercise and Environmental Medicine
The Institute for Exercise and Environmental Medicine (IEEM) was founded as a joint program between Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center at Dallas. Its mission is to promote basic and clinical research, education, and clinical practice in defining the limits to human functional capacity in health and disease, with the objective of improving the quality of life for human beings of all ages. The IEEM includes ten major laboratories tightly integrated and organized intellectually along the “oxygen cascade” — the path that oxygen must follow through the body from the external environment through the lungs, heart, and skeletal muscle to perform cognitive function and physical activity. The IEEM is among the only research centers in the world that fosters the fusion of basic science and clinical medicine in a program designed specifically to study human physiology.