{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T03:07:58Z","timestamp":1788664078724,"version":"build-2803163510"},"reference-count":42,"publisher":"CSIRO Publishing","issue":"1","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Impairment"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1443964621000176_as1\"><jats:title>Purpose:<\/jats:title><jats:p>To examine the feasibility and possible effect of an 8-week exercise program on sleep quality, insomnia and psychological distress in individuals with multiple sclerosis (MS).<\/jats:p><\/jats:sec><jats:sec id=\"S1443964621000176_as2\"><jats:title>Methods:<\/jats:title><jats:p>Twenty-four individuals with MS were recruited into a controlled pre-post feasibility study and divided into 2 groups: exercise (<jats:italic>n<\/jats:italic> = 13; Expanded Disability Status Scale (EDSS): 1.0\u20137.5) and a related control group with no exercise (<jats:italic>n<\/jats:italic> = 11; EDSS: 1.0\u20137.0). The exercise group performed combined upper limb, lower limb and breathing exercises in a controlled group (2d\/week, 60\u00a0min\/session) for 8 weeks. Participants were administered measures to evaluate sleep quality (Pittsburgh Sleep Quality Index, PSQI), insomnia severity (Insomnia Severity Index, ISI), psychological distress (Clinical Outcomes in Routine Evaluation\u2013Outcome Measure, CORE-OM) and additionally impact of fatigue (Modified Fatigue Impact Scale, MFIS) after 8-weeks.<\/jats:p><\/jats:sec><jats:sec id=\"S1443964621000176_as3\"><jats:title>Results:<\/jats:title><jats:p>Insomnia severity measured with ISI (<jats:italic>F<\/jats:italic>(1;22)=5.95, <jats:italic>p<\/jats:italic> = 0.023, <jats:italic>\u03b7<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><jats:sup>2<\/jats:sup> = 0.213, 90% CI = 0.02\u20130.42) and psychological distress measured with the CORE-OM (<jats:italic>F<\/jats:italic>(1;22)=4.82, <jats:italic>p<\/jats:italic> = 0.039, <jats:italic>\u03b7<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><jats:sup>2<\/jats:sup> = 0.179, 90% CI = 0.01\u20130.40) showed statistically significant group-by-time interaction. Sleep quality measured with the PSQI showed statistically significant group-by-time interaction only in an aspect of daytime sleep dysfunction (<jats:italic>F<\/jats:italic>(1;22)=5.33, <jats:italic>p<\/jats:italic> = 0.031, <jats:italic>\u03b7<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><jats:sup>2<\/jats:sup> = 0.195, 90% CI = 0.01\u20130.40). The fatigue impact measured with the MFIS showed statistically significant group-by-time interaction in physical (<jats:italic>F<\/jats:italic>(1;22)=6.80, <jats:italic>p<\/jats:italic> = 0.016, <jats:italic>\u03b7<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><jats:sup>2<\/jats:sup> = 0.236, 90% CI = 0.02\u20130.44) and cognitive aspects (<jats:italic>F<\/jats:italic>(1;22)=9.12<jats:italic>, p<\/jats:italic> = 0.006, <jats:italic>\u03b7<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><jats:sup>2<\/jats:sup> = 0.293, 90% CI = 0.05\u20130.49), and total score (<jats:italic>F<\/jats:italic>(1;22)=11.29, <jats:italic>p<\/jats:italic> = 0.003, <jats:italic>\u03b7<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><jats:sup>2<\/jats:sup> = 0.339, 90% CI = 0.08\u20130.52).<\/jats:p><\/jats:sec><jats:sec id=\"S1443964621000176_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Our 8-week program reduced insomnia severity, psychological distress and some aspects of fatigue (physical; cognitive; total), and improved sleep quality in an aspect of daytime sleep dysfunction in a small group of individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.<\/jats:p><\/jats:sec>","DOI":"10.1017\/brimp.2021.17","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T05:26:44Z","timestamp":1633066004000},"page":"86-102","source":"Crossref","is-referenced-by-count":14,"title":["Upper-lower limb and breathing exercise program for improving sleep quality and psychological status in multiple sclerosis: a pilot randomized controlled trial"],"prefix":"10.1071","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6769-5263","authenticated-orcid":false,"given":"Tanja","family":"Grubi\u0107 Kezele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zrinka","family":"Trope","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Ahel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natali","family":"Ru\u017ei\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1965-7355","authenticated-orcid":false,"given":"Hrvoje","family":"Omr\u010den","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luka","family":"\u0110udari\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Fu\u017einac-Smojver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"S1443964621000176_ref8","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/123494"},{"key":"S1443964621000176_ref16","doi-asserted-by":"publisher","DOI":"10.21860\/medflum2018_198218"},{"key":"S1443964621000176_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-019-0544-7"},{"key":"S1443964621000176_ref33","doi-asserted-by":"publisher","DOI":"10.1080\/13554794.2016.1237658"},{"key":"S1443964621000176_ref17","doi-asserted-by":"publisher","DOI":"10.13112\/PC.2019.32"},{"key":"S1443964621000176_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2015.01.018"},{"key":"S1443964621000176_ref25","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.5.601"},{"key":"S1443964621000176_ref10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0112414"},{"key":"S1443964621000176_ref42","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-60327-343-5_22"},{"key":"S1443964621000176_ref34","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0970"},{"key":"S1443964621000176_ref11","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.180.1.51"},{"key":"S1443964621000176_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(00)00065-4"},{"key":"S1443964621000176_ref41","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.553"},{"key":"S1443964621000176_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.acn.2005.04.002"},{"key":"S1443964621000176_ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s41983-018-0016-0"},{"key":"S1443964621000176_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/115.2.479"},{"key":"S1443964621000176_ref19","unstructured":"Joki\u0107-Begi\u0107, N. , Lauri Korajlija, A. , & Jurin, T. 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