Editorial - Volume 13, Issue 1 - March 2011

As those of us in the Northern Hemisphere celebrate the return of spring, it is fitting that we begin this volume of the International Journal of MS Care (IJMSC) with a theme issue on mobility, guest edited by Dr. Francois Bethoux, a physiatrist at the Mellen Center of the Cleveland Clinic, and Dr. Susan Bennett, a physical therapist and researcher on the faculty of the University at Buffalo. Our guest editors have written an introduction to the issue that describes the complexities of helping people with multiple sclerosis (MS) maintain and improve mobility. As they note, many interrelated factors as well as comorbidities need to be addressed, and this is best accomplished using a comprehensive care approach involving members of various specialties, all bringing their skills to bear on the problem. This issue contains two articles directly related to mobility, one on assessment tools and one on the frequency of walking as exercise in MS; two articles on exercise related to improving and maintaining mobility; and finally an article on bone health, which is strongly affected by and critical to mobility.

The guest editors, Drs. Bennett and Bethoux, have contributed a review article on the assessment of walking in patients with MS in clinical practice. Among the measurement tools that they studied, the combination of the observed Timed 25-Foot Walk, which is commonly used in neurologic as well as rehabilitation practices, and the less popular patient-reported 12-Item Multiple Sclerosis Walking Scale seemed to provide the best sense of patient functioning on a day-to-day basis, although other scales are also potentially useful in certain settings. Ms. Weikert, Ms. Dlugonski, Ms. Balantrapu, and Dr. Motl of the University of Illinois at Urbana-Champaign examined what forms of exercise MS patients are actually performing, and found that more patients reported walking as their chosen form of exercise than any other activity.

Two other articles address interventions intended to improve mobility and functioning in patients. Drs. Pfalzer and Fry of the University of Michigan–Flint approached increasing mobility by increasing inspiratory muscle functioning. They found that their 10-week program improved standing balance but had difficulty with the use of the Expanded Disability Status Scale as an outcome measure in MS patients with mild disability. Dr. Plow of the Cleveland Clinic Lerner Research Institute reports with Dr. Finlayson on their work done at her institution, the University of Illinois at Chicago, regarding the use of a very popular and widely available game, the Nintendo Wii Fit. Patients, like the rest of the population, are more likely to perform exercise if it is enjoyable, and Drs. Plow and Finlayson show that MS patients can benefit from the use of this device, and hopefully have fun at the same time. Ms. Larson and Dr. White of the University of Georgia, Athens, report on their work on the scaffolding of walking, examining asymmetrical bone density in MS. Their work emphasizes the need for awareness and prevention of osteopenia and osteoporosis, which are very common in the MS population.

Also in this issue, we mark the passing of another important neurologist working in the MS field, Hillel Panitch. Dr. Panitch spent much of his career in MS care and research at the University of Maryland, but had moved a decade ago to the University of Vermont. Those readers with attention to detail will note the special banner on our cover marking 10 years of continuous print and online publication of the IJMSC. The founding editor in chief, Dr. Robert Herndon, initially launched the journal in 1999 as an online-only publication. That publishing model was ahead of its time, and the following year the Consortium of Multiple Sclerosis Centers (CMSC) began a simultaneous print edition, with the first full volume in print issued in 2001. Lastly, we look forward to seeing you all this June at the CMSC's 25th Annual Meeting in Montreal, where we will enjoy exchanging up-to-date information on how to improve our care for MS patients and their caregivers, as well as experiencing collegial camaraderie and support among the multiple disciplines represented by the CMSC. At the meeting, an announcement will be made of the winner of the Herndon Award for the best article published in the IJMSC in 2010.