Effect of hydrotherapy on serum TNFα and IFNγ in the women with multiple sclerosis

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Research Paper 01/08/2013
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Effect of hydrotherapy on serum TNFα and IFNγ in the women with multiple sclerosis

Zohre Afsharmand, Vahid Imanipour, Fatemeh Mahdi, Mehdi Sadeghi, Alireza Naderi, Sokhanguei Yahya, Behboodi Laleh
Int. J. Biosci.3( 8), 168-173, August 2013.
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Aquatic exercise can refer to pool therapy, hydrotherapy, or balneotherapy. Hydrotherapy is frequently applied to patients with painful neurological or musculoskeletal alterations, because the heat and floatability of the water can block nociceptors by acting on thermal receptors and mechanoreceptors and exert a positive effect on spinal segmental mechanisms (Bender, 2005). Warm water can also increase the blood flow, helping to dissipate allogeneic chemicals and enhance muscle relaxation. The present study aims to explore the effect of 10 weeks hydrotherapy on EDSS, TNFα and IFNγ in female MS patients. The statistical population consists of 30 MS patients whose MS has been confirmed by a neurologist. They divided into two groups based on inclusion criteria. Experimental group consisted of 15 and the control group consisted of 15 people with ages ranging from 22 to 51 and the weight of 58.9 ± 9.3 kg – Height of 153.5 ± 15.6 cm. Hydrotherapy program for the experimental group was implemented for 10 weeks, 3 sessions per week. Control group participated in none activity program in this period. According to the descriptive statistics, EDSS decreased in the experimental group after 10 weeks hydrotherapy. But no significant different was seen in TNFα and IFNγ in two groups. Results showed that endocrine and proinflammatory immune responses to physical exercise are not significantly altered in MS. So EDSS decreased in experimental group. In the other hand, participating in hydrotherapy programs led to benefit in the MS patients.


Ackermann KD, Martino M, Heyman R, Moyna NM, Rabin BS. 1998. Stressor-induced alteration of cytokine production in multiple sclerosis patients and controls. Psychosomatic Medicine. 60, 484-491.

Gabrielsen A, Videbek R, Johansen LB. 2000. Forearm vascular and neuroendocrine responses to graded water immersion in humans. Acta Physiologica Scandinavica. 169 (2), 87-94.

Francon A, Forestier R. 2009. Spa therapy in rheumatology. Indications based on the clinical guidelines of the French national authority for health and the European league against rheumatism, and the results of 19 randomized clinical trials. Bulletin de l’Academie Nationale de Medicine. 193(6), 1345-1358.

Armstrong TS. 2003.  Symptoms  experience:  a concept analysis. Oncology Nursing Forum. 30, 601-606. http://dx.doi.org/10.1188/03.ONF.601-606

Aronson KJ. 1997. Quality of life among persons with multiple sclerosis and their caregivers. Neurology. 48,74-80. http://dx.doi.org/10.1212/WNL.48.1.74

Consentino M, Zaffaroni M, Marino M, Bombelli R, Ferrari M, Rasini E, Lecchini S, Ghezzi A, Frigo G. 2002. Catecholamine production and tyrosine hydroxylase expression in peripheral blood mononuclear cells from multiple sclerosis patients: effect of cell stimulation and possible relevance for activation-induced apoptosis. Journal of Neuroimmunology. 133, 223-240.

Drenth JP, Krebbers RJ, Bijzet J, Vandermeer JW. 1998. Increased circulating cytokine receptors and ex vivo interleukin-1 receptor antagonist and interleukin-1 b pro-duction but decreased tumor-necrosis factor- a production after a 5-km run. European Journal of Clinical Investigation. 28, 866-872. http://dx.doi.org/10.1046/j.1365-2362.1998.00366.x

Fassbender K, Schmidt R, M€ooßner, Kischka R, K€uuhnen U, Schwartz J, Hennerici AM. 1998. Mood disorders and dysfunction of the hypothalamic–pituitary–adrenal-axis in multiple sclerosis. Archives of Neurology. 55, 66-72. http://dx.doi.org/10.1001/archneur.55.1.66

Heesen C, Schulz H, Schmidt M, Gold S, Tessmer W, Schulz KH. 2002a. Endocrine and cytokine responses to acute psychological stress in multiple sclerosis. Brain, Behavior and Immunity. 16, 282-287. http://dx.doi.org/10.1006/brbi.2001.0628

Heesen C, Gold SM, Raji A, Schulz KH, Wiedemann K. 2002b. Cognitive impairment correlates with hypothal-amo–pituitary–adrenal axis dysregulation in multiple scle-rosis. Psychoneuroendocrinology. 27, 505-517. http://dx.doi.org/10.1016/S0306-4530(01)00071-3

Gulick EE. 1989. Model confirmation of the MS-Related Symptom Checklist. Nursing Research. 38, 147-153. http://dx.doi.org/10.1097/00006199-198905000-00012

Gulick EE. 2001. Emotional distress and activities of daily living functioning in persons with multiple sclerosis. Nursing Research. 50, 147-154. http://dx.doi.org/10.1097/00006199-200105000-00004

Hemmett L,  Holmes J, Barnes M, Russell N. 2004. What drives quality of life in multiple sclerosis. Q journal of Medicine. 97, 671-676. http://dx.doi.org/10.1093/qjmed/hch105

Kamioka H, Tsutani K, Okuizumi H. 2010. Effectiveness of aquatic exercise and balneotherapy : a summary of systematic reviews based on randomized controlled trials of water immersion therapies. Journal of Epidemiology. 20(1), 2-12. http://dx.doi.org/10.2188/jea.JE20090030

Kamioka H, Nakamura Y, Yazaki T. 2006. Comprehensive health education combining hot spa bathing and lifestyle education in middle-aged and elderly women: one-year follow-up on randomized controlled trial of three- and six-month interventions. The American Journal of Epidemiology. 16(1), 35-44. http://dx.doi.org/10.2188/jea.16.35

Howlett TA. 1987. Hormonal responses to exercise and training: a short review. Clinical Endocrinology. 26, 723-742

Maloni HW. 2000. Pain in multiple sclerosis: an overview of its nature and management. Journal of the  American  Association  of  Neuroscience  Nurses. 32(3), 139-152. http://dx.doi.org/10.1097/01376517-200006000-00004

Hall J, Swinkels A, Briddon J, Mc Cabe CS. 2008. Does aquatic exercise relieve pain in adults with neurologic or musculoskeletal disease? A systematic review and meta-analysis of randomized controlled trials. Archives of Physical Medicine & Rehabilitation. 89(5), 873-883. http://dx.doi.org/10.1016/j.apmr.2007.09.054

Esmonde L, Long AF. 2008. Complementary therapy use by persons with multiple sclerosis: benefits and research priorities. Complementary Therapies in Clinical Practice. 14 (3), 176-184.

National Institute of Clinical Excellence. 2003. Multiple Sclerosis. Understanding NICE Guidance-Information for People with Multiple Sclerosis, Their Families and Care r s, and The Public (Clinical Guideline-8). National Institute for Clinical Excellence, London, U K.

Northoff H, Berg AS, Wrinstock C. 1998. Similarities and differences of the immune response to exercise and trauma: the IFN- c concept. Canadian Journalof Physiology and Pharmacology. 76, 497-504. http://dx.doi.org/10.1139/y98-052

Ostrowski  K, Hermann C, Bangash A, Schjerling P,  Nielsen JN,  Pedersen BK. 1998. A trauma-like elevation of plasma cytokines in humnas in response to treadmill running. Journal of Physiology. 513, 889-894. http://dx.doi.org/10.1111/j.1469-7793.1998.889ba.x

Ostrowski K, Rohde T, Asp S, Schjerling P, Pedersen BK. 1999. Pro- and anti-inflammatory cytokine balance in strennous exercise in humans. Journal of Physiology. 515, 287-291. http://dx.doi.org/10.1111/j.1469-7793.1999.287ad.x

Petrovsky N. 2001. Whole blood assay and the influence of circadian rhythmicity on human cytokine measurement. In: O Neill, LAJ, Bowie, A. (Eds.). Methods in molecular medicine. 60, 163-174.

Rajda C, Bencsik K, Vecsei L, Bergquist J. 2002. Catecholamine levels in peripheral blood lymphocytes from multiple sclerosis patients. Journal of Neuroimmunology. 124, 93-100. http://dx.doi.org/10.1016/S0165-5728(02)00002-4

Rhind SG, Shek PN, Shepard RJ. 1995. The impact of exercise on cytokines and receptor expression. Exercise Immunology. 1, 97–148.

Forestier R, Francon A. 2008. Crenobalneotherapy for limb osteoarthritis: systematic literature review and methodological analysis. Joint Bone Spine. 75 (2), 138-148. http://dx.doi.org/10.1016/j.jbspin.2007.06.009

Santamaria P, Gherz RC, Bryan MK. 1989. Involvement of class II MHC molecules in LPS-induction of rIL-1/TNF secretion by human monocytes; quantitative differences at polymorphic level. Journal of Immunology. 143, 913–919.

Olsen SA. 2009. A review of complementary and alternative medicine (CAM) by people with multiple sclerosis. Occupational Therapy International. 16(1), 57-70. http://dx.doi.org/10.1002/oti.266

Bender  T, Karag¨ulle Z, Alint GPB, Gutenbrunner PVB. 2005. Hydrotherapy, balneotherapy, and   Spa treatment   in pain management. Rheumatology International. 25(3), 220-224. http://dx.doi.org/10.1007/s00296-004-0487-4

Teel CS, Meek P, McNamara AM, Watson L. 1997. Per-spectives unifying symptom interpretation. Image the journal of nursing scholarship. 29, 175-181. http://dx.doi.org/10.1111/j.1547-5069.1997.tb01553.x

Zoukos Y, Leonard JP, Thomaides T, Thompson AJ, Cuzner ML. 1992b. Adrenergic receptor density and function of peripheral blood mononuclear cells are in-creased in multiple sclerosis: a regulatory role for cortisol and interleukin-1. Annals of Neurology. 31, 657-662. http://dx.doi.org/10.1002/ana.410310614