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STUDY: Comparison of different endurance trainings in advanced MS patients
Comparison of different endurance trainings in advanced multiple sclerosis patients: a randomised, controlled pilot study
S. Briken, S. Gold, K. Schulz, D. Harbs, S. Patra, G. Ketels, C. Heesen (Hamburg, DE)
Objective: Exercise studies in MS to date have included patients during the early phase of disease with mild to moderate disability. In this pilot study, we investigated if standardized fitness training is feasible for patients with progressive disease and which training form may be most suitable for this group. In addition, we aimed to explore if exercise can enhance physical fitness, walking ability and cognitive function in this population.
Methods: Three different exercise interventions (arm ergometry, rowing, bicycle ergometry) were compared with a waitlist control group, measuring the effects on fitness, walking ability, quality of life, depression, fatigue and cognitive function. Forty-seven subjects with advanced SP-MS/PP-MS (EDSS 4-6) were included and randomized using a biased-coin algorithm adjusting for age, gender and EDSS. A standardized training schedule was developed for each subject based on the individual results from a bicycle ergometry performance test. Patients completed a training program with gradually increasing work load in each session. All subjects completed at least 20 training sessions in 8-10 weeks.
Results: All three exercise modalities were feasible in MS patients with advanced disability. The drop-out rate was 15% and did not significantly differ between the exercise and the control group. In comparison with the control group, the interventions led to significant improvements in most of the outcome parameters: Walking ability was significantly increased (six-minute-walking test: p=0.008, timed-tandem-walk: p=0.019, timed-up-and-go test: p=0.038). Improvements were seen in depression (p=0.002), fatigue (p=0.049) and cognitive function (verbal-learning-memorytest, subtest learning: p=0.02, subtest delayed recall: p=0.01). Post hoc analyses revealed strongest improvements in the bicycle and hand ergometry groups for walking ability, depression and fatigue compared to the control group. Intriguingly, all three interventions had an effect on memory and learning.
Conclusion: The different interventions had a significant impact, not only on the physical, but also on the other disability domains. We therefore believe, that well adjusted individual endurance training for multiple sclerosis patients should be more advocated also in advanced stages. Moreover, further larger multicenter studies as well as investigations on the putative neuroregenerative or neuroprotective effects of exercise training in MS are warranted.
S. Briken, S. Gold, K. Schulz, D. Harbs, S. Patra, G. Ketels, C. Heesen (Hamburg, DE)
Objective: Exercise studies in MS to date have included patients during the early phase of disease with mild to moderate disability. In this pilot study, we investigated if standardized fitness training is feasible for patients with progressive disease and which training form may be most suitable for this group. In addition, we aimed to explore if exercise can enhance physical fitness, walking ability and cognitive function in this population.
Methods: Three different exercise interventions (arm ergometry, rowing, bicycle ergometry) were compared with a waitlist control group, measuring the effects on fitness, walking ability, quality of life, depression, fatigue and cognitive function. Forty-seven subjects with advanced SP-MS/PP-MS (EDSS 4-6) were included and randomized using a biased-coin algorithm adjusting for age, gender and EDSS. A standardized training schedule was developed for each subject based on the individual results from a bicycle ergometry performance test. Patients completed a training program with gradually increasing work load in each session. All subjects completed at least 20 training sessions in 8-10 weeks.
Results: All three exercise modalities were feasible in MS patients with advanced disability. The drop-out rate was 15% and did not significantly differ between the exercise and the control group. In comparison with the control group, the interventions led to significant improvements in most of the outcome parameters: Walking ability was significantly increased (six-minute-walking test: p=0.008, timed-tandem-walk: p=0.019, timed-up-and-go test: p=0.038). Improvements were seen in depression (p=0.002), fatigue (p=0.049) and cognitive function (verbal-learning-memorytest, subtest learning: p=0.02, subtest delayed recall: p=0.01). Post hoc analyses revealed strongest improvements in the bicycle and hand ergometry groups for walking ability, depression and fatigue compared to the control group. Intriguingly, all three interventions had an effect on memory and learning.
Conclusion: The different interventions had a significant impact, not only on the physical, but also on the other disability domains. We therefore believe, that well adjusted individual endurance training for multiple sclerosis patients should be more advocated also in advanced stages. Moreover, further larger multicenter studies as well as investigations on the putative neuroregenerative or neuroprotective effects of exercise training in MS are warranted.
Doesn't seem like many studies of this nature are coming from the US
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