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Specific exercise training in patients with multiple sclerosis
L. Bernhardt, C. Jolk, M. Marziniak (Münster, DE)
Abstract
Background: Neurological symptoms of multiple sclerosis (MS) have a high impact of daily living, fatigue, motor weakness, spasticity, poor balance, heat sensitivity and mental depression. Although exercise training is an important therapeutic strategy to minimize the loss of functional capacity, it remains under-utilized as an intervention strategy in the MS population. The effect of specific exercise therapy programs on the management of balance and walking disorders in patients with MS have not been fully explained yet. Reproducible measurement systems are especially required to show their efficacy.
Objective: To test the hypothesis that specific exercise training can improve coordination, equilibration and gait impairment, secondarily muscle strength, spasticity and the functional capacity in patients with MS.
Methods: A randomized placebo controlled observational multicenter pilot trial with a 12-week study period was performed. SUBJECTS: 49 patients with MS and an EDSS from 0-6.5 were randomly allocated to one of the two groups. INTERVENTION: Group 1 (n=24) received twelve weeks of gymnastic training using different bodyweight exercises. Group 2 (n=25) were taken as control group without any additional physical activity. MAIN MEASURES: To measure equilibration, coordination and gait impairment, and level of spasticity, patients were assessed at baseline and 12 weeks post treatment with a neurological examination, maximum muscle strength, Modified Ashworth Scale and visual analogue scale.
Results: At the baseline we found 83 % of the participants with muscle strength differences with more than 10% in side comparison of leg, arm and core muscles. After 12 weeks intervention 18% of the muscle strength side differences could be reduced. The standardised specific exercise training improved significantly muscle strength. The quality of life and fatigue showed amelioration.
Conclusions: Specific exercise training once a week is an important and easily performed tool to improve focal neurological deficits, especially motor weakness, spasticity and gait impairment in patients with MS. Additionally the quality of life is increased and fatigue ameliorated.
L. Bernhardt, C. Jolk, M. Marziniak (Münster, DE)
Abstract
Background: Neurological symptoms of multiple sclerosis (MS) have a high impact of daily living, fatigue, motor weakness, spasticity, poor balance, heat sensitivity and mental depression. Although exercise training is an important therapeutic strategy to minimize the loss of functional capacity, it remains under-utilized as an intervention strategy in the MS population. The effect of specific exercise therapy programs on the management of balance and walking disorders in patients with MS have not been fully explained yet. Reproducible measurement systems are especially required to show their efficacy.
Objective: To test the hypothesis that specific exercise training can improve coordination, equilibration and gait impairment, secondarily muscle strength, spasticity and the functional capacity in patients with MS.
Methods: A randomized placebo controlled observational multicenter pilot trial with a 12-week study period was performed. SUBJECTS: 49 patients with MS and an EDSS from 0-6.5 were randomly allocated to one of the two groups. INTERVENTION: Group 1 (n=24) received twelve weeks of gymnastic training using different bodyweight exercises. Group 2 (n=25) were taken as control group without any additional physical activity. MAIN MEASURES: To measure equilibration, coordination and gait impairment, and level of spasticity, patients were assessed at baseline and 12 weeks post treatment with a neurological examination, maximum muscle strength, Modified Ashworth Scale and visual analogue scale.
Results: At the baseline we found 83 % of the participants with muscle strength differences with more than 10% in side comparison of leg, arm and core muscles. After 12 weeks intervention 18% of the muscle strength side differences could be reduced. The standardised specific exercise training improved significantly muscle strength. The quality of life and fatigue showed amelioration.
Conclusions: Specific exercise training once a week is an important and easily performed tool to improve focal neurological deficits, especially motor weakness, spasticity and gait impairment in patients with MS. Additionally the quality of life is increased and fatigue ameliorated.