Abstract
BackgroundThe aim of this study was to evaluate the safety, feasibility and preliminary effects of a high-intensity rehabilitative task-oriented circuit training (TOCT) in a sample of multiple sclerosis (MS) subjects on walking competency, mobility, fatigue and health-related quality of life (HRQoL).Methods24 MS subjects (EDSS 4.89 ± 0.54, 17 female and 7 male, 52.58 ± 11.21 years, MS duration 15.21 ± 8.68 years) have been enrolled and randomly assigned to 2 treatment groups: (i) experimental group received 10 TOCT sessions over 2 weeks (2 hours/each session) followed by a 3 months home exercise program, whereas control group did not receive any specific rehabilitation intervention. A feasibility patient-reported questionnaire was administered after TOCT. Functional outcome measures were: walking endurance (Six Minute Walk Test), gait speed (10 Meter Walk Test), mobility (Timed Up and Go test) and balance (Dynamic Gait Index). Furthermore, self-reported questionnaire of motor fatigue (Fatigue Severity Scale), walking ability (Multiple Sclerosis Walking Scale – 12) and health-related quality of life (Multiple Sclerosis Impact Scale – 29) were included. Subjects’ assessments were delivered at baseline (T0), after TOCT (T1) and 3 months of home-based exercise program (T2).ResultsAfter TOCT subjects reported a positive global rating on the received treatment. At 3 months, we found a 58.33% of adherence to the home-exercise program. After TOCT, walking ability and health-related quality of life were improved (p < 0.05) with minor retention after 3 months. The control group showed no significant changes in any variables.ConclusionsThis two weeks high-intensity task-oriented circuit class training followed by a three months home-based exercise program seems feasible and safe in MS people with moderate mobility impairments; moreover it might improve walking abilities.Trial registrationNCT01464749
Highlights
The aim of this study was to evaluate the safety, feasibility and preliminary effects of a high-intensity rehabilitative task-oriented circuit training (TOCT) in a sample of multiple sclerosis (MS) subjects on walking competency, mobility, fatigue and health-related quality of life (HRQoL)
Twenty-four people with MS (PwMS) have been assessed for eligibility in an outpatient rehabilitation clinic (Ferrara University Hospital)
Demographic and clinical characteristics are summarized in Table 2. 37.5% of subjects received diseasemodifying therapy (DMT) during the entire study (8.33% immunosuppressive treatments, 16.66% interferon beta, 4.16% glatiramer acetate and 8.33% fingolimod); 20.83% of them received therapies for MS symptoms management
Summary
The aim of this study was to evaluate the safety, feasibility and preliminary effects of a high-intensity rehabilitative task-oriented circuit training (TOCT) in a sample of multiple sclerosis (MS) subjects on walking competency, mobility, fatigue and health-related quality of life (HRQoL). Multiple sclerosis (MS) is a chronic and progressive neurologic disease that commonly affects young adults worldwide and it represents a major cause of disability over time [1,2] In this population gait and mobility impairments could have a negative impact on personal activities restricted to motor domains and is the exercise intensity that, compared to a conventional physiotherapy session, is nearer to the number of repetitions needed to achieve and maintain motor learning of these movements [15]. Task oriented circuit training (TOCT) is an intensive task-specific intervention, for this reason we designed a pilot randomized-controlled trial: (i) to test the safety, feasibility and acceptability of a two weeks high-intensity task oriented circuit training in multiple sclerosis subjects with moderate gait impairments; (ii) to assess its preliminary effects on walking, mobility, fatigue and quality of life; (iii) to evaluate the adherence to a three months home based training program that followed TOCT; (iv) to determine TOCT effect sizes and the sample needed for a future RCT study
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