Pilot Study to Investigate the Effect of a 10-Week Aquatic Exercise Program on Individuals With High Levels of Disability Due to Multiple Sclerosis

Abstract

Background and Purpose: Research has suggested that a properly designed and implemented aquatic exercise (AE) program can improve physiological function and quality-of-life (QOL) outcomes in individuals with minimal disability levels due to multiple sclerosis (MS). Minimal research has investigated AE in individuals with higher levels of disability. The purpose of this study was to investigate a 10-week AE program on walking speed and QOL outcomes, specifically the effect of fatigue, in individuals with higher levels of disability due to MS, at an Expanded Disability Status Scale (EDSS) score between 5.0 and 6.5. Methods: Fifteen females and 4 males with relapsing-remitting MS, mean age 46.4 years ± 10.0, EDSS score 5.9 ± 0.4, and disease duration 10.4 years ± 6.5. The AE group was individually modified and performed 3 times per week for 45 minutes at a rating of perceived exertion of 11 to 13 for 10 weeks. Prior to and upon completion of structured AE intervention, subjects performed the following tests: Multiple Sclerosis Functional Composite (MSFC), Multiple Sclerosis Quality of Life Inventory (MSQLI), and 25-ft Water Walk Test. Results: Improvement in the MSFC (P = .001) was noted in all 3 MSFC components: 25-ft Water Walk Test (P = .020), 9-Hole Peg Test (P = .006), and Paced Auditory Serial Addition Test (P = .005). Improvements in the following subtests of the MSQLI were noted: SF-36 (36-Item Short Form Health Survey) physical and mental component summary (PCS, P = .006) (MCS, P = .009); Modified Fatigue Impact Scale (P = .006); Pain Effects Scale (P = .006); Perceived Deficits Questionnaire (P = .003); and Mental Health Inventory (P = .040). Discussion and Conclusions: Results suggest that a 10-week AE program for individuals with MS improved walking speed, arm function, memory, mental health, and generic QOL and reduced fatigue, pain, and perceived cognitive impairment in individuals with moderate to severe disability without adverse symptoms.