Training In Multiple Sclerosis Research Articles

Editorial

Editorial

Effects of Resistance Training in Multiple Sclerosis

This study examined the effects of an eight-week progressive resistance training on different strength manifestations, muscle mass and functionality in multiple sclerosis patients. Thirteen volunteered patients (average age 43 years; range 35-51) with a confirmed diagnosis by a neurologist and mild to moderate disability participated twice a week in an eight-week progressive resistance training program after an eight-week control period without training. Intensity ranged from 40-70% of their maximal voluntary contraction. Outcome assessments included magnetic resonance image of the right and left thighs, strength manifestations (maximal voluntary contraction, muscular endurance and power), and functionality by the Up and Go test. All outcome assessments remained unaltered during the eight-week control period. After the eight-week strength training period, isometric strength (+16%, p<0.01), muscular endurance (+84%; p<0.001), maximal power (+51%, p<0.001), muscular hypertrophy from slice 6/27 to slice 11/27 of both thighs (p<0.05), and functionality (p<0.001) improved significantly. Moderate resistance training programs can improve muscle function without injuries and can be a promising therapy to delay the functional deterioration in multiple sclerosis patients.

Endurance exercise improves walking distance in MS patients with fatigue

Effects of endurance training in multiple sclerosis (MS) patients complaining of motor fatigue. Thirty MS patients complaining of fatigue with low to moderate disabilities randomly allocated to the intervention (thrice weekly 45-min intervals of endurance exercise) or control treatment (three 45-min episodes of stretching, balance training and coordination), both as 'add-on' therapy for 3 weeks during inpatient rehabilitation. Maximal walking distance before intervention averaged 1043 +/- 568 and 1163 +/- 750 m in the two groups. The intervention group increased its maximal walking distance by 650 +/- 474 m. The control group extended its walking distance by 96 +/- 70 m. The present data confirm a strong effect of endurance exercise on maximal walking distance. Remarkably, there were no parallel improvements on the Modified Fatigue Impact Scale, the Beck Depression Inventory and the Hamburg Quality of Life Questionnaire for MS.

The Efficacy of Telephone Counseling for Health Promotion in People With Multiple Sclerosis: A Randomized Controlled Trial

Bombardier CH, Cunniffe M, Wadhwani R, Gibbons LE, Blake KD, Kraft GH. The efficacy of telephone counseling for health promotion in people with multiple sclerosis: a randomized controlled trial. Objective To determine if motivational interviewing-based telephone counseling increases health promotion activities and improves other health outcomes in people with multiple sclerosis (MS). Design Randomized controlled trial with wait-list controls and single-blinded outcome assessments conducted at baseline and at 12 weeks. Setting MS research and training center in the Pacific Northwest. Participants Community-residing persons (N=130) with physician confirmed MS aged 18 or older who were able to walk unassisted at least 90m (300ft). Intervention A single in-person motivational interview followed by 5 scheduled telephone counseling sessions to facilitate improvement in 1 of 6 health promotion areas: exercise, fatigue management, communication and/or social support, anxiety and/or stress management, and reducing alcohol or other drug use. Main Outcome Measures Health Promotion Lifestyle Profile II plus fatigue impact, subjective health, and objective measures of strength, fitness, and cognition. Intent-to-treat analyses of change scores were analyzed using nonparametric tests. Results Seventy persons were randomized to treatment and 60 to the control condition. The treatment group reported significantly greater improvement in health promotion activities, including physical activity, spiritual growth, and stress management as well as in fatigue impact and mental health compared with controls. In addition, the exerciser subgroup showed greater improvement than controls in self-selected walking speed. Conclusions A less intensive, more accessible approach to health promotion based on telephone counseling and motivational interviewing shows promise and merits further study.

Impact of aerobic training on immune-endocrine parameters, neurotrophic factors, quality of life and coordinative function in multiple sclerosis

In recent years it has become clear that multiple sclerosis (MS) patients benefit from physical exercise as performed in aerobic training but little is known about the effect on functional domains and physiological factors mediating these effects. We studied immunological, endocrine and neurotrophic factors as well as coordinative function and quality of life during an 8-week aerobic bicycle training in a waitlist control design. In the immune-endocrine study (1) 28 patients were included, the coordinative extension study (2) included 39 patients. Training was performed at 60% VO 2max after determining individual exertion levels through step-by-step ergometry. Metabolic (lactate), endocrine (cortisol, adrendocortico-releasing hormone, epinephrine, norepinephrine), immune (IL-6, soluble IL-6 receptor), and neurotrophic (brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF)) parameters were compared from a prestudy and a poststudy endurance test at 60% VO 2max for 30 min. In study (1), lowered lactate levels despite higher workload levels indicated a training effect. Disease-specific quality of life (as measured by the Hamburg Quality of Life Questionnaire for Multiple Sclerosis, HAQUAMS) significantly increased in the training group. No significant training effects were seen for endocrine and immune parameters or neurotrophins. In study (2), two out of three coordinative parameters of the lower extremities were significantly improved. In summary, low-level aerobic training in MS improves not only quality of life but also coordinative function and physical fitness.

YNT‐Schering fellowship in clinical training in multiple sclerosis

YNT‐Schering fellowship in clinical training in multiple sclerosis

Expiratory training in multiple sclerosis

Objective: To compare the effects of expiratory muscle training and sham training on respiratory muscle strength in patients with multiple sclerosis (MS). Design: A randomized control trial; subjects were randomly assigned to either expiratory muscle training or sham training. Setting: Training and measurement of respiratory muscle pressures were conducted in patients' homes. Weekly home visits were conducted to assure compliance with the training protocols and to obtain measurements. Patients: Twenty subjects with clinically definite MS and decreased expiratory muscle strength entered the study; 10 subjects completed 3 months of expiratory training using a threshold training device and 5 subjects completed 3 months of sham training using the same device but without an expiratory training threshold load. Measurement: Respiratory muscle strength was assessed at baseline and after 1, 2, and 3 months of training; maximal inspiratory and expiratory pressures were used as measures of respiratory muscle strength. results: There was a significant increase in expiratory muscle strength after 3 months of training when the expiratory training group was compared to the sham group ( p = .003); no significant change in inspiratory muscle strength was observed. Conclusions: The results of this pilot study suggest that the strength of the expiratory muscles of persons with MS can be increased through respiratory muscle training targeted to the expiratory muscles. Further research is indicated to determine if increasing the strength of the expiratory muscles in MS has an effect on clinical outcomes in this patient population.