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Kileff, J., & Ashburn, A. (2005). A pilot study of the effect of aerobic exercise on people with moderate disability multiple sclerosis. Clinical Rehabilitation, 19, 165-169.
Abstract by: Pandit Tejal
The importance of regular exercise and its effect on healthy adults is widely documented but there is not enough literature regarding the effects of aerobic exercise on multiple sclerosis (MS). Since scientists have found that people with MS have reduced tolerance for exercise due to reduced cardio-respiratory fitness, while aerobic exercise increases overall physical activity and cardiovascular effort, this intervention was designed to use aerobic exercise for people with moderate MS. The main purpose of this pilot study was to find the effects of an aerobic training program to improve the function, specifically mobility, of people with moderate disability multiple sclerosis.
Eight female subjects, average age 45 years (range 33 to 61 years) with moderate disability MS (Kurtzke scale 4 to 6), were recruited from the outpatient clinics through consultants in neurology, but only six participants completed the study.
Moderate level MS (determined by Kurtzke scale 4 to 6). Mobile with or without an aid.
Mild or severe MS.
A main symptom of fatigue.
A recent exacerbation or other major medical problems, such as cardiovascular disease or musculoskeletal problems. Unable to cycle a stationary bike.
Pre-intervention, the stability of the condition of each individual was recognized by repeating the 6-min walk, 10-m walk and functional reach measures 3 times over 2 weeks.
The experiment protocol consisted of bi-weekly sessions of 20 minutes of cycling on a stationary bike at a participant maximal level of exertion of 12 weeks (24 sessions in total). At the first session, participants started with 14 minutes of cycling, and then increased their cycling progressively to 31 minutes over the first 4 sessions, with the exception of one subject who was unable to manage 31 minutes until session 10. Since it was not possible for the subjects to reach the calculated 'aerobic training zone,' they worked at their maximum each session. One physiotherapist recorded the initial measurements and was involved in providing the treatment. To avoid intra-rater error and to assess inter-rater agreement, a second assessor (not involved in the treatment) completed the final assessments. The mean of the differences between the assessors was calculated separately. Participants' reaching 60% to 80% of their working heart rate was calculated by subtracting their resting heart rates from maximum heart rates (209- (0.9 times; age)). The goal of each subject intervention was to enable participants to reach their aerobic training zone.
The study found a significant difference on the Guys Neurological Disability Scale (GNDS) (p = 0.026) and the 6-minute walk test (p = 0.046) in comparing pre- and post-intervention using the Wilcoxon signed rank test. Also, improvements in disability significantly took place only in the lower limb function section (p = 0.046), which reflected the training effect.
It has been suggested that the aerobic training can improve overall mobility and disability level of moderate MS patients and it has a positive treatment effect. However, more research should focus on the mechanisms that support aerobic training for different levels of MS. Since the results show endurance improvement in the subjects, it may be concluded that one of the benefits of the aerobic exercise training for people with MS is endurance enhancement and its positive implications for individuals' lifestyles.