Change in Aerobic Fitness of Patients with Multiple Sclerosis During a 6-Month Training Program

Twenty-three individuals with multiple sclerosis (MS) participated in a 6-month exercise training program; 11 ambulatory (AMB) and 8 semi-ambulatory (SEMI). Four persons with MS served as non-exercising controls (C). A test of maximal aerobic power (V̇O(2max)) was administered at baseline to all subjects. AMB and SEMI subjects exercised on alternating days for 30 minutes, at 55-60% V̇O(2max) using either a commercially available recumbent or upright combination leg/arm bicycle ergometer. At the end of 12 and 24 weeks, exercising subjects were re-evaluated. The C group was only re-evaluated at 24 weeks. The results show that the AMB and SEMI groups experienced a +20% and +5% improvement in V̇O(2max), respectively. The C group averaged a 12% decline in V̇O(2max) during the 6 months. These data demonstrate the possibility that although exercise improves cardiovascular fitness of some persons with less severe MS, this beneficial response may not apply to the more severely impaired patient. Nevertheless, improved cardiovascular health at any level may enhance the overall rehabilitation outcome of many individuals in this patient population

Maximal Aerobic Exercise of Individuals with Multiple Sclerosis Using Three Modes of Ergometry

This study examined metabolic and cardiopulmonary responses during maximal effort exercise in persons with multiple sclerosis (MS) using arm cranking (ARM), leg cycling (LEG), and combined arm/leg cycling (LEG/ARM). Ten individuals with MS were matched to ten, non-MS persons. Peak oxygen uptake (VO(2peak)) was determined via a leg/arm ergometer on 3 separate days. VO(2peak) was significantly higher for the non-MS group for the ARM and the LEG/ARM tests (p\u3c.05), but not for the LEG test. Heart rate (HR) at peak exercise for the MS group was 89, 86 and 91% of age predicted maximal HR during ARM, LEG and LEG/ARM exercise, respectively. The non-MS group was able to reach 96% of its age-predicted HR(max) during all protocols. The addiditive physiologic responses during combined arm/leg ergometry could be advantageous for fitness training persons with MS by dispersing the exercise over a larger muscle mass, placing less stress on any one group. This may translate into improved endurance for ambulation and/or performance activities of daily living

A pilot study of the effect of aerobic exercise on people with moderate disability multiple sclerosis

Objective: A pilot study to investigate the effect of aerobic exercise on the mobility and function of people with moderate disability multiple sclerosis (MS). Design: A small group, comparative, pre- and post-intervention study. Setting: A gymnasium within a general hospital. Subjects: Eight subjects, all female, average age 45 years (range 33-61) with moderate disability MS (Kurtzke scale 46), were recruited six completed the study. Intervention: Intervention consisted of bi-weekly sessions of 30 min cycling on a static bike at their maximal level of exertion for 12 weeks. Main measures: The stability of each individual's condition was established pre-intervention using three baseline assessments over two weeks. A battery of tests (the 10-metre and 6-min walk tests, the Functional Reach, the Gulick and the Guys Neurological Disability Scale) were completed pre and post intervention. Potential negative effects were recorded on the Fatigue Severity Scale and the Modified Ashworth Scale. An independent rater completed assessments post intervention. Inter-rater reliability was found to be acceptable. Results: Comparisons pre and post intervention (Wilcoxon signed ranked test) showed significant improvement on the Guys Neurological Disability Scale (p = 0.026), with the mean score reducing from 13 to 9, and the 6-min walk test (p = 0.046), with the mean distance increasing from 200 m to 261 m. Other measures failed to reach significance. Conclusions: Findings from this pilot study suggest overall disability and mobility improved with the aerobic training. A positive treatment effect in this small study suggests the need for a larger trial. Knowledge of how to establish predictive heart rate and how to monitor the effects of cycling with people with MS will be used to inform future clinical trials