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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2017 May 31

DOI: 10.23736/S1973-9087.17.04218-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Quality of the tools used to assess aerobic capacity in persons with multiple sclerosis: a systematic review

Maxime VALET 1, 2, Thierry LEJEUNE 1, 2, Jean C., HAKIZIMANA 2, Gaëtan STOQUART 1, 2

1 Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), Neuro Musculo Skeletal Lab (NMSK), Brussels, Belgium; 2 Cliniques Universitaires Saint-Luc, Service de Médecine Physique et Réadaptation, Brussels, Belgium


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BACKGROUND: Assessments of physical fitness, including exercise tolerance functions, are valuable in persons with Multiple Sclerosis (MS). Many tools with widely varying advantages and disadvantages have been used to assess physical fitness in research and clinical practice. To date, there are no recommendations regarding the best tools to use for this purpose in persons with MS.
AIM: This study aimed to systematically review the psychometric properties of the tools used to assess exercise tolerance functions in persons with MS and to propose recommendations regarding the best test to use.
DESIGN: Systematic review.
SETTING: All settings.
POPULATION: Persons with MS.
METHODS: The literature was searched (PubMed, SPORTdiscus, PEDro, MEDLINE, Embase (via Scopus), CINAHL and PsycInfo) to identify the tools most frequently used to assess exercise tolerance functions. These tools were systematically analysed.
RESULTS: Forty-eight articles were selected. Six tools or categories of tools concerning exercise tolerance functions were identified. Whole-body exercise tests combined with gas exchange analysis had the best psychometric properties (e.g., validity, reliability) for assessing aerobic capacity in pwMS with mild to moderate disability (Expanded Disability Status Scale (EDSS) ≤ 6.5). Although sometimes used for this purpose, walk tests seemed to assess walking performance rather than exercise tolerance functions. The psychometric properties of other tests had scarcely been studied.
CONCLUSIONS: The tools vary widely in quality. Whole-body exercise testing combined with gas exchange analysis has the best psychometric properties of the reviewed tools.
CLINICAL REHABILITATION IMPACT: If gas exchange analysis is feasible, whole-body exercise tests combined with gas exchange analysis, with maximal exercise effort for pwMS with EDSS ≤ 4 and submaximal exercise effort for pwMS with EDSS ≥ 4.5, should be recommended to assess exercise tolerance, both in research and in clinical practice. A selection algorithm is proposed.


KEY WORDS: Multiple sclerosis - Aerobic capacity - Exercise tolerance - Physical fitness - ICF

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thierry.lejeune@uclouvain.be