ORIGINAL ARTICLES   Free access

European Journal of Physical and Rehabilitation Medicine 2015 December;51(6):755-62

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Changes of gait parameters following long-term aerobic endurance exercise in mildly disabled multiple sclerosis patients: an exploratory study

Wonneberger M. ¹, Schmidt S. ^{2, 3} ✉

¹ Schule für Physiotherapie Gummersbach ‑ DAA Gesundheit und Soziales ‑ Gummersbach, Germany; ² Neurologische Gemeinschaftspraxis Bonn, Gesundheitszentrum St. Johannes, Bonn, Germany; ³ Ruhr‑University of Bochum, Department of Neurology, Knappschafts‑Krankenhaus Langendreer, Bochum, Germany

BACKGROUND: The long-term effects of walking based aerobic endurance exercise on gait parameters have not yet been sufficiently investigated in patients with multiple sclerosis (MS).
AIM: To investigate the effects of an aerobic walking exercise program on gait parameters in MS patients over a period of 12 months.
DESIGN: Non-randomized, controlled, exploratory trial.
SETTING: Outpatient, home-based program.
POPULATION: Sixty ambulatory patients with relapsing-remitting MS and an EDSS≤3.5 participating in an individualized twelve month aerobic endurance exercise program were evaluated during a treadmill exercise by video recordings with regard to step cadence, step length and ground contact time at baseline and every three months thereafter for twelve months.
RESULTS: From the 44 patients who completed the study, the ground contact time of the feet was significantly elevated at two load steps (3.2 km/h with 3.5 % slope and 4.8 km/h at 7.5 % incline) after 12 months (P<0.001, ƞp2=0.2; P=0.01, ƞp2=0.1). The step cadence decreased significantly at 3.2 km/h speed with 3.5 % slope (P<0.001, ƞp2=0.2) and the step length increased significantly at the same load step (P<0.001, ƞp2=0.15). Post-hoc analysis revealed no changes in any of the analyzed gait parameters in the internal control group (N.=16) who performed a treadmill exercise after 12 months.
CONCLUSION: Walking based aerobic endurance exercise may contribute to improved gait parameters in MS patients. Further prospective controlled studies are needed to investigate the impact of long-term endurance walking exercise on gait parameters and stability in MS patients.
CLINICAL REHABILITATION IMPACT: The observation that mere walking-based exercise changes gait parameters and could therefore possibly contribute to gait stability without specific balance or muscular training might largely facilitate treatment recommendations for mildly disabled MS patients.