Vigorous cool room treadmill training to improve walking ability in people with Multiple Sclerosis who use ambulatory assistive devices: A feasibility study.

10.21203/rs.2.17182/v3 ◽

2020 ◽

Author(s):

Augustine J Devasahayam ◽

Arthur R Chaves ◽

Wendy O Lasisi ◽

Marie E Curtis ◽

Katie P Wadden ◽

...

Keyword(s):

Quality Of Life ◽

Walking Speed ◽

Maximal Oxygen Consumption ◽

Walking Ability ◽

Attendance Rates ◽

Brain Repair ◽

Impact Scale ◽

Sf 36 ◽

Fatigue Impact Scale

Abstract Background: Aerobic training has the potential to restore function, stimulate brain repair, and reduce inflammation in people with Multiple Sclerosis (MS). However, disability, fatigue, and heat sensitivity are major barriers to exercise for people with MS. We aimed to determine the feasibility of conducting vigorous harness-supported treadmill training in a room cooled to 16°C (10 weeks; 3times/week) and examine the longer-term effects on markers of function, brain repair, and inflammation among those using ambulatory aids. Methods: Ten participants (9 females) aged 29 to 74 years with an Expanded Disability Status Scale ranging from 6 to 7 underwent training (40 to 65% heart rate reserve) starting at 80% self-selected walking speed. Feasibility of conducting vigorous training was assessed using a checklist, which included attendance rates, number of missed appointments, reasons for not attending, adverse events, safety hazards during training, reasons for dropout, tolerance to training load, subjective reporting of symptom worsening during and after exercise, and physiological responses to exercise. Functional outcomes were assessed before, after, and 3 months after training. Walking ability was measured using Timed 25 Foot Walk test and on an instrumented walkway at both fast and self-selected speeds. Fatigue was measured using fatigue/energy/vitality sub-scale of 36-Item Short-Form (SF-36) Health Survey, Fatigue Severity Scale, modified Fatigue Impact Scale. Aerobic fitness (maximal oxygen consumption) was measured using maximal graded exercise test (GXT). Quality-of-life was measured using SF-36 Health Survey. Serum levels of neurotrophin (brain-derived neurotrophic factor) and cytokine (interleukin-6) were assessed before and after GXT. Results: Eight of the ten participants completed training (attendance rates >80%). No adverse events were observed. Fast walking speed (cm/s), gait quality (double-support (%)) while walking at self-selected speed, fatigue (modified Fatigue Impact Scale), fitness (maximal workload achieved during GXT), and quality-of-life (physical functioning sub-scale of SF-36) improved significantly after training, and improvements were sustained after 3-months. Improvements in fitness (maximal respiratory exchange ratio and maximal oxygen consumption during GXT) were associated with increased brain-derived neurotrophic factor and decreased interleukin-6. Conclusion: Vigorous cool room training is feasible and can potentially improve walking, fatigue, fitness, and quality-of-life among people with moderate to severe MS-related disability.

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Vigorous cool room treadmill training to improve walking ability in people with Multiple Sclerosis using ambulatory assistive devices: A feasibility study.

10.21203/rs.2.17182/v1 ◽

2019 ◽

Author(s):

Augustine J Devasahayam ◽

Arthur R Chaves ◽

Wendy O Lasisi ◽

Marie E Curtis ◽

Katie P Wadden ◽

...

Keyword(s):

Quality Of Life ◽

Health Survey ◽

Maximal Oxygen Consumption ◽

Walking Ability ◽

Brain Repair ◽

Double Support ◽

Impact Scale ◽

Sf 36 ◽

Fatigue Impact Scale

Abstract Background: Aerobic training has the potential to restore function, stimulate brain repair, and reduce inflammation in people with Multiple Sclerosis (MS). However, disability, fatigue, and heat sensitivity are major barriers to exercise for people with MS. We aimed to determine the feasibility of conducting vigorous harness-supported treadmill training in a room cooled to 16°C (10 weeks; 3times/week) and examine the longer-term effects on markers of function, brain repair, and inflammation among those using ambulatory aids. Methods: Ten participants (9 females) aged 29 to 74 years with an Expanded Disability Status Scale ranging from 6 to 7 underwent training (40 to 65% heart rate reserve) starting at 80% self-selected walking speed. Feasibility of conducting vigorous training was assessed using a checklist, which included attendance rates, number of missed appointments, reasons for not attending, adverse events, safety hazards during training, reasons for dropout, tolerance to training load, subjective reporting of symptom worsening during and after exercise, and physiological responses to exercise. Functional outcomes were assessed before, after, and 3 months after the completion of training. Walking ability was measured using Timed 25 Foot Walk test and on an instrumented walkway at both fast and self-selected speeds (stance (%), swing (%), double support (%)). Fatigue was measured using standardized questionnaires (fatigue/energy/vitality sub-scale of 36-Item Short-Form (SF-36) Health Survey, Fatigue Severity Scale, modified Fatigue Impact Scale). Aerobic fitness (maximal oxygen consumption) was measured using maximal graded exercise test (GXT). Quality-of-life was measured using SF-36 Health Survey. Serum levels of neurotrophin (brain-derived neurotrophic factor) and cytokine (interleukin-6) were assessed before and after GXT. Results: Fast walking speed (cm/s), gait quality (double-support (%)) while walking at self-selected speed, fatigue (modified Fatigue Impact Scale), fitness (maximal workload achieved during GXT), and quality-of-life (physical functioning sub-scale of SF-36 Health Survey) improved significantly after training, and improvements were sustained after 3-months. Improvements in fitness (maximal respiratory exchange ratio and maximal oxygen consumption during GXT) were associated with increased brain-derived neurotrophic factor and decreased interleukin-6. Conclusion: Vigorous cool room training is feasible and can potentially improve walking, fatigue, fitness, and quality-of-life among people with moderate to severe MS-related disability.

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Randomized controlled trial of an energy conservation course for persons with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1198oa ◽

2005 ◽

Vol 11 (5) ◽

pp. 592-601 ◽

Cited By ~ 129

Author(s):

Virgil G Mathiowetz ◽

Marcia L Finlayson ◽

Kathleen M Matuska ◽

Hua Yun Chen ◽

Ping Luo

Keyword(s):

Quality Of Life ◽

Energy Conservation ◽

Self Efficacy ◽

Controlled Trial ◽

Conservation Strategies ◽

Randomized Controlled ◽

Impact Scale ◽

Sf 36 ◽

Fatigue Impact Scale

Objective: To assess the short-term efficacy and effectiveness of a six-week energy conservation course on fatigue impact, quality of life and self-efficacy for persons with multiple sclerosis (MS). Methods: In this randomized controlled trial, we randomly assigned 169 persons with MS to an immediate intervention group or a delayed control group using a crossover design. The outcome measures: Fatigue Impact Scale, SF-36 Health Survey and Self-Efficacy for Performing Energy Conservation Strategies were measured before and after courses and no intervention control periods. We performed intent-to-treat analysis and compliers-only analyses using mixed effects analysis of variance models. Results: Taking the energy conservation course had significant effects on reducing the physical and social subscales of Fatigue Impact Scale and on increasing the Vitality subscale of the SF-36 scores compared with not taking the course. Additional subscales were significant depending on methods of analyses. Self-Efficacy for Performing Energy Conservation Strategies Assessment increased significantly (p<0.05) postcourse compared to precourse. Conclusions: Results support the efficacy and effectiveness of the energy conservation course to decrease fatigue impact, and to increase self-efficacy and some aspects of quality of life.

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Physical, cognitive and psychosocial effects of telerehabilitation-based motor imagery training in people with multiple sclerosis: A randomized controlled pilot trial

Journal of Telemedicine and Telecare ◽

10.1177/1357633x18822355 ◽

2019 ◽

Vol 26 (5) ◽

pp. 251-260 ◽

Cited By ~ 2

Author(s):

Turhan Kahraman ◽

Sema Savci ◽

Asiye Tuba Ozdogar ◽

Zumrut Gedik ◽

Egemen Idiman

Keyword(s):

Quality Of Life ◽

Motor Imagery ◽

Cognitive Functions ◽

Walking Speed ◽

Dynamic Balance ◽

Pilot Trial ◽

Control Group ◽

Walking Ability ◽

Balance Confidence

Introduction Motor imagery training delivered at home via telerehabilitation is a novel rehabilitation concept. The aim was to investigate the effects of telerehabilitation-based motor imaging training (Tele-MIT) on gait, balance and cognitive and psychosocial outcomes in people with multiple sclerosis (pwMS). Methods This randomized, controlled pilot trial included pwMS and healthy individuals. pwMS were randomly divided into two groups, intervention and control. The intervention group received Tele-MIT twice a week for 8 weeks. The control group was a wait-list group without any additional specific treatment. Healthy participants served as a baseline comparison. The Dynamic Gait Index, used to assess dynamic balance during walking, was the primary outcome. Secondary outcomes included assessments of walking speed, endurance and perceived ability, balance performance assessed by a computerized posturography device, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life. Results Baseline comparisons with healthy individuals revealed that motor imagery abilities were preserved in pwMS ( p > 0.05). The intervention group exhibited significant improvements in dynamic balance during walking ( p = 0.002), walking speed ( p = 0.007), perceived walking ability ( p = 0.008), balance confidence ( p = 0.002), most cognitive functions ( p = 0.001–0.008), fatigue ( p = 0.001), anxiety ( p = 0.001), depression ( p = 0.005) and quality of life ( p = 0.002). No significant changes were observed in the control group in any of the outcome measures ( p > 0.05). Discussion Tele-MIT is a novel method that proved feasible and effective in improving dynamic balance during walking, walking speed and perceived walking ability, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life in pwMS.

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Comparison of the influence of different rehabilitation programmes on clinical, spirometric and spiroergometric parameters in patients with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/135248506ms1248oa ◽

2006 ◽

Vol 12 (2) ◽

pp. 227-234 ◽

Cited By ~ 53

Author(s):

K Rasova ◽

E Havrdova ◽

P Brandejsky ◽

M Zálišová ◽

B Foubikova ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Aerobic Training ◽

Combined Therapy ◽

Bicycle Ergometer ◽

Beck Depression Inventory Score ◽

Impact Scale ◽

Fatigue Impact Scale ◽

Training Programmes

Purpose The aim of this study was to compare the effect of four different programmes on spiroergometric, spirometric and clinical parameters in multiple sclerosis (MS) patients.Methods One hundred and twelve MS patients were divided into four groups. The first group underwent neurophysiologically based physiotherapy, the second aerobic training, the third combined therapy (neurophysiologically based physiotherapy and aerobic training) and the fourth did not change any habits. Seventeen patients did not finish the study. Patients were examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer).Results The patients who participated in one of our training programmes showed a significant improvement of the examined parameters in comparison to those who did not change their present habits. Each of the four training programmes had a different impact on the parameters, which means that each of them had a different effect. The neurophysiologically based physiotherapy had the greatest impact on impairment, and the aerobic training on spirometric and spiroergometric parameters. All methods (the neurophysiologically based physiotherapy, the aerobic training and the combined programme) had an impact on fatigue.

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Fatigue in Parkinson’s disease: Metric properties of the fatigue impact scale for daily use (D-FIS), and its impact on quality of life

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2018.03.020 ◽

2018 ◽

Vol 169 ◽

pp. 12-15 ◽

Cited By ~ 4

Author(s):

Marcos Serrano-Dueñas ◽

Rosaura Bravo ◽

Tamara Merchán ◽

Maite Serrano

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Metric Properties ◽

Impact Scale ◽

Fatigue Impact Scale

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Effect of Gait Parameters On Balance and Quality of Life in Recovering Stroke Patients- A Correlation Study

Journal of Pharmaceutical Research ◽

10.33140/jpr.06.02.03 ◽

2021 ◽

Vol 6 (2) ◽

Keyword(s):

Quality Of Life ◽

Stride Length ◽

Correlation Study ◽

Gait Velocity ◽

Walking Ability ◽

Stroke Patients ◽

Gait Parameters ◽

Stroke Impact Scale ◽

Impact Scale

Introduction: Stroke is neurovascular disease caused by disruption of blood flow to brain, result in neurological deficit. As a consequence of stroke there will be loss of leg strength and impaired balance that may affect walking ability. Gait parameters are also affected as a consequences of stroke. Overall affection of gait parameters and balance will affect Quality of Life. Objective: The study is conducted to find out relationship between Gait parameters, Balance and Quality of Life in recovering stroke patients- A Correlation Study” Material and Methodology: Total 32 patients were screened as per inclusion and exclusion criteria. Demographic data was taken. At the time of discharge from the hospital Health status was assessed with use of stroke Impact scale. TUG was taken to measure the Balance. Gait velocity was calculated by use of 6 minute walk test. Result: Total 32 Recovering stroke Patients have participated in the study. All the stroke patients who have participated in the study were having mean age of 52.65 years and participants of both the genders were included. Amongst the participants’ males were 78.21% and females were 21.9%. Were included in the study. Participants with both sided strokes were consider for data collection. Stroke impact scale score has found to have positive correlation with Gait velocity, and stride length, and negative correlation with TUG. (P = .001 to P = .031). TUG score correlated negatively with Gait Velocity and Stride Length. Conclusion: Gait parameters have impact on Quality of Life have but will not produce much difference on balance. There is no significant influence of gait parameters on Balance.

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Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100015353 ◽

2012 ◽

Vol 39 (5) ◽

pp. 619-625 ◽

Cited By ~ 23

Author(s):

Natalie E. Parks ◽

Gail A. Eskes ◽

Gordon J. Gubitz ◽

Yvette Reidy ◽

Christine Christian ◽

...

Keyword(s):

Quality Of Life ◽

Ischemic Stroke ◽

Stroke Severity ◽

Stroke Patients ◽

Younger Patients ◽

Post Stroke ◽

Impact Scale ◽

Fatigue Impact Scale ◽

One Year

Background:Fatigue affects 33-77% of stroke survivors. There is no consensus concerning risk factors for fatigue post-stroke, perhaps reflecting the multifaceted nature of fatigue. We characterized post-stroke fatigue using the Fatigue Impact Scale (FIS), a validated questionnaire capturing physical, cognitive, and psychosocial aspects of fatigue.Methods:The Stroke Outcomes Study (SOS) prospectively enrolled ischemic stroke patients from 2001-2002. Measures collected included basic demographics, pre-morbid function (Oxford Handicap Scale, OHS), stroke severity (Stroke Severity Scale, SSS), stroke subtype (Oxfordshire Community Stroke Project Classification, OCSP), and discharge function (OHS; Barthel Index, BI). An interview was performed at 12 months evaluating function (BI; Modified Rankin Score, mRS), quality of life (Reintegration into Normal living Scale, RNL), depression (Geriatric Depression Scale, GDS), and fatigue (FIS).Results:We enrolled 522 ischemic stroke patients and 228 (57.6%) survivors completed one-year follow-up. In total, 36.8% endorsed fatigue (59.5% rated one of worst post-stroke symptoms). Linear regression demonstrated younger age was associated with increased fatigue frequency (β=-0.20;p=0.01), duration (β=-0.22;p<0.01), and disability (β=-0.24;p<0.01). Younger patients were more likely to describe fatigue as one of the worst symptoms post-stroke (β=-0.24;p=0.001). Younger patients experienced greater impact on cognitive (β=-0.27;p<0.05) and psychosocial (β=-0.27;p<0.05) function due to fatigue. Fatigue was correlated with depressive symptoms and diminished quality of life. Fatigue occurred without depression as 49.0% of respondents with fatigue as one of their worst symptoms did not have an elevated GDS.Conclusions:Age was the only consistent predictor of fatigue severity at one year. Younger participants experienced increased cognitive and psychosocial fatigue.

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Associations between health-related quality of life, physical function and pain in older women with osteoporosis and vertebral fracture

BMC Geriatrics ◽

10.1186/s12877-019-1268-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Brita Stanghelle ◽

Hege Bentzen ◽

Lora Giangregorio ◽

Are Hugo Pripp ◽

Astrid Bergland

Keyword(s):

Quality Of Life ◽

Vertebral Fracture ◽

Physical Function ◽

Older Women ◽

Walking Speed ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related

Abstract Background Osteoporosis and vertebral fractures represent a major health burden worldwide, and the prevalence of osteoporosis is expected to increase as the world’s population ages. Suffering from vertebral fracture has a substantial impact on the individual’s health-related quality of life (HRQoL), physical function and pain. Complex health challenges experienced by older people with osteoporosis and vertebral fractures call for identification of factors that may influence HRQoL, as some of these factors may be modifiable. The objective is to examine the independent associations between HRQoL, physical function and pain in older women with osteoporosis and vertebral fracture. Methods This study has a cross-sectional design, using data from 149 home-dwelling Norwegian women with osteoporosis and vertebral fracture, aged 65+. Data on HRQoL (Short Form 36 (SF-36), Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41)), physical function (walking speed, balance and strength), pain, as well as sociodemographic information were collected. Simple linear regression analyses were conducted and multivariable regression models were fitted to investigate the associations. Results Lower levels of HRQoL were significantly associated with lower levels of physical function, measured by walking speed, and higher levels of pain. Pain was significantly associated with all of the subscales in SF-36, with the exception of Mental Health and Mental Component Score, and all the subscales of QUALEFFO-41. Walking speed was significantly associated with 5 of 8 subscales of SF-36 (except Bodily Pain, Vitality, Mental Health and Mental Component Score), and with 4 of 6 subscales of QUALEFFO-41 (except Score Pain and Mood). Conclusion This study shows that pain and walking speed were, independently of one another, associated with HRQoL in older women with osteoporosis and vertebral fracture. These findings can inform clinicians and health managers about the importance of pain management and exercise interventions in health care for this group. Future research should address interventions targeting both physical function and pain with HRQoL as an outcome. Registration ClincialTrials.gov Identifier: NCT02781974. Registered 18.05.16. Retrospectively registered.

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Spiroergometric and spirometric parameters in patients with multiple sclerosis: are there any links between these parameters and fatigue, depression, neurological impairment, disability, handicap and quality of life in multiple sclerosis?

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1155oa ◽

2005 ◽

Vol 11 (2) ◽

pp. 213-221 ◽

Cited By ~ 19

Author(s):

K Rasova ◽

P Brandejsky ◽

E Havrdova ◽

M Zalisova ◽

P Rexova

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Neurological Impairment ◽

Population Based ◽

Bicycle Ergometer ◽

Beck Depression Inventory Score ◽

Respiratory Dysfunction ◽

Impact Scale ◽

Fatigue Impact Scale

One-hundred and twelve patients with multiple sclerosis were selected as population-based sample and examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), the quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer).The aim of the study was to examine and analyse (descriptive statistics) spiroergometric and spirometric parameters in patients with multiple sclerosis. Firstly, we tested the hypothesis whether spiroergometric and spirometric parameters are decreased and whether there are any correlations between these parameters and measures of impairment, depression, disability, handicap and quality of life. Secondly, we tested the hypothesis whether there is any correlation between a possible deconditioning and fatigue, and between a possible respiratory dysfunction and fatigue in multiple sclerosis.It results from this study that many spiroergometric parameters in patients with multiple sclerosis are significantly lowered in comparison to the population norm. A link can be found between some spiroergometric parameters and neurological impairment, disability, handicap and quality of life. It is not possible to prove any correlation between spiroergometric parameters and depression. From the spirometric parameters, these are expiratory flows that are significantly lowered in MS patients. It is not possible to prove any correlation between spirometric parameters and fatigue, depression, neurological impairment, duration of the disease, disability, handicap and quality of life in multiple sclerosis.

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