Multimodal exercise training in multiple sclerosis: A randomized controlled trial in persons with substantial mobility disability
Multimodal exercise training in multiple sclerosis: A randomized controlled trial in persons with substantial mobility disability
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DOI：
10.1016/j.cct.2017.07.016
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发表时间：
2017-10-01
影响因子：
2.2
通讯作者：
Motl, Robert W.
中科院分区：
文献类型：
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作者：
Sandroff, Brian M.;Bollaert, Rachel E.;Motl, Robert W.
背景：行动不便是多发性硬化症(MS)常见的、使人衰弱的特征。运动训练已被确定为改善多发性硬化症相关活动障碍的一种方法。然而，关于多发性硬化症患者行动能力的运动随机对照试验(RCT)一般没有选择性地针对那些发生不可逆性行动能力障碍的患者。目的：目前的多地点随机对照试验比较了6个月有监督的多模式运动训练和积极控制条件在改善MS相关性行动障碍患者的行动能力、步态、体能和认知结果方面的有效性。方法：83名MS相关活动障碍的参与者接受了最初的行动能力、步态、体能和认知加工速度评估，并被随机分配到6个月的监督多模式(渐进性有氧、阻力、和平衡)运动训练(干预条件)或伸展和调理活动(对照条件)。结果：6分钟步行能力(F(2158)=3.12，p=0.05，ETA(2)(P)=0.04)、峰值功率输出(F(2150)=8.16，p<；与对照组相比，干预组的步态成绩无显著差异(F(2162)=4.67，p=0.01，ETA(2)(P)=0.05)。结论：多模式运动训练可改善MS患者的耐力行走能力和认知加工速度，其机制可能与心肺功能的改善有关。这对于在更大样本的多发性硬化症相关活动障碍患者中开发多部位运动康复计划至关重要。
Background: Mobility disability is a common, debilitating feature of multiple sclerosis (MS). Exercise training has been identified as an approach to improve MS-related mobility disability. However, exercise randomized controlled trials (RCTs) on mobility in MS have generally not selectively targeted those with the onset of irreversible mobility disability.Objectives: The current multi-site RCT compared the efficacy of 6-months of supervised, multimodal exercise training with an active control condition for improving mobility, gait, physical fitness, and cognitive outcomes in persons with substantial MS-related mobility disability.Methods: 83 participants with substantial MS-related mobility disability underwent initial mobility, gait, fitness, and cognitive processing speed assessments and were randomly assigned to 6-months of supervised multimodal (progressive aerobic, resistance, and balance) exercise training (intervention condition) or stretching-and-toning activities (control condition). Participants completed the same outcome assessments halfway through and immediately following the 6-month study period.Results: There were statistically significant improvements in six-minute walk performance (F(2158) = 3.12, p = 0.05, eta(2)(p) = 0.04), peak power output (F(2150) = 8.16, p < 0.01, eta(2)(p) = 0.10), and Paced Auditory Serial Addition Test performance (F(2162) = 4.67, p = 0.01, eta(2)(p) = 0.05), but not gait outcomes, for those who underwent the intervention compared with those who underwent the control condition.Conclusions: This RCT provides novel, preliminary evidence that multimodal exercise training may improve endurance walking performance and cognitive processing speed, perhaps based on improvements in cardiorespiratory capacity, in persons with MS with substantial mobility disability. This is critical for informing the development of multi-site exercise rehabilitation programs in larger samples of persons with MS-related mobility disability.