Nagarjuna Narayanasetti

A study to assess the effectiveness of aerobic training on exercise tolerance and functional independence in patients with multiple sclerosis – a quasi experimental study

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  • Nagarjuna Narayanasetti

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Multiple Sclerosis (MS) is a chronic neurological condition characterized by an interruption of action potentials in the brain and spinal cord due to areas of inflammation, demyelination and axonal degeneration. Most people with Multiple Sclerosis (PWMS) complain of physical activity limitations due to fatigue and reduced Exercise Tolerance that leads to reduction in Functional Independence. Till date, there is a limited published evidence of the efficacy of aerobic training on Exercise Tolerance and Functional Independence in individuals with Multiple Sclerosis, although some studies that incorporate aerobic training into rehabilitation programs report positive outcomes with no harmful effects. This was an effort to study the effect of aerobic training on exercise tolerance and functional independence in patients with Multiple Sclerosis. 12 Subjects were selected for the study on the basis of convenient Sampling method. Subjects who were independently mobile with Kurtzke Expanded Disability Status Scale (EDSS) score between 2 and 6.5 and medically stable were included for the study. The parameters of Exercise Tolerance and Functional Independence were assessed with six min walk test distance (6MWTD) and FIMTM+FAM respectively as Pre test measurement. All the subjects were given Aerobic training(AT) with Elliptical trainer and the intensity of the exercise was individualized according to their tolerance with initial stage incline of 0 (no incline) and a resistance of 1 (lowest possible resistance) was fixed. Training was done in a well ventilated training setup and subject was provided with cool water to minimize the effect of heat on activity. Subjects were monitored during the exercise training via heart rate monitor fixed to the machine; heart rate was taken every 3 minutes. The subjects were advised to perform the exercise in their own pace throughout training session for 30 min with breaks as many as they require. Progression of exercise intensity was achieved by increasing the resistance level of the Elliptical machine and/or by increasing the subject's steps per minute (stepping speed was controlled by the subject and not the elliptical machine).To ensure the progress of exercise protocol, the exercise intensity increased every 3 to 4 sessions. Totally 15 sessions were given in 6 weeks period. After 15 session of training Post test measurement for Exercise Tolerance and Functional Independence were taken. The Significance of the Pre test Post test difference were analyzed statistically using student paired “t‟ test . After 6 weeks (15 sessions) of Aerobic training with Elliptical trainer the subjects improved in Exercise Tolerance and level of Functional Independence as compared with the base line conditions. This was indicated by the changes in the Distance covered in 6 MWT and the FIMTM+ FAM score with P value <0.001. In all the subjects who were participated in this study showed greater improvement in the 6 Minute walk test distance and FIMTM+FAM scores. It implies that Aerobic training by Elliptical Trainer is effective for improving Exercise Tolerance and Functional Independence in PWMS.

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