Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Ave, Urbana, IL, USA.
Neuropsychiatr Dis Treat. 2010 Nov 16;6:767-74. doi: 10.2147/NDT.S10480.
Multiple sclerosis (MS) is a chronic disease of the central nervous system that culminates in the progression of physical and cognitive disability over time. Walking impairment is a ubiquitous feature of MS and a sentinel characteristic of the later or advanced stages of the disease. This paper presents a conceptual rationale along with empirical evidence for exercise training as a rehabilitation approach for managing walking impairment and improving walking function in persons with MS. Conceptually, MS is associated with a decrease in physical activity, which, in turn, can result in deconditioning across multiple domains of physiological functioning. The resulting deconditioning feeds back and further drives physical inactivity until a threshold is reached that likely initiates the progression of walking impairment in MS. Empirically, physical activity and exercise training have been associated with beneficial effects on walking function in persons with MS. This is based on cross-sectional, longitudinal, and experimental research that included diversity in the breadth of measures of walking, persons with MS, and exercise/physical activity characteristics. Of particular importance, future researchers might consider examining the combinatory effects of exercise training plus pharmacological agents on walking mobility in MS. Collectively, exercise training and physical activity might hold significant potential for the management of progressive mobility disability in MS.
多发性硬化症 (MS) 是一种中枢神经系统的慢性疾病，随着时间的推移，会导致身体和认知能力逐渐衰退。行走障碍是 MS 的普遍特征，也是疾病后期或晚期的一个显著特征。本文提出了一个概念性的基本原理，并提供了实证证据，证明运动训练是一种康复方法，可用于管理 MS 患者的行走障碍和改善行走功能。从概念上讲，MS 与身体活动减少有关，而身体活动减少又会导致多个生理功能领域的身体适应不良。由此产生的身体适应不良会产生反馈，进一步导致身体不活动，直到达到一个可能引发 MS 行走障碍进展的阈值。从实证角度来看，身体活动和运动训练与 MS 患者的行走功能改善有关。这是基于横断面、纵向和实验研究得出的，这些研究包括了行走、MS 患者和运动/身体活动特征的广泛测量方法的多样性。特别重要的是，未来的研究人员可能会考虑研究运动训练加药物治疗对 MS 行走移动性的联合效应。总的来说，运动训练和身体活动可能对 MS 进行性移动性残疾的管理具有重要意义。
