Department of Physiology and Immunology, University of Rijeka Faculty of Medicine, B. Branchetta 20, 51000, Rijeka, Croatia.
Department of Physiotherapy, University of Rijeka Faculty of Health Studies, Rijeka, Croatia.
Neurol Sci. 2019 Apr;40(4):733-743. doi: 10.1007/s10072-019-3707-0. Epub 2019 Jan 18.
To evaluate the feasibility of a combined upper limb and breathing exercise for a home-based program and to explore its effect on primary fatigue and quality of life in ambulatory and non-ambulatory individuals with multiple sclerosis (MS) in a short time.
Nineteen individuals with MS were assigned into semi-controlled pre-post feasibility study based on Expanded Disability Status Scale (EDSS) status and divided into two groups: exercise (five ambulatory, five non-ambulatory; EDSS 1.0-8.0) and related control with no exercise (four ambulatory, five non-ambulatory; EDSS 1.0-7.5). Exercise group performed combined upper limb and breathing exercise in a controlled group (2 days/week, 60 min/session) accompanied by independent home exercise (3 days/week, ≥ 20 min/session). Participants underwent measures of fatigue impact (Modified Fatigue Impact Scale (MFIS) and quality of life (RAND Medical outcomes study 36-item short-form health survey (SF-36)) before and after a 4-week period.
The MFIS (physical, psychosocial, total) showed statistically significant group-by-time interaction in ambulatory (p = 0.033, d = 1.60; p = 0.039, d = 1.59; p = 0.033, d = 1.62) and non-ambulatory individuals (p = 0.009, d = 2.42; p = 0.018, d = 1.96; p = 0.0008, d = 3.92). Physical functioning (SF-36) showed statistically significant group-by-time interaction in ambulatory (p = 0.014, d = 2.14) but no significance in non-ambulatory (p = 0.368, d = 0.68) individuals. Despite the absent statistical significance, there were large intervention effects on MFIS cognitive scores for ambulatory (d = 1.28) and non-ambulatory (d = 1.47), and on other SF-36 scores for ambulatory (general health: d = 1.76 and pain: d = 1.02) and non-ambulatory (physical limitation: d = 1.03 and emotional well-being: d = 0.94) individuals.
Our 4-week program reduced some aspects of fatigue and improved some aspects of quality of life in a small group of ambulatory and non-ambulatory individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.
Name of the registry: The Impact of Exercise Training on Living Quality in Multiple Sclerosis. Registration: The study was registered at www.clinicaltrial.gov on July 14, 2017. First participant enrollment: August 28, 2017. URL: 602-01/17-01-147; Trial registration ID: NTC03222596.
评估联合上肢和呼吸运动的家庭锻炼方案的可行性，并探讨其对处于活动期和非活动期的多发性硬化症（MS）患者的原发性疲劳和生活质量的短期影响。
根据扩展残疾状态量表（EDSS）的状态，19 名 MS 患者被纳入半对照前后的可行性研究，并分为两组：锻炼组（活动期 5 名，非活动期 5 名；EDSS 1.0-8.0）和相关对照组（活动期 4 名，非活动期 5 名；EDSS 1.0-7.5）。锻炼组在控制组中进行联合上肢和呼吸运动（每周 2 天，每次 60 分钟），并同时进行家庭独立运动（每周 3 天，每次 20 分钟以上）。参与者在 4 周后接受疲劳影响（改良疲劳影响量表（MFIS））和生活质量（RAND 医疗结果研究 36 项简明健康调查（SF-36））的测量。
MFIS（身体、心理社会、总）在活动期（p=0.033，d=1.60；p=0.039，d=1.59；p=0.033，d=1.62）和非活动期（p=0.009，d=2.42；p=0.018，d=1.96；p=0.0008，d=3.92）个体中均显示出统计学上的组间时间交互作用。SF-36 的身体机能（p=0.014，d=2.14）在活动期显示出统计学上的组间时间交互作用，但在非活动期（p=0.368，d=0.68）个体中没有统计学意义。尽管没有统计学意义，但 MFIS 认知评分在活动期（d=1.28）和非活动期（d=1.47）、SF-36 其他评分在活动期（一般健康：d=1.76 和疼痛：d=1.02）和非活动期（身体受限：d=1.03 和情绪健康：d=0.94）个体中都有较大的干预效果。
我们的 4 周方案减少了一部分活动期和非活动期 MS 患者的疲劳程度，并改善了一部分患者的生活质量。良好的可行性和从基线开始的显著积极变化值得进一步探索。
试验名称：运动训练对多发性硬化症患者生活质量的影响。注册机构：该研究于 2017 年 7 月 14 日在 www.clinicaltrial.gov 进行了注册。第一个参与者的入组时间：2017 年 8 月 28 日。网址：602-01/17-01-147；试验注册 ID：NTC03222596。
