Mañago Mark M, Forster Jeri E, Biondi Eliza, Schenkman Margaret, Cameron Michelle H, Christiansen Cory L
Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO (M.M.M., J.E.F., E.B., M.S., C.L.C.); Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (M.M.M.); Department of Research, VA Eastern Colorado Healthcare System, Aurora, CO (M.M.M.); Department of Veterans Affairs, VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center, Aurora, CO (J.E.F); Department of Neurology, Oregon Health & Science University, Portland, OR (M.H.C); and Department of Veterans Affairs, VA Geriatric Research Education and Clinical Center (GRECC), Rocky Mountain Regional VA Medical Center, Aurora, CO (C.L.C.).
J Neurol Phys Ther. 2024 Nov 25. doi: 10.1097/NPT.0000000000000504.
This pilot study examined the feasibility of a proximal muscle resistance training program to improve walking in people with multiple sclerosis using a combination of in-person, virtual, and independent exercise sessions.
People with multiple sclerosis (Expanded Disability Status Scale Score is <6.0) were recruited to a study of resistance training exercises targeting hip abduction and trunk muscles for 10 weeks. Feasibility criteria were: enrolling 40 participants, retaining ≥80%, ≥80% visit adherence, no serious intervention-related adverse events, and ≥80% satisfaction. The 6-Minute Walk Test, Timed 25-Foot Walk Test, muscle performance (hip abduction and lateral trunk flexion strength, and trunk flexion endurance), patient-reported outcomes, daily step count, and pelvis and trunk kinematics were measured before and after intervention. Patient-reported outcomes and step count were measured again 12 weeks after intervention.
Twenty-eight people (median Expanded Disability Status Scale is 3.5) enrolled and 92.8% were retained. Visit adherence was 86.5% (96% for virtual visits, 74% for in-person visits), and 48% of participants preferred virtual visits, while 20% preferred in-person visits. There were no serious intervention-related adverse events, and there was 100% satisfaction. Following intervention, 6-Minute Walk Test distance increased 29.6 m (95% confidence interval [CI], 12.2-47.0), Timed 25-Foot Walk Test decreased by 0.57 seconds (95% CI, -0.85 to -0.29), and all muscle performance outcomes improved. Patient-reported outcomes also improved immediately following intervention. There were no changes in average daily step count or trunk and pelvis kinematics.
This proximal muscle resistance training program was feasible, with benefits in walking and muscle strength, warranting a future efficacy study.
Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A499 ).
本试点研究探讨了近端肌肉阻力训练计划的可行性，该计划通过结合面对面、虚拟和自主锻炼课程，改善多发性硬化症患者的步行能力。
招募多发性硬化症患者（扩展残疾状态量表评分<6.0）参加一项针对髋外展和躯干肌肉的阻力训练研究，为期10周。可行性标准为：招募40名参与者，保留率≥80%，就诊依从率≥80%，无严重的干预相关不良事件，满意度≥80%。在干预前后测量6分钟步行试验、25英尺定时步行试验、肌肉性能（髋外展和侧躯干屈曲力量以及躯干屈曲耐力）、患者报告的结果、每日步数以及骨盆和躯干运动学。在干预12周后再次测量患者报告的结果和步数。
28人（扩展残疾状态量表中位数为3.5）入组，保留率为92.8%。就诊依从率为86.5%（虚拟就诊为96%，面对面就诊为74%），48%的参与者更喜欢虚拟就诊，20%的参与者更喜欢面对面就诊。没有严重的干预相关不良事件，满意度为100%。干预后，6分钟步行试验距离增加了29.6米（95%置信区间[CI]，12.2 - 47.0），25英尺定时步行试验减少了0.57秒（95%CI，-0.85至-0.29），所有肌肉性能指标均有所改善。干预后患者报告的结果也立即得到改善。平均每日步数以及躯干和骨盆运动学没有变化。
该近端肌肉阻力训练计划是可行的，对步行和肌肉力量有益，值得未来进行疗效研究。
可获取视频摘要以了解作者更多见解（见视频，补充数字内容1，可在：http://links.lww.com/JNPT/A499 查看）。
