[Effect of physical exercise on adaptation to energy expenditure in multiple sclerosis].

The ability to walk and the activities of daily life in patients with multiple sclerosis may be impaired by metabolic and cardiorespiratory factors, since an energy cost of walking (Cw) more than twice the normal value has recently been demonstrated. In 12 clinically stable patients (9 men, 3 women, age 38 +/- 7 years) resting pulmonary functions, walking performance and cardiorespiratory response to walking on a treadmill at slow speed were examined before and after a 24 +/- 6 days period of rehabilitation. There was a significant improvement (p less than 0.01) in walking distance (+31%), endurance time (+26%), maximal speed (+15%) and oxygen pulse at the maximal speed (+18%). The heart rate/oxygen consumption and minute ventilation/oxygen consumption ratios and Cw were above normal and were unchanged after the period of rehabilitation. The respiratory muscle strength was decreased by 38% (p less than 0.05 from a control group) and did not change. From these preliminary results it is concluded that a 3-4 week period of rehabilitation improves walking performance. This improvement is probably the result of improved cardiorespiratory fitness due to the training effect.