ADAPTED EXERCISE INTERVENTIONS FOR PERSONS WITH PROGRESSIVE MULTIPLE SCLEROSIS

Abstract

<p>Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease that results in a myriad of physical and mental symptoms. Current disease-modifying therapies do not prevent long-term disability accumulation and are particularly ineffective for patients with a progressive disease onset. Exercise may represent an alternative strategy for managing symptoms and disability accumulation, particularly in progressive MS.</p> <p>Whereas the benefits of exercise have been established primarily in ambulatory MS patients with a relapsing disease course, few studies have investigated the benefits of exercise for patients with progressive MS with greater impairment. Therefore, the purpose of this dissertation was to determine the short-term, long-term, and maintenance effects of adapted exercise interventions for patients with progressive MS of high disability which was addressed by conducting two adapted exercise interventions.</p> <p>The first intervention examined the effects of 24 weeks of body weight supported treadmill training (BWSTT) on outcomes of physical and mental functioning, fatigue, quality of life, and brain health. Outcomes were evaluated at baseline, 12, and 24 weeks following the intervention, and again 12 weeks post-intervention. The second intervention evaluated and compared the effects of 12 weeks of total-body recumbent stepper training (TBRST) to BWSTT on outcomes of safety, physical and mental functioning, fatigue, quality of life, and equipment preference.</p> <p>Safety of BWSTT and TBRST was established. Significant improvements in fatigue and QoL were observed with both training modalities; however, neither significantly improved physical function. There was some evidence to suggest long-term BWSTT may improve cognitive performance and brain health, and that TBRST was the preferred exercise modality. Furthermore, most beneficial effects of long-term BWSTT tended not to be maintained when exercise was discontinued.</p> <p>This dissertation established evidence for the potential benefits of BWSTT and TBRST in patients with progressive MS with high disability. BWSTT and TBRST may represent viable alternative strategies for disease management.<strong></strong></p>