A task-oriented circuit training in multiple sclerosis: a feasibility study

Abstract

BackgroundThe aim of this study was to evaluate the safety, feasibility and preliminary effects of a high-intensity rehabilitative task-oriented circuit training (TOCT) in a sample of multiple sclerosis (MS) subjects on walking competency, mobility, fatigue and health-related quality of life (HRQoL).Methods24 MS subjects (EDSS 4.89 ± 0.54, 17 female and 7 male, 52.58 ± 11.21 years, MS duration 15.21 ± 8.68 years) have been enrolled and randomly assigned to 2 treatment groups: (i) experimental group received 10 TOCT sessions over 2 weeks (2 hours/each session) followed by a 3 months home exercise program, whereas control group did not receive any specific rehabilitation intervention. A feasibility patient-reported questionnaire was administered after TOCT. Functional outcome measures were: walking endurance (Six Minute Walk Test), gait speed (10 Meter Walk Test), mobility (Timed Up and Go test) and balance (Dynamic Gait Index). Furthermore, self-reported questionnaire of motor fatigue (Fatigue Severity Scale), walking ability (Multiple Sclerosis Walking Scale – 12) and health-related quality of life (Multiple Sclerosis Impact Scale – 29) were included. Subjects’ assessments were delivered at baseline (T0), after TOCT (T1) and 3 months of home-based exercise program (T2).ResultsAfter TOCT subjects reported a positive global rating on the received treatment. At 3 months, we found a 58.33% of adherence to the home-exercise program. After TOCT, walking ability and health-related quality of life were improved (p < 0.05) with minor retention after 3 months. The control group showed no significant changes in any variables.ConclusionsThis two weeks high-intensity task-oriented circuit class training followed by a three months home-based exercise program seems feasible and safe in MS people with moderate mobility impairments; moreover it might improve walking abilities.Trial registrationNCT01464749

Efeito do treinamento em circuito orientado para tarefa sobre o desempenho motor e a qualidade de vida de pacientes com doença de Parkinson: um estudo de casos.

“…Vários tipos de abordagens promovem melhorias motoras e psicológicas e o cuidado multiprofissional é considerado o modelo mais vantajoso não só para essa, mas para outras doenças neurodegenerativas [7][8][9] . O treinamento em circuito orientado para tarefa (TCOT) é baseado em estações de trabalho que reproduzem atividades físicas executadas no dia-a-dia do indivíduo, ou seja, caminhar, subir escadas, manter equilíbrio, vestir-se, com o objetivo de aprendizagem motora e retenção da tarefa 10 . O TCOT é considerado uma boa opção de tratamento, pois além de proporcionar a prática intensiva das necessidades individuais; pode englobar dinâmicas de grupo que auxiliam na interação social que promove benefícios psicossociais, melhora do humor e da autoconfiança.…”

Effect of Comorbidities on Outcomes of Neurorehabilitation Interventions in Multiple Sclerosis

“…Of the four studies that excluded cognitive impairment, only one provided information on the measurement tools and cutoff scores used to determine eligibility. 25 No studies provided details on the number of individuals excluded because of comorbidity. Furthermore, no studies reported on the comorbidities of enrolled participants or examined the possible mediating or moderating effect of comorbidities on intervention outcomes.…”

“…20,21,24,25 The most commonly excluded comorbidities were cognitive impairment (n = 4, 57%) 20,21,24,25 and psychiatric disorders (n = 3, 43%) 20,21,24 (Figure 3). These psychiatric disorders were not identified.…”

“…The mean age of the groups ranged from 33 19 to 55 25 years. Participants were mostly females (range, 54%-83%) with RRMS and minimal to severe disability measured using the EDSS.…”

“…25 The number of intervention sessions ranged from 10 25 to 24 24 over 2 25 to 8 24 weeks. The duration of each session ranged from 30 21 to 120 25 minutes.…”