Perceived fatigue, lower limb muscle force and performance fatigability after a rehabilitation program in Multiple Sclerosis

Abstract

Muscle weakness and fatigue represent frequent disabling symptoms for Multiple Sclerosis (MS) patients. We evaluated the effects of an intensive task-oriented circuit training (TOCT) on perceived fatigue, muscle strength and changes in motor performance fatigability in mildly impaired MS patients. Fifteen MS patients performed different functional scales, self-reported questionnaires and instrumental evaluations before (T0) and after (T1) TOCT. Strength and performance fatigability were analyzed during isometric knee extension and ankle dorsiflexion through an isokinetic dinamometer, recording surface EMG signals of Vastus Medialis and Tibialis Anterior. The Dinamic Gait Index, Multiple Sclerosis Impact Scale-29, Modified Fatigue Impact Scale and Multiple Sclerosis Walking Scale–12 significantly improved after training. An increase of exerted force during isometric knee extension was observed, whereas no significant changes were revealed on mechanical and electrical fatigue. Moreover, the improvement in perceived disability after treatment was related to strength increase in knee mechanical force output. The TOCT positively modifies perceived fatigue, perceived ambulatory function and knee force output in mildly impaired MS subjects, suggesting a virtuous circle between strength levels, recovery of functional skills and improved quality of life.

Multiple Sclerosis in the Digital Health Age: Challenges and Opportunities - A Systematic Review

“…Rehabilitation interventions have shown potential for enhancing maximal neural drive during knee extensions, as indicated by integrated EMG measures 86 . However, no significant changes were observed in mechanical and electrical fatigue after two weeks of rehabilitation, despite higher force output 87 . Table 1 summarises the main clinical findings when using time-series biosignals, namely EEG, IMU, and EMG data.…”

“…Similar to the collection of IMU data for MS monitoring, walking tasks have been used to collect EMG 72,[79][80][81][82][83] . Furthermore, popular were contraction and extensions tasks [84][85][86][87] as well as reaching tasks 88,89 . EMG sensors have also been used to investigate dysphagia [90][91][92] .…”

Intensive Circuit Class Therapy in Patients with Relapsing-Remitting Multiple Sclerosis

“…The results of this study follow a positive trend similar to the already published data of Chisari et al ( 33 ), in which a group of 17 patients with MS showed significant improvement in the TUG test and a positive trend in the SF-36 questionnaire. In another study published by Tramonti et al ( 14 , 15 ), a group of 15 patients with MS showed only an insignificant trend in TUG test, but a clear improvement in the MFIS and MSWS-12 questionnaires. However, both studies were more task-oriented and lacked a control group.…”

“…There is moderate evidence that circuit class therapy is effective in improving mobility for people after stroke; they may be able to walk further, faster, and with more independence and confidence in their balance. The effectiveness of circuit class therapy on walking ability in patients with MS has been demonstrated in a small number of patients ( 12 , 13 , 14 , 15 ). In addition, circuit class therapy reduces the high demands on physiotherapists in conventional one-on-one exercise, and may therefore be made available to more patients.…”