Walking endurance and perceived symptom severity after a single maximal exercise test in persons with mild disability because of multiple sclerosis

Abstract

People with multiple sclerosis (PwMS) are less physically active compared with the general population. This might also be because of the perception of temporary worsening of symptoms during physical activity. Forty-two PwMS with a mild level of disability underwent a maximal exercise test on a bicycle ergometer. Fifteen minutes before and 15 and 75 min after the maximal exercise test, the 6-minute walking test was conducted and the rate of perceived exertion was recorded. Twice before and three times after the maximal exercise test, participants rated the symptom inventory, including symptom domains of general fatigue, muscle fatigue, balance, gait pattern, muscle weakness, spasticity, pain, sensory disturbance, dizziness, and visual impairment. The visual analogue scale was used to rate the perceived symptoms from 0 (no intensity) to 10 (maximal intensity). The 6-minute walking test distance increased significantly over time, whereas the rate of perceived exertion increased temporarily after the maximal exercise test. Immediately after the maximal exercise test, significant temporary increases were found in balance, gait pattern, muscle weakness, and visual impairment. General and muscle fatigue were elevated, compared with the baseline, till 15 and 75 min after the maximal exercise test, respectively. A short-term impact of a single maximal exercise test was considered as the temporary worsening of perceived symptoms, especially (muscle) fatigue and the gait pattern, in PwMS with a mild level of disability. However, a recovery was observed after 75 min. Walking endurance was not affected by the maximal exercise test.

Using Body-Worn Sensors to Detect Changes in Balance and Mobility After Acute Aerobic Exercise in Adults with Multiple Sclerosis

“…Previous research has also demonstrated improved mobility after an acute bout of exercise. Moumdjian et al 10 found improved walking endurance in participants with MS after bicycle ergometry regardless of perceived worsening of balance and gait symptoms. These researchers suggested that the exercise may have promoted changes in gait quality even with perceived decrements in gait pattern.…”

“…11 There is also evidence showing that in one session of bicycle ergometry, in which perceived decrements in balance and gait were reported, walking endurance actually improved. 10 Although such findings are promising in terms of the utility of exercise as a prescriptive health treatment modality, the findings are limited by considering symptoms as a composite measure rather than separate symptom domains or by examining only changes in the perception of these balance and mobility changes rather than objectively measured changes. For those with MS, instrumented measures of standing balance and gait have been shown to be more sensitive in detecting subtle gait deficits in the absence of clinical manifestation.…”

“…[7][8][9] It has been found that, in most participants, any worsening in the number or intensity of sensory symptoms is temporary, with levels returning to preexercise status within 30 minutes to 1 hour. 7,10 Research has also confirmed that ratings of general physical functioning are not significantly affected by a single exercise session 8,9 and that eters, would evidence change from before to after 15 minutes of moderate leg cycling and that these changes would persist for up to 2 hours after the exercise bout.…”

Symptom, Adopting Healthy Life Style, and Quality of Life in Patients with Liver Cirrhosis: A Cross-Sectional Study

“…SOB may have inhibited exercise in cirrhosis population because this symptom becomes worse during exercise. Patients who perceive a temporary worsening of symptoms during physical activity may be less physically active [20].…”

Relationship Between Symptoms and Stage of Change in Both Adopting a Healthy Life Style and Quality of Life in Patients with Liver Cirrhosis: A Cross-Sectional Study

“…SOB may have inhibited exercise in the cirrhosis patient population because this symptom becomes worse during exercise. Patients who perceive a temporary worsening of symptoms during physical activity may be less physically active [30]. Previous studies of the relationship between dyspnea and exercise intolerance were conducted in patients with pulmonary disease and multiple sclerosis.…”