Article

Fatigue and fatigability are common problems in patients with multiple
sclerosis, which might be improved by rehabilitation.
The aim of this pilot study
was to assess changes in the fatigue and fatigability of knee extensors in
patients with multiple sclerosis after a short intensive, combined rehabilitation
programme (including physiotherapy primarily focused on gait and balance,
endurance and resistance training). METHODS: Twenty-three patients with multiple
sclerosis (10 men, 13 women) underwent isokinetic evaluations of fatigability of
the knee extensor muscles during concentric contractions and rated a
self-reported fatigue scale (Modified Fatigue Impact Scale; MFIS) before and
after a rehabilitation programme. Patients performed rehabilitation for 150 min,
4 days per week for 4 weeks, with physiotherapy focused primarily on gait and
balance, endurance training and resistance training. RESULTS: After
rehabilitation, perception of fatigue decreased significantly (median MFIS scores
[1st; 3rd quartiles], pre: 44 [33; 53] vs post: 33.5 [16; 43]; <0.00025). Moment
fatigue index increased (pre: 37.70+/-13.40 vs post: 48.10+/-9.39; p<0.0125), but
end-test moment did not change. After rehabilitation, strength increased during
both isometric and concentric contraction (mean first 5 and mean 50 contractions
of the fatigue protocol) (p<0.0125). After rehabilitation, neuromuscular
efficiency improved (p<0.0125). CONCLUSION: After a short, intensive, combined
rehabilitation programme, fatigue decreased but fatigability increased (moment
fatigue index). Indeed, fatigability increased because strength in the initial
state increased and strength in the fatigued state did not change. Although the
rehabilitation programme was designed so that resistance training was carried out
after endurance training to specifically train muscles in a fatigued state, no
improvements in strength in the fatigued state were measured.

Langue : ANGLAIS