Article

Multiple sclerosis (MS) is characterized by a demyelination that
results in reduced conductivity in the somatosensory nervous system, decreased
muscle strength, vestibular alteration, and severe fatigue. Progressive
resistance training (PRT) has proven to be a promising intervention showing a
positive effect on muscle strength. Another promising intervention frequently
used in neuro-rehabilitation is task specific training where also Balance and
Motor Control Training (BMCT) are incorporated. Interestingly, the principles of
BMCT do fundamentally contrast the principles of PRT in terms of variation in
movement pattern, loading and repetitions. Consequently, knowledge of any diverse
effect would be of clinical relevance. AIM: To evaluate the effects of PRT and
BMCT on gait, balance and fatigue in persons with MS. METHOD: A three-armed
multi-center, single-blinded cluster randomized controlled trial with two
intervention groups (1. PRT of the lower extremities. 2. BMCT that challenges
gait function) and a control group that receives usual care while on a waitlist
for a combined PRT + BMCT intervention performed after the two interventions
groups have completed their interventions. The interventions last ten weeks with
two sessions per week, in groups of 3-6 participants. Number of participants is
30 per intervention - 90 in total. Primary outcome measures for gait function are
the Timed 25 Foot Walk (T25FW) and the Six Spot Step Test (SSST). Secondary
outcomes are fatigue, perceived gait function, temporo-spatial gait
characteristics, balance and strength.Inclusion criteria are: EDSS 2-6, SSST >8
sec and T25FW >5 sec. Exclusion: Recent attacks and ongoing intensive
rehabilitation. ANALYSIS: The effects in the three groups are examined in a mixed
effects regression analysis with group and time as fixed effects and center and
patient within center as random effects. Spearman or Pearson correlation analysis
will be conducted on baseline data to determine associations between the primary
outcomes on gait function and the secondary outcomes on fatigue, spatial gait
parameters, balance and patient reported measures. TRIAL REGISTRATION: The study
is approved by the Regional ethical committee and registered at
clinicaltrials.gov, NCT02870023.

Langue : ANGLAIS