Combined Training Improves Walking Mobility in Persons With Significant Disability From Multiple Sclerosis: A Pilot Study

Motl, Robert W. PhD; Smith, Douglas C. PhD; Elliott, Jeannette PT; Weikert, Madeline BS; Dlugonski, Deirdre BS; Sosnoff, Jacob J. PhD

Journal of Neurologic Physical Therapy: March 2012 - Volume 36 - Issue 1 - p 32–37
doi: 10.1097/NPT.0b013e3182477c92
Research Articles

Background and Purpose: The disabling consequences of multiple sclerosis (MS) emphasize the significance of developing physiologically relevant strategies for rehabilitation of function. This pilot study examined changes in walking function associated with combined exercise training consisting of aerobic, resistance, and balance activities in persons with MS who had recent onset of gait impairment.

Methods: Thirteen participants with significant disability due to MS (Expanded Disability Status Scale range = 4.0–6.0) completed the Multiple Sclerosis Walking Scale–12, 2 trials of the Timed 25-Foot Walk, the Timed Up & Go, and functional ambulation profile score derived from 4 walking trials on an instrumented walkway (GaitRite) before and after an 8-week training period. The training program was designed by a physical therapist and was performed 3 days per week under the supervision of an exercise specialist. In week 1, the session was 15 minutes in duration (ie, 5 minutes of each mode of exercise), session durations were increased by approximately 5 minutes per week up to a maximum of 60 minutes in week 8 (ie, 20 minutes of each mode of exercise).

Results: There were significant improvements in Multiple Sclerosis Walking Scale–12 scores (Mpre = 56.0, Mpost = 46.7, P = 0.03, d = 0.56), Timed 25-Foot Walk (Mpre = 11.7, Mpost = 9.8, P = 0.004, d = 0.90) and Timed Up & Go (Mpre = 16.0, Mpost = 13.0, P = 0.01, d = 0.72) performance, and functional ambulation profile score (Mpre = 72.8, Mpost = 77.6, P = 0.02, d = 0.65).

Discussion and Conclusion: These results suggest that a moderately intense, comprehensive, combined exercise training program represents a rehabilitation strategy that is associated with improved walking mobility in a small sample of persons with MS who have recent onset of gait impairment.

Department of Kinesiology and Community Health (R.W.M., M.W., D.D., J.J.S.), School of Social Work (D.C.S.), and Division of Rehabilitation and Education Services (J.E.), University of Illinois at Urbana–Champaign.

Correspondence: Robert W. Motl, PhD, Department of Kinesiology and Community Health, University of Illinois, 350 Freer Hall, Urbana, IL 61801 (

This manuscript reflects the work that was previously presented during the 2011 annual meeting of the Consortium of Multiple Sclerosis Centers in Montreal, Canada.

Funded by the Mary Jane Neer Research Fund.

The authors declare no conflict of interest.

© 2012 Neurology Section, APTA