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Cycling Progressive Resistance Training for People with Multiple Sclerosis: A Randomized Controlled Study

Cakit, Burcu Duyur MD; Nacir, Baris MD; Genç, Hakan MD; Saraçoğlu, Meryem MD; Karagöz, Aynur MD; Erdem, Hatice Rana MD; Ergün, Ufuk MD

American Journal of Physical Medicine & Rehabilitation: June 2010 - Volume 89 - Issue 6 - p 446-457
doi: 10.1097/PHM.0b013e3181d3e71f
Original Research Article: Exercise

Çakıt BD, Nacir B, Genç H, Saraçoğlu M, Karagöz A, Erdem HR, Ergün U: Cycling progressive resistance training for people with multiple sclerosis: A randomized controlled study.

Objective: To evaluate the effects of cycling progressive resistance training combined with balance exercises on walking speed, balance, fatigue, fear of falling, depression, and quality of life in patients with multiple sclerosis.

Design: In this prospective randomized controlled trial, 45 patients were randomized into two exercise training (n = 30) groups and one control (n = 15) group. The patients in training group 1 (n = 15) underwent progressive resistance training on a bicycle ergometer and balance exercise, whereas group 2 (n = 15) patients received a home-based lower-limb strengthening and balance exercise. Outcome measures, including the duration of exercise, tolerated maximum workload, timed up and go test, Dynamic Gait Index, functional reach, Falls Efficacy scale, 10-m walk test, Fatigue Severity Scale, Beck Depression Inventory, and Short Form 36 scores, were assessed initially and at 8 wks.

Results: After dropouts, the whole study group consisted of 20 women and 13 men (mean age, 37.9 ± 10.43 yrs). In training group 1, duration of exercise, tolerated maximum workload, timed up and go test, Dynamic Gait Index, functional reach, falls efficacy scale, 10-m walk test, Fatigue Severity scale, and Beck Depression Inventory scores, and in group 2, the mean duration of exercise, tolerated maximum workload, and Falls Efficacy scale scores were significantly improved after the training program (P < 0.05). There were no significant improvements in any of the outcome measurements in the control group (P > 0.05). In between-group comparisons, improvements in outcome measures of group 1 patients were significantly higher than those in other groups, except for 10-m walking test. Group 1 patients showed statistically significant improvement in physical functioning and role-physical functioning scales of the Short Form 36 (P < 0.01 and P < 0.05, respectively), and group 2 patients showed statistically significant improvement in only physical functioning scale of Short Form 36 (P < 0.05) after 8 wks.

Conclusions: Specific exercise programs, including cycling progressive resistance training, may improve balance, fatigue, and depression and reduce fear of falling in patients with multiple sclerosis without worsening multiple sclerosis signs and symptoms.

From the Ministry of Health Ankara Training and Research Hospital, Departments of Second Physical Medicine and Rehabilitation (BDC, BN, HG, MS, AK, HRE) and Neurology (UE), Ankara, Turkey.

All correspondence and requests for reprints should be addressed to: Burcu Duyur Çakit, MD, S.B. Ankara Egitim ve Arastirma Hastanesi, II. Fizik Tedavi ve Rehabilitasyon Klinigi, Ankara, Turkey.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2010 Lippincott Williams & Wilkins, Inc.