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Effect of arm cycling and task-oriented exercises on fatigue and upper limb performance in multiple sclerosis

a randomized crossover study

Gervasoni, Elisaa,b; Cattaneo, Davidea; Bertoni, Ritaa; Grosso, Cristinaa; Bisio, Ambrab; Rovaris, Marcoa; Bove, Marcob

International Journal of Rehabilitation Research: December 2019 - Volume 42 - Issue 4 - p 300–308
doi: 10.1097/MRR.0000000000000362
Original Articles
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Rehabilitation treatments have been proven to be a viable way to reduce fatigue and upper limb impairments in people with multiple sclerosis (PwMS). Our aim was to examine which treatment has better short-term and carryover effects on fatigue and manual dexterity in multiple sclerosis population. Twenty PwMS participated in a 16-week randomized crossover study composed of 20 sessions. The participants were divided into two groups (group A and group B). Sessions containing combined arm cycling and task-oriented exercises were administered by a physical therapist in hospital setting. Each group received 20 sessions of aerobic training and task-oriented exercises and then an 8-week rest period or vice versa with group A receiving sessions first. Fatigue was assessed by using the Modified Fatigue Impact Scale (MFIS) and Motor Fatigability Index (MFI), which was assessed using an engineered glove during a fatiguing finger tapping task. To measure manual dexterity, the nine hole peg test (NHPT) and a rate of tapping at maximum velocity task (RATE-MV) were utilized. Treatment effects were assessed by t-test or Mann–Whitney test at the end of both periods checking for carryover effects. After treatment the combined (Groups A and B) between-period differences were MFIS: 5.2 (10.7) points, P = 0.05; MFI: −0.007 (<0.001)Hz/s, P = 0.05 and RATE-MV: 0.2 (0.4) Hz/s, P = 0.05 in favor of the treatment period. No statistically significant between-period differences were found for the NHPT: 3.6 (25.0) s, P = 0.63. No carryover effects (P > 0.05) were observed. In conclusion, sessions of arm cycling and tailored task-oriented exercises have shown to be a viable resource for treating manual dexterity and fatigue in PwMS.

aIRCSS Fondazione Don Carlo Gnocchi, Via Capecelatro, Milano

bDepartment of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy

Received 1 April 2019 Accepted 19 June 2019

Correspondence to Davide Cattaneo, PhD, IRCSS Fondazione Don Carlo Gnocchi, Via Capecelatro 66, 20148 Milano, Italy, Tel: + 39 0240308814; fax: + 39 0240308459; e-mail: dcattaneo@dongnocchi.it

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