Effectiveness of Aerobic Treadmill Training on Walking Distance in Patients with Multiple Sclerosis with Moderate Disability: A Randomised Controlled Multicentre Trial

Abstract

BackgroundPatients with Multiple Sclerosis (PwMS) have gait disorders. The efficiency of treadmill training on walking distance is debatable.ObjectiveThis study evaluated the efficacy of a 6-week treadmill training program at heart rate at the first ventilatory threshold (HR_VT1) on walking distance compared with a control group in PwMS.MethodsThis prospective, multicenter study included 46 PwMS with moderate disability which randomized into training group (TG) and control group (CG). Patients performed cardiopulmonary exercise test to determine HR_VT1. TG realized walking treadmill training program at HR_VT1: 18 sessions (3 sessions/week) over 6 weeks. The distance on the six-minute walk test (6MWT), Timed 25 foot walk, patient-reported walking ability, berg balance scale, fatigue scale, the HR at the end of the 6MWT (HR_6MWT) were collected at baseline, 6 weeks and 12 weeks.ResultsThe 6MWT distance showed a significant overall group effect (30.6 m; 95%CI = (6.6; 54.6); p = 0.017). The perceived impact of walking was significantly decreased in the TG (-6.1; 95% CI = (-9.2; -2.9); p = 0.0006). No correlation was found between HR_VT1 and HR_6MWT.ConclusionAerobic treadmill training significantly enhanced walking distance and reduced perceived walking difficulties in PwMS.

Keywords: aerobic training; cardiopulmonary exercise test; chronic neurological disease; gait impairments; rehabilitation; tolerance.