People with multiple sclerosis (MS) are often offered walking aids and compensatory strategies rather than restorative rehabilitation. We have developed a cool room treadmill training method that uses body-weight support that people with MS fatigue and heat sensitivity can tolerate. Our previous research shows that people with advanced MS use three times more energy for essential tasks such as walking. This project will test whether 10 weeks of body-weight supported treadmill training in a room cooled to 16°C improves walking, fitness and fatigue in people with advanced MS.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
A total of 30 training sessions will be conducted in 10 weeks for 30 minutes per session and 3 times per week in a cool room (16⁰ C) on a treadmill that is equipped with safety straps to prevent falls. A pneumatic harness system will be used to provide 10% body-weight support during training sessions. The participants will start exercising on the treadmill at 80% of their self-selected walking speed with 1% incline and will increase as per their tolerance (will progress weekly based on 40-65% heart rate reserve). Heart rate, perceived fatigue and rating of perceived exertion will be monitored continuously during exercise sessions. Initial training will commence with intermittent rest periods \[1 to 5 minutes\] as requested by the participants and will be progressed to a maximum of 30-minute continuous treadmill walking.
Memorial University of Newfoundland
St. John's, Newfoundland and Labrador, Canada
Feasibility of conducting vigorous cool room treadmill training
Recruitment and retention rates
Time frame: 10 weeks
Feasibility of conducting vigorous cool room treadmill training
Incidence of adverse events
Time frame: 10 weeks
Feasibility of conducting vigorous cool room treadmill training
Degree of body-weight support provided by the harness (%)
Time frame: 10 weeks
Feasibility of conducting vigorous cool room treadmill training
Rest required (minutes)
Time frame: 10 weeks
Timed 25 foot walk test
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Spatiotemporal parameters of gait measured while walking at fast and self-selected pace
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Fatigue severity scale
A 9-item questionnaire, which assesses the severity of fatigue with items scored on a 7-point scale, '1 = strongly disagree' and '7 = strongly agree'. The minimum and maximum score possible are 9 and 63 respectively. Another reporting method is the mean of all scores from all 9-items, with minimum and maximum score possible being 1 and 7 respectively.
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Modified fatigue impact scale
A 21-item scale, which assesses the perceived impact of fatigue with items rated by participants on a 5-point Likert scale, '0 = never' to '4 = almost always'. The items are aggregated into total score as well as three subscales: physical, cognitive, and psychosocial. The total score ranges from 0 to 84, physical subscale from 0 to 36, cognitive subscale from 0 to 40, and psychosocial subscale from 0 to 8.
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Maximal oxygen consumption during graded exercise test
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Health-related quality of life assessed using 36-Item Short-Form Health Survey
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Serum brain derived neurotrophic factor
Resting and exercise-induced serum levels of brain derived neurotrophic factor in response to the 10-week exercise intervention
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Serum interleukin-6
Resting and exercise-induced serum levels of interleukin-6 in response to the 10-week exercise intervention
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Montreal cognitive assessment
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Corticospinal excitability measured using transcranial magnetic stimulation
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Body composition measured using dual energy x-ray absorptiometry
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Magnetization transfer ratio measured using magnetic resonance imaging
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Aerobic cost of walking
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
Step counts
Via Accelerometry
Time frame: Following completion of the 10-week exercise intervention and 3-months post-exercise intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.