Changes of gait parameters following long-term aerobic endurance exercise in mildly disabled multiple sclerosis patients: an exploratory study.

BACKGROUND: The long-term effects of walking based aerobic endurance exercise on gait parameters have not yet been sufficiently investigated in patients with multiple sclerosis (MS). AIM: To investigate the effects of an aerobic walking exercise program on gait parameters in MS patients over a period of 12 months. DESIGN: Non-randomized, controlled, exploratory trial. SETTING: Outpatient, home-based program. POPULATION: Sixty ambulatory patients with relapsing-remitting MS and an EDSS≤3.5 participating in an individualized twelve month aerobic endurance exercise program were evaluated during a treadmill exercise by video recordings with regard to step cadence, step length and ground contact time at baseline and every three months thereafter for twelve months. RESULTS: From the 44 patients who completed the study, the ground contact time of the feet was significantly elevated at two load steps (3.2 km/h with 3.5% slope and 4.8 km/h at 7.5% incline) after 12 months (P<0.001, ƞp2=0.2; P=0.01, ƞp2=0.1). The step cadence decreased significantly at 3.2 km/h speed with 3.5% slope (P<0.001, ƞp2=0.2) and the step length increased significantly at the same load step (P<0.001, ƞp2=0.15). Post-hoc analysis revealed no changes in any of the analyzed gait parameters in the internal control group (N.=16) who performed a treadmill exercise after 12 months. CONCLUSION: Walking based aerobic endurance exercise may contribute to improved gait parameters in MS patients. Further prospective controlled studies are needed to investigate the impact of long-term endurance walking exercise on gait parameters and stability in MS patients. CLINICAL REHABILITATION IMPACT: The observation that mere walking-based exercise changes gait parameters and could therefore possibly contribute to gait stability without specific balance or muscular training might largely facilitate treatment recommendations for mildly disabled MS patients.