Effect of Training Exercises Incorporating Mechanical Devices on Fatigue and Gait Pattern in Persons with Relapsing-Remitting Multiple Sclerosis.

PURPOSE: The aim of this study was to evaluate the effects of regular exercise incorporating mechanical devices on fatigue, gait pattern, mood, and quality of life in persons with relapsing-remitting multiple sclerosis (RRMS). METHOD: A total of 55 individuals with RRMS with an Expanded Disability Status Scale (EDSS) score of 0-4.5 and a Fatigue Severity Scale (FSS) score of 4.0 or more were randomly assigned to one of two exercise groups or a control group (n = 18). Exercise programmes used aerobic, body weight, coordination, and balance exercises with either whole-body vibration (WBV; n = 19; drop-outs, n = 3) or the Balance Trainer system (n = 18; drop-outs, n = 4). Outcome measures included the FSS, Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-II), and Multiple Sclerosis International Quality of Life (MusiQoL). Spatiotemporal gait parameters were assessed using the GAITRite electronic walkway. Pre- and post-intervention assessments were performed by a blinded assessor. Intra- and inter-group analysis was performed, using the paired-samples f-test, by calculating the effect size with Cohen's (/analysis and one-way analysis of variance, respectively. RESULTS: Significant improvements in fatigue and mood were identified for both intervention groups (p < 0.05). Gait parameters also improved significantly in the WBV group: velocity and step length increased (12.8% and 6.5%, respectively; p < 0.005), and step time, stance time, double support time, and step length asymmetry decreased (-5.3%, -1.4%, -5.9%, and -43.7%, respectively; p < 0.005). CONCLUSIONS: The results of this study support the hypothesis that combined training programmes help to reduce fatigue and improve mood in persons with mild to moderate RRMS. WBV combined with a standard exercise programme significantly improves spatiotemporal gait parameters.