Supervisors info:
Σκορδίλης Εμμανουήλ, Αναπληρωτής καθηγητής, ΣΕΦΑΑ/ΕΚΠΑ
Αναστάσιος Φιλίππου, Επίκουρος Καθηγητής Πειραματικής Φυσιολογίας, Ιατρική Σχολή, ΕΚΠΑ
Σεραφείμ Ν. Νανάς, Καθηγητής Εντατικής Θεραπείας, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Multiple sclerosis (MS) is one of the most common neurological disorders today, which can lead to mild or even severe physical disability. Patients with MS tend to have limited physical activity, which is directly affecting their functional capacity. Walking exercise is the most common self-selected type of physical activity by patients with MS. The aim of this study was to study the effect of a walking training program with blood flow restriction of the lower limb on functional capacity of patients with MS. In total, 13 patients with MS (6 men and 7 women) were selected by convenience sampling and completed the intervention (age 48.62 ± 10.55 yrs, body weight 77.38 ± 22.29 kg, height 1.69 ± 0.10 m and body mass index 27 ± 6.54). The severity of MS disease according to the Expanded Disability Status Scale (EDSS) scale was 3.38 ± 1.66 and its diagnosis was made 9.69 ± 4.66 years ago. The primary outcome measures at baseline and after the intervention were 10MWT, BBS, 6MWT , 3MBW, 25FWT, WHODAS 2.0 and the heart rate recovery during the 1st minute after the 6MWT. The secondary outcome measures were resting blood pressure and the responses on the MFIS and WHOQOL questionnaires. The patients were randomly allocated into three groups, the Walking Exercise+BFR (WE+ BFR), the Walking Exercise (WE) and the Control Group (CG). Both the WE+BFR and the WE groups performed a 6-week walking intervention, with a frequency of 3 sessions per week, duration 50-55 minutes and an intensity at 80% of their measured speed of 6MWT test. During walking, the patients of the WE+BFR group wore elastic cuffs around the most proximal regions of both tights, which were inflated at the 60% of the total occlusion of the tibial artery flow. After the training intervention, there is showed an improvement in WE and WE+BFR groups in 10MWT, BBS, 6MWT, 3MBW and 25FWT , while in the CG no difference was observed. A significant difference was observed in the WE group and in the WE+BFR group, in the primary outcome variables 6MWT and BBS after the intervention. Additionally, a significant improvement was observed in the secondary outcome variable MFIS in the WE and WE+BFR groups. The WHODAS 2.0 index showed a decrease in the average values only in the WE+BFR group, while no significant difference was observed, nor in the average values, in the WHOQOL quality of life index. Based on our findings, walking training, with or without blood flow restriction, benefits patients with MS by improving their balance, functional capacity and fatigue index. More randomized controlled trials and different exercise protocols (e.g., hybrid protocols) are encouraged to further explore the physiological adaptations of blood flow restriction training in patients with MS.
Keywords:
Multiple sclerosis, Blood flow restriction, Walking training, Functional capacity
