# Exercise as it relates to Disease/Can gait patterns improve with resistance training in multiple sclerosis patients?

This is an analysis journal article ‘ Resistance training improves gait kinematics in persons with multiple sclerosis ’ by G.M Gutierrez’ (2005).

## What is the background to this research
##### Multiple sclerosis

Multiple scleroses is commonly known around the word as MS disease. It is a degenerative disease of the central nervous system (CNS) affecting the myelin, oligodendrocyte and axons. MS leads to deficits of the body functions, which impact negatively on the participant's daily activates such as walking, and generally participation. MS is frequently found in younger adults usually at the age of 20-40years. MS has decreased factors. MS is not a hereditary disease, but having a bloodline relationship will increase their chances of getting it.

##### Resistance Training

Can be performed by most all works of life and performed in the gym or at a home enrolment. Resistance training is suitable and effective for levels of fitness. Resistance training is seen to improve muscular strength and endurance, (7) making

### Where was the research from?

This research was conducted by researches at the department of applied physiology and kinesiology, University of Florida, Gainesville, FL.

### What kind of research was this?

The systematic review involved 8 participants 7 women and 1 man, which suffered from MS categorically selected if they had a status scale ranging from 2.5- 5.5. (fig 1.1). The status scale was created in 1983 from neurologist John Kurtzke, which is used around the world, to determine the increased disability overtime of the individual suffering from MS. This study was to evaluate the effects of an 8-week lower body, resistance-training program on walking mechanisms in individuals suffering from MS.

### What did this research involve

The systemic review involved 8 individuals that suffered from MS, which are ambulatory that have a status scale (EDSS) ranging from 2.5- 5.5 (fig 1.1). This study was to evaluate the effects of an 8-week lower body, resistance-training program on walking mechanisms in individuals suffering from MS.
There were 1 male subject and 7 female subjects age ranging from 46 ± 11.5 years. The recruited participants had clearance from a physician, and were asked to complete light intensity walking pre intervention. These measures were taken to ensure the participants in the study were kept safe and that the participants were not starting from a sedentary background.
The participants completed an informed consent before they started the 3-month light intensity. In the 2 weeks, Prior to the 8- week progressive resistance training some baseline measurement were collected:.
* - Lower limb muscle strength
* - Gait kinematics
* - 3- minute stepping task
* - A self directed EDSS was recorded
The participants then started there 8 – week program, performing 2 sessions a week and no sessions exceeded 30 minutes. The training consisted of 10 -15 reps of individuals 70% predicted 1RM for lower limb exercises that included:.
* - Knee flexion
* - Keen extension
* - Plantar flexion
* - Trunk flexion
* - Trunk extension
All the results were recorded and post testing was completed.

### Results
##### The main finding

Resistance training had positive effects on improving gait and functional ability, as well as decreasing the EDSS self directed score

##### Other findings

* There was an increase in the percentage time in the swing phase, step length and food angle
* There was a decrease in stride time in the stance, double support phase and toe clearance.
* The 3 minute stepping task improved by 8.7%
All the support the improved gait of the MS participant's

### How did the researcher interrupt the results

It was hypothesized that a lower limb resistance-training program would alter the gait patterns in MS patients. Researchers have determined that there has been a positive increase in all participants involved in the 8-week program. Stride time was seen with an important increase, which had improvements in the swing phase, step length, stride length and foot angle. Other studies have shown that the more accurate the gait pattern is the safer and more efficient the individual will be
The toe clearance, and the stance phase had a significant decrease, and were becoming more inline with the normative data, thus providing the importance of the resistance training. Although limited studies have been conducted comparing strength training and MS patients, some studies have shown that individuals that have higher overall strength have fewer complications in general daily tasks

### What conclusions can be taken away from the resreach?

This study is the first recorded attempt of implementing a resistance program for MS diagnosed patients. As all the results in the study have shown an improvement in the MS patients physical and mental wellbeing, it would be concluded that with approved consent of medical staff, that more MS patients should get involved with a personalised program, to improve daily task, thus improving their independence.

### Implications of Research

This research has shown, the importance and safety for MS patients to be participating in resistance training. There are many levels, exercises and combinations of a resistance program Fleck, Steven thus enabling all patients t o be evolved and giving them a chance of longer independence, and greaterx mobility.

### future readings

For further readings regarding multiple sclerosis click on the links below
* The benefits of exercise training in multiple sclerosis: http://www.nature.com/nrneurol/journal/v8/n9/full/nrneurol.2012.136.html
* Improving Gait in Multiple Sclerosis Using Robot-Assisted, Body Weight Supported Treadmill Training http://nnr.sagepub.com.ezproxy.canberra.edu.au/content/22/6/661
* Recommendations for Physical Activity in Patients with Multiple Sclerosis. http://zh9bf5sp6t.scholar.serialssolutions.com/?sid=google&auinit=JH&aulast=Petajan&atitle=Recommendations+for+physical+activity+in+patients+with+multiple+sclerosis&id=doi:10.2165/00007256-199927030-00004&title=Sports+medicine+(Auckland)&volume=27&issue=3&date=1999&spage=179&issn=0112-1642
* Exercise and Multiple Sclerosis http://zh9bf5sp6t.scholar.serialssolutions.com/?sid=google&auinit=LJ&aulast=White&atitle=Exercise+and+multiple+sclerosis&id=doi:10.2165/00007256-200434150-00005&title=Sports+medicine+(Auckland)&volume=34&issue=15&date=2004&spage=1077&issn=0112-1642

#### References

* 1 2 3 4 5 6 7 Gutierrez GM, Chow JW, Tillman MD, Mccoy SC, Castellano V, White LJ. Resistance Training Improves Gait Kinematics in Persons With Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation. 2005;86(9):1824–9
* ↑ Motl RW, Sandroff BM. Benefits of Exercise Training in Multiple Sclerosis. Current Neurology and Neuroscience Reports Curr Neurol Neurosci Rep. 2015;15(9).
* ↑ Group TMSG. Multiple susceptibility loci for multiple sclerosis. Human Molecular Genetics. 2002;11(19):2251–6.
* ↑ Expanded Disability Status Scale (EDSS) [Internet]. MS Trust. [cited 2016Sep22]. Available from: https://www.mstrust.org.uk/a-z/expanded-disability-status-scale-edss
* ↑ Watelain E, Barbier F, Allard P, Thevenon AE, Angu[Eacute] J-C. Gait pattern classification of healthy elderly men based on biomechanical data. Archives of Physical Medicine and Rehabilitation. 2000;81(5):579–86.
* ↑ Bauman A. Health benefits of physical activity for older adults – epidemiological approaches to the evidence. Optimizing Exercise and Physical Activity in Older People. 2004;:1–25.
* ↑ Romberg A, Virtanen A, Ruutiainen J, Aunola S, Karppi S-L, Vaara M, et al. Effects of a 6-month exercise program on patients with multiple sclerosis: A randomized study. Neurology. 2004;63(11):2034–8.
* ↑ J, Kraemer, William. Designing Resistance Training Programs-4th Edition [Internet]. Vol. 1. Human Kinetics; 2014. Available from: https://books.google.com.au/books?id=uzv7agaaqbaj&dq=the makeup of a resistance training program&lr=&source=gbs_navlinks_s