Body-Weight Supported Treadmill Training in Persons with MS with Mobility Limitations

Background: Exercise has significant benefits on mobility in persons with MS. However, the benefits of exercise in persons with MS with mobility impairments are not fully understood.  A promising mode of exercise that is suited for individuals with mobility impairments is body weight supported treadmill training (BWSTT). However, there is lack of data concerning BWSTT in this population.

Objectives: To determine the effect of a 20-week BWSTT intervention on mobility, balance and cardiorespiratory fitness in persons with MS with walking impairment.

Methods: 33 individuals were enrolled in the investigation. 16 participants were assigned to the intervention arm and 17 to the control arm. The intervention arm consisted of 20 minutes of BWSTT twice a week for 20 weeks. The control arm received no treatment. Standardized assessments focusing on walking, balance, and cardiorespiratory fitness took place prior to the intervention, after 10 weeks of training and at the end of the intervention. All outcome measures were placed into a 2 (condition: intervention/control) by 3 (time: pre, 10 weeks and post) mixed-model analysis of variance (ANOVA).

Results: Overall, the sample ranged in age from 25 to 64 with a mean of 52.3 years (SD 8.6). Per design self-reported EDSS ranged from 5.5 to 7.5 with a median of 6.5 (IQR 1.5). There was no difference between the control and intervention group in age, gender, MS duration, and disability (p’s>0.05). Overall a trend for an improvement in walking speed as a function of group and time was noted [F(2,30)=2.5; p=.11; η² = .14].  Subsequent analysis demonstrated that there was 0.9 s increase (12%) in T25FW performance in the control arm, while there was a 6.8 s (30.9%) increase in the intervention arm.  Statistical analysis of the BBS revealed a significant group by time interaction [F(2,30)=3.0;p=.05;η² = .16]. Post-hoc analysis revealed that the control arm decreased BBS score by 4.7 points while the experimental arm increased by 3.9 points. Overall, there was no effect of group or time on cardiorespiratory fitness as assessed by peak VO₂ (p>0.05).

Conclusions: BWSTT is an efficacious approach to improve walking and balance performance in persons with MS with mobility limitations. Future investigations should examine BWSTT in comparisons to other treatment options for examining its effectiveness.