A Comparison Study of 8-Week Functional Strength and Pilates Based Training Program in Moderately Disabled Multiple Sclerosis (MS)
A handful of studies have reported benefit of Pilates Training in MS across the MS-disability spectrum. Functional Strength Training (FST) focuses on muscle strengthening in movement and positions that the body recognizes as functional. This is to be contrasted to classical strength training which focuses on training isolated muscles against resistance. FST is unexplored in MS. Interested in the overlapping and differing concepts between FST and PBT- we completed a comparative pilot study in MS subjects.
To compare the feasiblity and benefit of FST and PBT in a group of moderately impaired MS subjects.
Ten MS subjects were recruited and randomized to an 8-week group class of either functional strength training (FST) or Pilates-based training (PBT). Classes were bi-weekly. Subjects were tested pre- and post- 8-week session by an examiner blinded to subject group (FST vs PBT). Testing included: Timed-up and Go (TUG), Berg Balance Test (BBT), Single Limb Stance (SLS), self-report EDSS (SR_EDSS), MS Impact Scale (MSIS), MS Walking Scale (MSWS-12), Modified Fatigue Impact Scale (MFIS).
Although 10 subjects initially agreed to join the study, 3-subjects dropped out prior to completing first week of classes. This resulted in 7 subject’s data available for analysis and an imbalance in the groups: 3-FST and 4-PBT completers. With these small numbers, no statistically significant findings were found. However, several important trends demonstrated benefit for both FST and PBT. The FST group had notable improvement in the median SR_EDSS (pre- median = 5.0) vs. the PBT group had no change in median SR_EDSS (pre- and post-median = 4). Single-limb stance time was substantially improved in the PBT group with mean improvement of almost 13 seconds (pre- vs post-: R-leg mean(sd): 2.3(1.8) vs. 21.1(26) & L-leg: 9.1 (13.5) vs 15.7 (1)). There was a 71% (5/7 subjects) improvement in MSIS scores pre- vs. post- training in all subjects: mean(sd), 63(11.6) vs 57(15); median 61 vs 54, respectively.
This small pilot study confirms the feasibility of FST and PBT in moderately disabled MS subjects. Improvements were seen in both objective and subjective measures for both FST and PBT. Future studies will explore these findings in larger and longer studies. After the study, the PBT group independently continued the PBT. We plan to reassess these PBT subjects at 12-months post-study assessment.