Physical fitness assessment in multiple sclerosis patients: a controlled study.
Even mildly affected MS adults fail basic fitness tests while reporting normal effort, so objective measures must guide rehab plans.
01Research in Context
What this study did
Van Hanegem et al. (2014) ran a quasi-experiment with adults who have mild multiple sclerosis. They gave everyone the same fitness tests: balance, strength, and a six-minute walk.
Each MS adult was matched to a healthy peer of the same age and sex. Both groups were sedentary, so any gap would come from the disease, not couch time.
What they found
The mild MS group scored lower on every hard measure. Balance sway was bigger, knee strength was weaker, and walking distance was shorter.
Odd twist: after the walk both groups said the effort felt the same. Objective tests caught problems the clients could not feel.
How this fits with other research
Congiu et al. (2010) looked at the same mild MS crowd but added fatigue, handwriting, and daily-living checks. Their mix correctly flagged 88 % of patients, showing one test is not enough.
Enkelaar et al. (2013) gave balance and gait tests to older adults with intellectual disability. Like E et al., they saw large deficits versus controls, proving cheap clinical tools are sensitive.
de Kuijper et al. (2014) tested kids with developmental language disorder. Fitness scores were lower even though activity logs matched typical peers, echoing the "feel fine, test poor" pattern seen here.
Why it matters
If you serve adults with MS, do not trust "I feel okay" alone. Add a quick balance scale, grip meter, or six-minute walk to your intake. These low-tech tools spot decline early and give you hard numbers to track before and after any rehab plan you run.
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Add one balance test and one strength test to your intake packet for every adult MS client.
02At a glance
03Original abstract
There is growing evidence to show the effectiveness of physical exercise for multiple sclerosis (MS) patients. Aim of this study was to evaluate aerobic capacity, strength, balance, and the rate of perceived exertion (RPE) after exercise, in ambulatory patients with mild MS and matched control healthy participants. Seventeen MS patients aged 48.09 ± 10.0 years, with mild MS disability (Expanded Disability Status Scale: EDSS 1.5 to 4.5) and 10 healthy sedentary age matched (41.9 ± 11.2 years) subjects volunteered for the study. MS patients underwent medical examination with resting electrocardiogram, arterial blood pressure, EDSS, and Modified Fatigue Impact Scale-MFIS. Both groups also underwent physical assessment with the Berg Balance Scale(,) test (Berg), Six Minutes Walking Test (6MWT), maximal isometric voluntary contraction (MIVC) of forearm, lower limb, shoulder strength test, and the Borg 10-point scale test. The one-way ANOVA showed significant differences for MFIS (F1.19=9.420; p<0.01), Berg (F1.19=13.125; p<0.01), handgrip MIVC (F1.19=4.567; p<0.05), lower limbs MIVC (F1.19=7.429; p<0.01), and 6MWT (F1.19=28.061; p<0.01) between groups. EDSS, Berg test and Borg scores explained 80% of 6MWT variation. Mild grade EDSS patients exhibited impaired balance, muscle strength, and low self pace-6MWT scores, whereas RPE response after the exercise was similar to that of sedentary individuals. Both groups showed similar global physiological adjustments to exercise.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.06.013