Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial
Background: Walking disability is one of the most frequent and burdening symptoms of progressive multiple sclerosis (MS). Most of the exercise intervention studies that showed an improvement in mobility performance were conducted in low to moderately disabled relapsing–remitting MS patients with int...
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Frontiers Media S.A.
2021-07-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.644533/full |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Inga Heinrich Friederike Rosenthal Stefan Patra Karl-Heinz Schulz Götz H. Welsch Eik Vettorazzi Sina C. Rosenkranz Sina C. Rosenkranz Jan Patrick Stellmann Jan Patrick Stellmann Jan Patrick Stellmann Caren Ramien Jana Pöttgen Jana Pöttgen Stefan M. Gold Stefan M. Gold Stefan M. Gold Christoph Heesen Christoph Heesen |
spellingShingle |
Inga Heinrich Friederike Rosenthal Stefan Patra Karl-Heinz Schulz Götz H. Welsch Eik Vettorazzi Sina C. Rosenkranz Sina C. Rosenkranz Jan Patrick Stellmann Jan Patrick Stellmann Jan Patrick Stellmann Caren Ramien Jana Pöttgen Jana Pöttgen Stefan M. Gold Stefan M. Gold Stefan M. Gold Christoph Heesen Christoph Heesen Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial Frontiers in Neurology aerobic exercise multiple sclerosis progressive multiple sclerosis arm ergometry cognition |
author_facet |
Inga Heinrich Friederike Rosenthal Stefan Patra Karl-Heinz Schulz Götz H. Welsch Eik Vettorazzi Sina C. Rosenkranz Sina C. Rosenkranz Jan Patrick Stellmann Jan Patrick Stellmann Jan Patrick Stellmann Caren Ramien Jana Pöttgen Jana Pöttgen Stefan M. Gold Stefan M. Gold Stefan M. Gold Christoph Heesen Christoph Heesen |
author_sort |
Inga Heinrich |
title |
Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial |
title_short |
Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial |
title_full |
Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial |
title_fullStr |
Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial |
title_full_unstemmed |
Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial |
title_sort |
arm ergometry to improve mobility in progressive multiple sclerosis (ambos)—results of a pilot randomized controlled trial |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2021-07-01 |
description |
Background: Walking disability is one of the most frequent and burdening symptoms of progressive multiple sclerosis (MS). Most of the exercise intervention studies that showed an improvement in mobility performance were conducted in low to moderately disabled relapsing–remitting MS patients with interventions using the legs. However, MS patients with substantial walking disability hardly can perform these tasks. Earlier work has indicated that aerobic arm training might also improve walking performance and could therefore be a therapeutic option in already moderately disabled progressive MS patients.Methods: Patients with progressive MS and EDSS 4–6.5 were randomized using a computer-generated algorithm list to either a waitlist control group (CG) or an intervention group (IG). The IG performed a 12-week home-based, individualized arm ergometry exercise training program. Maximum walking distance as measured by the 6-min walking test (6MWT) was the primary endpoint. Secondary endpoints included aerobic fitness, other mobility tests, cognitive functioning, as well as fatigue and depression.Results: Of n = 86 screened patients, 53 with moderate disability (mean EDSS 5.5, SD 0.9) were included and data of 39 patients were analyzed. Patients in the IG showed strong adherence to the program with a mean of 67 (SD 26.4) training sessions. Maximum work load (Pmax) increased in the training group while other fitness indicators did not. Walking distance in the 6MWT improved in both training and waitlist group but not significantly more in trained patients. Similarly, other mobility measures showed no differential group effect. Cognitive functioning remained unchanged. No serious events attributable to the intervention occurred.Conclusion: Although maximum work load improved, 3 months of high-frequency arm ergometry training of low to moderate intensity could not show improved walking ability or cognitive functioning in progressive MS compared to a waitlist CG.The study was registered at www.clinicaltrials.gov (NCT03147105) and funded by the local MS self-help organization. |
topic |
aerobic exercise multiple sclerosis progressive multiple sclerosis arm ergometry cognition |
url |
https://www.frontiersin.org/articles/10.3389/fneur.2021.644533/full |
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doaj-b858b692f7984a41941205620a3e49492021-07-19T10:02:58ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-07-011210.3389/fneur.2021.644533644533Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled TrialInga Heinrich0Friederike Rosenthal1Stefan Patra2Karl-Heinz Schulz3Götz H. Welsch4Eik Vettorazzi5Sina C. Rosenkranz6Sina C. Rosenkranz7Jan Patrick Stellmann8Jan Patrick Stellmann9Jan Patrick Stellmann10Caren Ramien11Jana Pöttgen12Jana Pöttgen13Stefan M. Gold14Stefan M. Gold15Stefan M. Gold16Christoph Heesen17Christoph Heesen18Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUniversitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum) und Institut und Poliklinik für Medizinische Psychologie, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUniversitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum) und Institut und Poliklinik für Medizinische Psychologie, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUniversitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum) und Institut und Poliklinik für Medizinische Psychologie, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Biometry, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyAPHM, Hospital de la Timone, CEMEREM, Marseille, FranceAix Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille, FranceInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, GermanyDivision of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Medical Department, Berlin, GermanyInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyBackground: Walking disability is one of the most frequent and burdening symptoms of progressive multiple sclerosis (MS). Most of the exercise intervention studies that showed an improvement in mobility performance were conducted in low to moderately disabled relapsing–remitting MS patients with interventions using the legs. However, MS patients with substantial walking disability hardly can perform these tasks. Earlier work has indicated that aerobic arm training might also improve walking performance and could therefore be a therapeutic option in already moderately disabled progressive MS patients.Methods: Patients with progressive MS and EDSS 4–6.5 were randomized using a computer-generated algorithm list to either a waitlist control group (CG) or an intervention group (IG). The IG performed a 12-week home-based, individualized arm ergometry exercise training program. Maximum walking distance as measured by the 6-min walking test (6MWT) was the primary endpoint. Secondary endpoints included aerobic fitness, other mobility tests, cognitive functioning, as well as fatigue and depression.Results: Of n = 86 screened patients, 53 with moderate disability (mean EDSS 5.5, SD 0.9) were included and data of 39 patients were analyzed. Patients in the IG showed strong adherence to the program with a mean of 67 (SD 26.4) training sessions. Maximum work load (Pmax) increased in the training group while other fitness indicators did not. Walking distance in the 6MWT improved in both training and waitlist group but not significantly more in trained patients. Similarly, other mobility measures showed no differential group effect. Cognitive functioning remained unchanged. No serious events attributable to the intervention occurred.Conclusion: Although maximum work load improved, 3 months of high-frequency arm ergometry training of low to moderate intensity could not show improved walking ability or cognitive functioning in progressive MS compared to a waitlist CG.The study was registered at www.clinicaltrials.gov (NCT03147105) and funded by the local MS self-help organization.https://www.frontiersin.org/articles/10.3389/fneur.2021.644533/fullaerobic exercisemultiple sclerosisprogressive multiple sclerosisarm ergometrycognition |