Investigation of the effect of selective exercise training on muscle architecture, balance, function and fatigue in multiple sclerosis

This study was performed to determine the effects of selective training that specific for muscle groups, eccentric and concentric training on balance, function, fatigue and muscle architecture in patients with Multiple Sclerosis (MS). In this single-blind, randomized controlled study, 33 MS patients with EDSS score of 4 and below were included. The patients were divided into three groups. For the first group, selective training was applied to for 3 days/week, for the second group, downhill walking training on the treadmill for 2 days/week, and for the third group, uphill walking training on the treadmill for 2 days/week for 8 weeks. Eleven healthy individuals were evaluated as the control group to define the muscle architecture. Evaluations were repeated at week 1, 8 and 12. Muscle strength was evaluated by hand dynamometer. For fatigue; Fatigue Severity Scale, Modified Borg Scale before and after 6-minute walking test and Walking Fatigue Index were used. The pennation angle, fiber length and thickness of the rectus femoris, biceps femoris, gastro-soleus, gastrocnemius and tibialis anterior were evaluated with Ultrasound. Single standing and 4 square step tests were used for balance. Functional activities were evaluated with timed-up go, 2-minute walk and 25-feet walk test. In our study, the results in terms of balance, functional activity and fatigue were similar in the three groups after the training (p>0.05). Plantar flexor strength in downhill group, in the the dorsi flexor strength in uphill group increased (p <0.05). The rectus femoris muscle thickness of MS patients was lower than healthy individuals (p <0.05). As a result, we found that three different exercise trainings had positive effects on balance, functional activity, fatigue and muscle architecture. Results of the selective exercise training group are similar to downhill and uphill walking training groups, we think that there may be an alternative approach in MS rehabilitation and studies involving different muscle groups are needed. Keywords: Eccentric Exercise, Muscle Architecture, Concentric Exercise, Multiple Sclerosis, Fatigue