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Home - 03.10.2013 - New insights on exercise therapy in MS

New insights on exercise therapy in MS

Thursday, October 03, 2013, 15:15 - 15:27

The effects of Pilates-based core stability training in ambulant people with multiple sclerosis: a multicentre, block randomised, double blinded placebo controlled trial

E.E Fox, A.D. Hough, S. Creanor, M. Gear, J.A. Freeman (Plymouth, Lerwick, GB)

Background: Multiple Sclerosis (MS) commonly leads to balance and mobility impairments. Pilates based core stability training targets the deep abdominal muscles, aiming to improve trunk stability and consequently balance and mobility. This form of exercise is frequently used by physiotherapists for people with MS despite a paucity of evidence to support its effectiveness.
Aim: To compare the effectiveness of 12 weeks Pilates based core stability training with a standardised physiotherapy programme of lower limb exercises and relaxation (placebo control).
Methods: This multi-centre, double blinded, block randomised controlled trial recruited 100 participants from 7 centres across the United Kingdom. Blinded assessments of mobility and balance were undertaken at baseline, immediately post intervention (12 weeks) and at one month follow-up. The standardised and validated measures included clinician rated (10 metre timed walk {10MTW}, functional reach test) and patient reported measures (MS 12 item Walking Scale {MSWS12}, Activities Balance Confidence Scale, visual analogue scale of ‘difficulty walking whilst carrying a drink’). Preliminary descriptive analyses of key data have been undertaken.
Results: To date, of the 100 participants recruited, 79 have completed assessments at all 3 time-points, 7 have relapsed (withdrawn) and 10 dropped out (due to other medical or logistical reasons). Demographic and diagnostic information available to date (n=92): mean (sd) age 54.6 (10.2) years, 72% female, and mean (sd) years since diagnosis 13.4 (10.7). The average changes between baseline and week 12 for the 2 primary outcome measures (10MTW, MSWS12) were descriptively compared between the 3 groups. For the 10MTW, there was a mean improvement of 1.79 seconds (95% CI 0.48 to 3.10) in the Pilates group (n=28); 2.55 seconds (95% CI 1.59 to 3.51) in the standardised exercise group (n=26) and 1.93 seconds (95% CI 0.20 to 3.66) in the placebo control group (n=17). There was a mean improvement of 7.3 (95% CI 0.4 to 14.2) on MSWS12 for the Pilates group (n=27); 12.5 (95% CI 7.5 to 17.5) for the standardised exercise group (n=25) and 4.9 (95% CI -2.2 to 12.0) for the placebo control group (n=18).
Discussion: These preliminary data demonstrate improvements in clinician-rated (all groups) and patient reported mobility (Pilates and standardised exercise groups). This trial will be completed in June 2013, after which time final results will be presented.

nothing to disclose