Verbesserung der Gehstrecke bei Patienten mit Multipler Sklerose

Zusammenfassung

Einleitung: Im Krankheitsverlauf der Multiplen Sklerose (MS) können sich Symptome wie Gleichgewichtsstörungen, Muskelschwäche und Spastik einstellen. Eine reduzierte Gehfähigkeit ist eine verbreitete Behinderung für MS Patienten, Erkenntnisse zu den Trainingseffekten nach Gerätetraining oder nach einer Gruppengymnastik auf diese körperliche Fähigkeit sind kaum vorhanden. Studienziel: Das Ziel dieser Studie war zu untersuchen, welchen Einfluss eine gezielte Gruppengymnastik verglichen mit Gerätetraining und Non-Intervention auf die Gehfähigkeit von Patienten mit einer MS hat. Methoden: Eine Studie mit einer 12-wöchigen Interventionsphase und einer Verlängerungszeit von 12 Wochen wurde durchgeführt. 70 Patienten mit MS nahmen an der Untersuchung teil. Intervention: Gruppe 1 führte ein gezieltes Ganzkörpertraining in der Gruppe durch, Gruppe 2 absolvierte ein progressives Gerätetraining. Gruppe 3 bildete die Kontrollgruppe ohne Übungsprogramm. Beide Trainingsgruppen absolvierten 12 Trainingseinheiten mit jeweils einer Trainingseinheit pro Woche und einer Trainingsdauer von 60 min. Anschließend erhielten die Teilnehmer die Möglichkeit das Training um weitere 12 Wochen zu verlängern. Ergebnisse: Signifikante Verbesserungen der maximalen Gehstrecke konnte bei beiden Interventionsgruppen nach 24 Wochen gefunden werden. Während sich die Gerätetrainingsgruppe von 1 366 ± 160 m auf 1 806 ± 172m (32,2%; p = 0,004) steigern konnte, verbesserte sich die Gymnastikgruppe von 1089 ± 154 m auf 1 467 ± 190 m (34,9%; p = 0,002). Die Gehgeschwindigkeit auf einer Strecke von 7,62 m veränderte sich nicht. Zusammenfassung: Die neue Erkenntnis unserer Studie zeigte, dass eine gezielte Gruppengymnastik die maximale Gehstrecke von MS-Patienten signifikant verlängerte, ebenso wie das progressive Gerätetraining an Geräten. Die Gehgeschwindigkeit konnte nicht beeinflusst werden.

Summary:

Background: Multiple sclerosis (MS) is a chronic inflammatory disease which may result in motor weakness, spasticity and poor balance. The decrease of walking capacity is a common burden of patients in MS. The knowledge about effects after resistance training is small, after group intervention is poor. Objective: To study the effects of progressive resistance training (PoRT) in comparison to a core and stability training in groups (CoaST) versus a waiting group on the maximum walking distance and walking speed for patients with MS. Methods: A randomized controlled three-armed multi-centre trial with a 12 weeks study period and an optional voluntary follow up of 12 weeks was performed. 70 patients with MS and an EDSS from 1–6 were randomly allocated to one of the three groups. Intervention: Group 1 received a progressive resistance training (PoRT) using weight machines. Group 2 performed a core and stability training (CoaST) in group settings. Group 3 (Control) followed normal daily living with no further increase of physical activities. Both intervention groups performed 60 minutes training sessions once week. Results: Significant improvements on the maximum walking distance could be found in both intervention groups after 24 weeks. While the PoRT group improved the walking distance from 1 366 ± 160 m up to 1 806 ± 172 m (32,2%; p = 0.004), the CoaST group improved from 1 089 ± 154 m to 1 467 ± 190m (34,9%; p = 0.002). Conclusion: The new finding is that a core and stability training (CoaST) in groups improved significantly the walking distance. Progressive resistance training (PoRT) could improve walking distance but not walking speed for people in MS.

Schlüsselwörter

Multiple Sklerose - Training - Gymnastik - Gruppe - maximale Gehstrecke - Gehfähigkeit - T25W - Gehgeschwindigkeit

Keywords

Multiple sclerosis - exercise - walking capacity - T25W - walking distance - walking speed

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