Studie se zúčastnilo osmnáct osob s roztroušenou mozkomíšní sklerózou. Experimentální skupina byla po dobu šesti týdnů podrobena komplexnímu fyzioterapeutickému programu, jehož součástí byla aerobní zátěž. Kontrolní skupina dodržovala dosavadní zvyklosti. U probandů experimentální skupiny došlo ke zlepšení fyzické kondice (zátěžové vyšetření na rumpálovém ergometru), únavy (Modified Fatigue Impact Scale) a celkového stavu (klinické vyšet- ření fyzioterapeutem, neurologem, vyšetření stability stoje na posturografu).

Eighteen patients with multiple sclerosis participated in the study. The experimental group was subjected for six weeks to a comprehensive physiotherapeutic programme involving a erobic training. The control group adhered to the previous regime. Probands of the experimental group improved as regards their physical condition (tests on a windlass ergometer), as regards the modified fatigue impact scale and general condition (clinical examination by a physiotherapist, neurologist, examination of stability in an erect position on a posturograph).

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Pilot Projects MeSH
• Multiple Sclerosis rehabilitation   MeSH
• Oxygen Consumption MeSH
• Physical Fitness MeSH
• Fatigue MeSH
• Exercise Test methods   instrumentation   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Review MeSH
• Comparative Study MeSH

Studie se zúčastnilo osmnáct probandů - nemocných RS. Experimentální skupina byla po dobu šesti týdnů podrobena komplexnímu fyzioterapeutickému programu, jehož součástí byla aerobní zátěž. Kontrolní skupina dodržovala dosavadní zvyklosti. U probandů experimentální skupiny došlo ke zvýšení fyzické kondice (zátěžové vyšetření na rumpálovém ergometru) a snížení únavy (Modified Fatigue hnpact Scale).

18 patients with multiple sclerosis had participated on this study. Experiemtnal group underwent during a period of 6 weeks to a complex physiotherapeutic program, parts of which was aerobic load. Increasing of physical shape (investigation of load with the help of ergometer) and fatigue decrease (Modified Fatigue Impact Scale) were observed in members of control group.

• MeSH
• Adult MeSH
• Ergometry methods   MeSH
• Humans MeSH
• Multiple Sclerosis MeSH
• Physical Fitness MeSH
• Fatigue diagnosis   rehabilitation   therapy   MeSH
• Exercise Test methods   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Publication type
• Comparative Study MeSH

Únava je považovaná za jeden z hlavných príznakov, ktorý sťažuje život pacientom so sclerosis multiplex (SM). Cieľom nášho výskumu bolo zistiť vplyv únavy na fyzickú, kognitívnu a psychosociálnu oblasť života pacientov so SM a zároveň poukázať na význam pravidelnej fyzioterapie v manažmente tohto symptómu. Pre zhodnotenie vplyvu únavy na sledované parametre sme použili medzinárodne akceptovanú Modifikovanú škálu vplyvu únavy (Modified Fatigue Impact Scale, MFIS). Výskumu sa zúčastnilo 94 pacientov (priemerný vek 46,22 rokov (SD ?10,54 min. 21 max. 66, z toho 18 mužov a 76 žien), rozdelení boli do troch skupín podľa rozsahu ich fyzickej invalidity. Na získanie sociodemografických a klinických údajov respondenti vyplnili autormi vytvorený dotazník. V sledovaných skupinách sa cítili najmenej unavení pacienti, ktorí sa pravidelne zúčastňovali fyzioterapie. Signifikantný význam pozitívneho vplyvu pravidelnej fyzioterapie na úroveň únavy týchto chorých však nebol použitými štatistickými metódami dokázaný.

Fatigue is considered as one of the main symptoms burdening patients with multiple sclerosis (MS). The objective of the research was to investigate the impact of fatigue on physical, cognitive and psychosocial areas of MS patientęs life, and also to focus on the importance of physiotherapy in the management of this symptom. An evaluation of the impact of fatigue on physical, mental and psychosocial areas of MS patientęs life was assessed using the Modified Fatigue Impact Scale (MFIS). Patients completed by the authors prepared questionnaire that includes questions for investigation of the sociodemographic and clinical data. Total number of investigated responders was consisted of 94 patients with MS. The average age was 46.22 years (SD ? 10.54 min.21 max. 66), from that 18 men and 76 women. In the studied groups of patients the lowest fatigue was experienced by the patients who regularly participated in physiotherapy. In the work has not been confirmed a statistically significant positive effect of regular physiotherapy to the level of fatigue.

• MeSH
• Analysis of Variance MeSH
• Adult MeSH
• Outcome Assessment, Health Care statistics & numerical data   MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Cross-Sectional Studies MeSH
• Surveys and Questionnaires MeSH
• Multiple Sclerosis * psychology   rehabilitation   MeSH
• Aged MeSH
• Patient Satisfaction MeSH
• Severity of Illness Index MeSH
• Physical Therapy Modalities * utilization   MeSH
• Physical Fitness MeSH
• Fatigue * complications   prevention & control   rehabilitation   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Tables MeSH

Aim: The aim of the study was to determine the frequency of theincidence of fatigue, and its impact on the performance ofactivities of daily living inpatients with the diagnosis of multiple sclerosis (MS),regardingtheir cognitive, physical,and psychosocial functioning,and alsoto identify differences in the frequency of its occurrence inpatients diagnosed with the disease for up to five years,and in those diagnosed for more than five years. Design:Aquantitative cross-sectional study.Methods:Atotalof 94 MS patients with the mean age of 38.70 ± 11.20,and average disease duration of 6.5 ± 4.7,were included in the sample. An adapted version of a self-assessed questionnaire,the Modified Fatigue Impact Scale(MFIS),was used to collect empirical data.Results:Fatigue had the greatest incidence and impact on activities in the physical subscale ofthe used tool (19.98 ± 8.71). Weidentified statistically significant differences betweenthe first group of MS patients with disease duration of up to five years,and the second group with disease duration of over five years in the physical (p = 0.019) and psychosocial subscales(p = 0.006). The group of respondents withMS for more than five years reportedhigher incidence of fatigue onboth subscales. No significant differences were identified onthe cognitive subscale. Conclusion:Objectification of the frequency of fatigue incidence–aburdensomesymptom of the disease–and the monitoring of its impact on activities of daily living bymeans of suitable measuring instruments, such as the MFIS, contributeto a better understanding of the issue in diagnostics. It also opens up possibilities for its effective management. In terms of further research, itwould be valuableto conductvalidation studiesof this instrument in the Slovak sociocultural environment.

• Keywords
• Modified Fatigue Impact Scale,
• MeSH
• Adult MeSH
• Quality of Life MeSH
• Middle Aged MeSH
• Humans MeSH
• Cross-Sectional Studies MeSH
• Surveys and Questionnaires MeSH
• Multiple Sclerosis * complications   MeSH
• Fatigue * diagnosis   epidemiology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH

BACKGROUND: The relationship between fatigue impact and walking capacity and perceived ability in patients with multiple sclerosis (MS) is inconclusive in the existing literature. A better understanding might guide new treatment avenues for fatigue and/or walking capacity in patients with MS. OBJECTIVE: To investigate the relationship between the subjective impact of fatigue and objective walking capacity as well as subjective walking ability in MS patients. METHODS: A cross-sectional multicenter study design was applied. Ambulatory MS patients (n = 189, age: 47.6 ± 10.5 years; gender: 115/74 women/men; Expanded Disability Status Scale (EDSS): 4.1 ± 1.8 [range: 0-6.5]) were tested at 11 sites. Objective tests of walking capacity included short walking tests (Timed 25-Foot Walk (T25FW), 10-Metre Walk Test (10mWT) at usual and fastest speed and the timed up and go (TUG)), and long walking tests (2- and 6-Minute Walk Tests (MWT). Subjective walking ability was tested applying the Multiple Sclerosis Walking Scale-12 (MSWS-12). Fatigue impact was measured by the self-reported modified fatigue impact scale (MFIS) consisting of a total score (MFIStotal) and three subscales (MFISphysical, MFIScognitive and MFISpsychosocial). Uni- and multivariate regression analysis were performed to evaluate the relation between walking and fatigue impact. RESULTS: MFIStotal was negatively related with long (6MWT, r = -0.14, p = 0.05) and short composite (TUG, r = -0.22, p = 0.003) walking measures. MFISphysical showed a significant albeit weak relationship to walking speed in all walking capacity tests (r = -0.22 to -0.33, p < .0001), which persisted in the multivariate linear regression analysis. Subjective walking ability (MSWS-12) was related to MFIStotal (r = 0.49, p < 0.0001), as well as to all other subscales of MFIS (r = 0.24-0.63, p < 0.001), showing stronger relationships than objective measures of walking. CONCLUSIONS: The physical impact of fatigue is weakly related to objective walking capacity, while general, physical, cognitive and psychosocial fatigue impact are weakly to moderately related to subjective walking ability, when analysed in a large heterogeneous sample of MS patients.

• MeSH
• Walking physiology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Gait Disorders, Neurologic etiology   MeSH
• Perception physiology   MeSH
• Disability Evaluation MeSH
• Cross-Sectional Studies MeSH
• Regression Analysis MeSH
• Multiple Sclerosis complications   psychology   MeSH
• Aged MeSH
• Walk Test MeSH
• Fatigue etiology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH

Příručka podává návod k fyzioterapeutické léčbě u nemocných s roztroušenou sklerózou mozkomíšní. Zpracovává teoretická východiska pro terapii, v praktické části seznamuje s modelovými situacemi.

• Keywords
• roztroušená skleróza, neurorehabilitace,
• MeSH
• Rehabilitation MeSH
• Multiple Sclerosis MeSH

• Conspectus
• Fyzioterapie. Psychoterapie. Alternativní lékařství

OBJECTIVE: Long-term physiotherapy is of considerable benefit to patients with multiple sclerosis (MS) who have motor dysfunction or gait impairment. The aim of this study was to determine the effectiveness of a 12-week intensive circuit class therapy for patients with MS, with a wider focus on fatigue and gait ability. METHODS: A total of 46 patients with relapsing-remitting MS were divided randomly into 2 groups: 23 patients (mean Expanded Disability Status Scale (EDSS) 2.33 ± 0.74) participated in an intensive 12-week course of intensive circuit class therapy, and 23 patients (mean EDSS 2.04 ± 0.63) served as a control group. The EDSS, Timed Up and Go (TUG) test and Four-Stage Balance Test (FSBT) made up the physical testing part, supplemented by questionnaires such as the Modified Fatigue Impact Scale (MFIS), 12-Item Multiple Sclerosis Walking Scale (MSWS-12), Beck Depression Inventory (BDI) and 36-Item Short Form Survey (SF-36). RESULTS: Significant improvements were found among intensive circuit class therapy-exercising patients in FSBT (p < 0.05), TUG test (p < 0.01), MFIS (p < 0.01), BDI (p < 0.05), MSWS-12 (p < 0.05) and the 3 subscales of SF-36 after 12 weeks of intensive circuit class therapy, while there were no significant changes in the control group. CONCLUSION: Intensive circuit class therapy is an effective therapeutic approach for improving gait and balance problems in patients with MS. It has also proved to alleviate fatigue and symptoms of depression.

• MeSH
• Gait physiology   MeSH
• Humans MeSH
• Multiple Sclerosis, Relapsing-Remitting * physiopathology   therapy   MeSH
• Exercise Therapy * MeSH
• Fatigue prevention & control   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

Úvod: Poruchy chůze a rovnováhy jsou častým symptomem u osob s roztroušenou sklerózou (RS) a mohou být přítomné již od počátku onemocnění. Pravidelná pohybová aktivita by měla být součástí léčebných režimových opatření při RS a cvičení Pilates představuje jednu z možností. Cílem naší pilotní studie bylo ozřejmit vliv pravidelného cvičení Pilates na chůzi a rovnováhu u osob s RS.Metodika: Probandi z experimentální skupiny absolvovali 10 týdnů pravidelného cvičení Pilates. Kontrolní skupina neměla žádné změny pohybového režimu. Chůze a rovnováha byly vyšetřeny pomocí funkčních testů (Timed 25 foot walk test, Timed Up and Go test, 2 minutový test, Berg Balance Test, MiniBEST test). Pro zhodnocení subjektivního efektu pravidelného cvičení byly využity standardizované dotazníky (Multiple Sclerosis Walking Scale 12, Falls Efficacy Scale, Modified Fatigue Impact Scale) a námi vytvořený dotazník. Výsledky: Do studie bylo zařazeno 32 osob s RS: 21 osob bylo zařazeno do experimentální skupiny cvičící Pilates (21 žen, průměrný věk 38,5 roku, průměrná doba trvání onemocnění 6 let a průměrné EDSS 2,5). Kontrolní skupina byla tvořena 11 osobami (1 muž, průměrný věk 43 let, průměrné EDSS 2,9). Probandi z experimentální skupiny cvičící Pilates dosáhli zlepšení v testech rovnováhy a chůze MiniBEST test, Timed Up and Go a 2minutový test chůze. Subjektivní zlepšení rovnováhy bylo zaznamenáno i v dotazníku Falls Efficacy Scale. Závěr: Pilates může být pro osoby s mírnou neurologickou disabilitou možnou pohybovou aktivitou pro zlepšení rovnováhy.

Background: Balance and gait impairment are common in people with multiple sclerosis (MS). This disabling deficit can be present even in people with mild neurological disability. People with MS are encouraged to perform some regular physical activity for improving fitness and muscle strength. Pilates is popular exercise system focusing upon controlled movement, activation of core muscles and breathing. The aim of the study was compare effect of short-term Pilates exercise on balance and gait performance in group of people with mild MS. Methods: Participants received 10 weeks of training sessions of Pilates exercise (supervised by physiotherapist with experience in Mat Pilates exercise), control group has no change of lifestyle regimen. Balance was evaluated using Berg Balance Scale, MiniBest test, Timed Up and Go test, Single leg stance and Step test on baseline and after completing of training. Gait performance was assessed using Timed 25 Foot Walk test, The 2-minute walk test and by GAITRite instrument. Results: Thirty-three participants completed the study: 21 people in Pilates group (21 women, mean age 38.5 y, mean disease duration 6 y, mean EDSS 2.5) and 11 people in control group (1 man, mean age 43 y, mean disease duration 9 y, mean EDSS 2.9). After completing 10 weeks of Pilates exercise participant significantly improved in balance (MiniBest test p=0.025, TUG p=0.041) and walking endurance (the 2-minute walk test p=0.002). Gait performance in normal walk measured by GAITRite was improved in both groups. Conclusion: Pilates could be offered as possible exercise to people with mild MS to improve balance. However, for treatment serious balance deficit individual physiotherapy should be prescribed.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Pilot Projects MeSH
• Multiple Sclerosis * rehabilitation   MeSH
• Exercise Movement Techniques * methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

PURPOSE: The aim of this study was to compare the effect of four different programmes on spiroergometric, spirometric and clinical parameters in multiple sclerosis (MS) patients. METHODS: One hundred and twelve MS patients were divided into four groups. The first group underwent neurophysiologically based physiotherapy, the second aerobic training, the third combined therapy (neurophysiologically based physiotherapy and aerobic training) and the fourth did not change any habits. Seventeen patients did not finish the study. Patients were examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer). RESULTS: The patients who participated in one of our training programmes showed a significant improvement of the examined parameters in comparison to those who did not change their present habits. Each of the four training programmes had a different impact on the parameters, which means that each of them had a different effect. The neurophysiologically based physiotherapy had the greatest impact on impairment, and the aerobic training on spirometric and spiroergometric parameters. All methods (the neurophysiologically based physiotherapy, the aerobic training and the combined programme) had an impact on fatigue.

• MeSH
• Financing, Organized MeSH
• Controlled Clinical Trials as Topic MeSH
• Quality of Life MeSH
• Humans MeSH
• Persons with Disabilities MeSH
• Multiple Sclerosis physiopathology   psychology   rehabilitation   MeSH
• Spirometry MeSH
• Physical Therapy Modalities MeSH
• Exercise Therapy MeSH
• Exercise Test MeSH
• Check Tag
• Humans MeSH
• Publication type
• Comparative Study MeSH

BACKGROUND: Newly diagnosed people with multiple sclerosis frequently report fatigue, pain, depression and anxiety. Preventative programmes may be beneficial, but there is limited evidence of their effectiveness, especially long-term follow-up. METHODS: The programme consisted of 6-month face to face intervention (an introductory workshop, psychology-led group sessions and individual physical therapy) followed by 6-month self-guided therapy. Outcome measures were taken at baseline, 6 and 12 months. Primary outcomes measures were self-report questionnaires for fatigue, satisfaction with life and disease acceptance. Secondary outcomes were spirometry, spiroergometric parameters and neuroactive steroid levels. RESULTS: From 22 participants enrolled, 17 completed the first 6 months and 13 the follow-up. Fatigue measured on the Fatigue scale for motor and cognitive functions decreased significantly at 6 months (p = 0.035) and at follow-up (p = 0.007). The Modified Fatigue Impact Scale (p = 0.035) and Satisfaction With Life Scale (p = 0.007) significantly increased at follow-up. Spirometry, spiroergometric parameters, steroid hormones and neuroactive steroids levels did not change significantly. CONCLUSION: This programme reduces fatigue and improves satisfaction with life in this patient group with improvements sustained at 12 months. People who participated more frequently showed greater benefit. CLINICAL REHABILITATION IMPACT: The paper describes the effects of a complex preventative intervention for people with newly diagnosed Multiple Sclerosis. The study found that this programme reduces fatigue and improves satisfaction with life with long-term benefit (at 12-month follow up). The individuals who participated less frequently experienced fewer benefits.

• Publication type
• Journal Article MeSH