Effect of combined training exercises on fatigue and gait pattern in persons with relapsing-remitting multiple sclerosis

The intervention has been designed based on the intensity, frequency and duration established in the last reviews and the hypothesis that the Whole Body Vibration (WBV) or Balance Trainer (BT) in addition to a standard exercises program can improve fatigue and gait pattern. The duration was twice a week, during twelve week (24 sessions in total). The duration of the interventions increased progressively from 60 to 100 minutes, reached at the sixth-eighth week The participants will be divide in three groups: Whole Body Vibration group (WBVgroup), Balance Trainer group (BTgroup) and Control group (CTgroup), which was in a waiting list to receive treatment. In the first two groups the nature of the program will be the same: Standard Exercise Program - 5min Warm Up - 15-30min Aerobic Exercise: (e.g. stationary bike, treadmill walking, elliptical or brisk walking in a circular corridor of 150m) - 15-30min Circuit Exercises: body weight exercises, coordination and balance exercises ((e.g. squats, unilateral weight bearing, dual-task, walk in a straight line, pilates ball exercises) - 15min Stretching: major muscle groups - 5min Cool-down: relaxation and breathing There will be breaks between exercises and the exercise programme is progressive and tailored towards individual capabilities and preferences. Mode of administration: Circuit training, a group exercise program adapted for individuals, supervised by an neurologic physical therapist. 4 to 8 individuals per group. In addition to a standard exercises program Group A) Whole Body Vibration Group [Using a Zeptor med System (Fa. Scisens, Germany)] Amplitude: 3mm, Frecuency f: 6Hz +/- 1Hz/sec. 5 repetition X 1 min (1 min rest) Group B) Balance Trainer Group Balance training is mechanical device that provides a fall-safe balancing environment (Medica Medizintechnik GmbH, Hochdorf, Germany) in interaction with the computer in order to training balance. 15 minutes of Balance Trainer. Twice times / week. -60-100 minutes/session Group C) Control Group. (Waiting list/No treatment) Adherence to treatment is monitored by records of attendance and punctuality. Level of Assistance to sessions Excellent: 90% or more. Good: 75% - 90%. Medium: 50% - 75%. Poor: less than 50%. Self-perception of physical effort and level of satisfaction is monitored using a Likert-type scale self-designed for the trial.