Multiple Sclerosis (MS)
Conditions
Keywords
Multiple Sclerosis, Physical therapy, Physical capacity, Fatigue
Brief summary
The purpose of this study is to assess the physical capacity of patients with multiple sclerosis and the effects of rehabilitation, encompassing physical therapy and physical activity as it is carried out in the day hospital of (the Physical and Rehabilitation Medicine department) at Garches Hospital. We will compare the results of assessments carried out before and after a standard rehabilitation program.
Detailed description
Single center, retrospective and prospective study. In order to assess the efficiency of the of usual rehabilitation proposed to patients in the day hospital, assessments are systematically performed before and after the rehabilitation program: 1. Assessment of muscular strength and fatigue: Assessments of voluntary force will be those usually performed in the context of the evaluation of patients. The isokinetic dynamometer CON-TREX ® is a device that provides a quantified result of the torque developed in a predetermined joint area with a constant speed which is also defined in advance. The assessment includes an assessment of the strength in isometric contraction (at 40 and 90 degrees of knee flexion) and concentric contraction (30, 60 and 90 degrees per second). Fatigue is evaluated by two self-administered questionnaires: the Fatigue Severity Scale and Modified Fatigue Impact Scale. 2. Effort test: The aerobic capacity of patients will be assessed by a triangular maximal exercise test. The effort test is performed on a cycle ergometer from a triangular incremental exercise. Beforehand, blood pressure and ECG are recorded to establish that the patient can safely achieve a gradual stress test. Heart rate, blood pressure, oxygen consumption, the feeling (Borg scale) and ECG are recorded immediately before and immediately after the end of the test and every minute for at least 5-10 minutes during the recovery phase. 3. Clinical assessment: The Timed Up and Go test will be used to assess the patient's capacity of postural transition. This is a timed quantitative assessment of the duration needed to change from sitting in a chair, get up and walk three meters, make a U-turn and come back to sit down. The 10 meters test quantifies the walking speed of patients (meters / second) over 10 meters A test of ascending and descending10 stairs is also performed, as well as the 6 minutes walking test. In addition to these functional assessments, clinical tests are conventionally performed such as the measurement of muscle strength (Medical Research Council scale), range of motion, spasticity (modified Ashworth scale) and an assessment of the balance and posture. The SEP-59 questionnaire will be used to assess the patients quality of life.
Interventions
OTHERRehabilitation
Physiotherapy and physical activity
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Multiple Sclerosis with EDSS ≤ 6 (Expanded Disability Status Scale) * Patient ≥ 18 years old * Patient able to comply with the recommended monitoring * No relapse within the last three months * More than six months elapsed since last medical care in day hospital * No recent modification (six month) of medications for MS * More than three months elapsed since last change of associated treatments (Fampyra, botulinum toxin)
Exclusion criteria
* Patients under any form of guardianship or curatorship * Breastfeeding * Orthopedic complications with repercussions on walking activities * No affiliation to a social security scheme (beneficiary or assignee)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of the strength and fatigue | Within 10 weeks from the start of the rehabilitation program | Assessment realised with an isokinetic dynamometer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of aerobic capacity during an effort test | Within 10 weeks from the start of the rehabilitation program | Aerobic capacity (VO2max) |
| Assessment of the balance of patients | Within 10 weeks from the start of the rehabilitation program | Berg Balance Scale |
| Assessment of Spasticity with the Modified Ashworth Scale (MAS), | Within 10 weeks from the start of the rehabilitation program | — |
| 10 meters Walk test | Within 10 weeks from the start of the rehabilitation | Patients have to walk over a 14 meter walkway and time required to traverse the middle 10 meters of the walk was recorded to avoid acceleration and deceleration effects |
| 6 minutes walking test | Within 10 weeks from the start of the rehabilitation program | Patients were instructed to walk as far as possible in a 50 meters corridor during 6 minutes |
| Time to ascend and descend stairs | Within 10 weeks from the start of the rehabilitation | Participants were instructed to ascend and descend 10 stairs using the hand rail |
| Assessment of Strength with the Medical Research Council (MRC), | Within 10 weeks from the start of the rehabilitation | — |
| Assessment of Quality of Life with SEP-59 Scale | Within 10 weeks from the start of the rehabilitation | — |
| Timed up and go test | Within 10 weeks from the start of the rehabilitation | Patients have to get up from a chair, walk 3 meters, turn around and return to sitting as quickly as possible |
Countries
France
Contacts
Primary ContactDjamel Bensmail, MD, PhD
Outcome results
None listed