Quantitative Changes in Gait Parameters after Cycling among Multiple Sclerosis Patients with Ataxia: A Pilot Study
-
Sarvenaz Rahimibarghani
,
Seyedeh Zahra Emami-Razavi
,
Abdorreza Naser Moghadasi
,
Mohaddeseh Azadvari
,
Mahya Shojaee Fard
,
Shahram Rahimi-Dehgolan
Abstract
Introduction: Cerebellar ataxia is a common symptom of multiple sclerosis (MS), particularly in progressive forms, where gait and balance problems are the most debilitating symptoms. Exercise training is a critical component of rehabilitation in managing equilibrium dysfunction, and stationary bicycling is a safe, feasible, and effective method to reduce the symptom. Clinical walking performance tests are typically used to assess gait in these patients. However, gait analysis technologies are more sensitive and accurate at detecting subtle and subclinical changes. The purpose of this study was to determine the changes in gait parameters in MS patients with ataxic gait after using a stationary bicycle.
Materials and Methods: Ten secondary progressive MS patients with ataxic gait and a mean expanded disability status scale (EDSS) of four were recruited. The participants cycled on a stationary bike. Gait analysis was performed before and after 12 sessions of cycling. It included spatiotemporal and balance parameter measurements.
Results: Gait analysis showed statistically significant changes in spatiotemporal parameters, including speed (P=0.02, r=-0.51), and stride length (P=0.01, r=-0.63). Of balance-related indices, the mediolateral (ML) center of pressure (COP) displacement, anterior and posterior COP overshoot, and COP velocity changes were statistically remarkable after the intervention respectively. (P=0.01, r=-0.63), (P=0.02, r=-0.51), (P=0.03, r=-0.49), (P=0.01, r=-0.54).
Conclusion: Gait analysis is applicable to track changes following rehabilitation in individuals with MS. The results indicate that using a stationary bicycle can improve some spatiotemporal and COP-related parameters.
1. Filippi M, Bar-Or A, Piehl F, Preziosa P, Solari A, Vukusic S, et al. Multiple sclerosis. Nat Rev Dis Prim 2018 41 [Internet]. 2018 Nov 8 [cited 2022 Feb 6];4(1):1–27. Available from: https://www.nature.com/articles/s41572-018-0041-4
2. Stevens V, Goodman K, Rough K, Kraft GH. Gait impairment and optimizing mobility in multiple sclerosis. Phys Med Rehabil Clin N Am [Internet]. 2013 Nov [cited 2022 Feb 6];24(4):573–92. Available from: https://pubmed.ncbi.nlm.nih.gov/24314677/
3. Ali AS, Darwish MH, Shalaby NM, Abbas RL, Soubhy HZ. Efficacy of core stability versus task oriented trainings on balance in ataxic persons with multiple sclerosis. A single blinded randomized controlled trial. Mult Scler Relat Disord [Internet]. 2021 May 1 [cited 2022 Feb 6];50. Available from: https://pubmed.ncbi.nlm.nih.gov/33652233/
4. Wilkins A. Cerebellar Dysfunction in Multiple Sclerosis. Front Neurol [Internet]. 2017 Jun 28 [cited 2022 Feb 6];8(JUN):312. Available from: /pmc/articles/PMC5487391/
5. Dujmovic I, Radovanovic S, Martinovic V, Dackovic J, Maric G, Mesaros S, et al. Gait pattern in patients with different multiple sclerosis phenotypes. Mult Scler Relat Disord [Internet]. 2017 Apr 1 [cited 2022 Feb 6];13:13–20. Available from: https://pubmed.ncbi.nlm.nih.gov/28427694/
6. Aliabadi S, Khanmohammadi R, Olyaei G, Ghotbi N, Talebian S, Moghadasi AN. Comparison of the Position Sense of the Knee Joint in Patients With Multiple Sclerosis and Healthy Controls. J Mod Rehabil [Internet]. 2019 Nov 27 [cited 2022 Feb 6];13(1):59–64. Available from: https://jmr.tums.ac.ir/index.php/jmr/article/view/230
7. Backus D, Moldavskiy M, Sweatman WM. Effects of Functional Electrical Stimulation Cycling on Fatigue and Quality of Life in People with Multiple Sclerosis Who Are Nonambulatory. Int J MS Care [Internet]. 2020 Jul 1 [cited 2022 Feb 6];22(4):193. Available from: /pmc/articles/PMC7446631/
8. Barclay A, Paul L, MacFarlane N, McFadyen AK. The effect of cycling using active-passive trainers on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe Multiple Sclerosis (MS); a feasibility study. Mult Scler Relat Disord [Internet]. 2019 Sep 1 [cited 2022 Feb 6];34:128–34. Available from: https://pubmed.ncbi.nlm.nih.gov/31260943/
9. Soltanpour H, Kalantari M, Modern MR-J of, 2018 undefined. Inter-rater Reliability, Test-retest Reliability, and Internal Consistency of the Persian Version of Dynamic Gait Index in Patients With Multiple Sclerosis. jmr.tums.ac.ir [Internet]. 2018 [cited 2022 Feb 6];12(4). Available from: http://jmr.tums.ac.ir/index.php/jmr/article/view/176
10. Shanahan CJ, Boonstra FMC, Cofré Lizama LE, Strik M, Moffat BA, Khan F, et al. Technologies for Advanced Gait and Balance Assessments in People with Multiple Sclerosis. Front Neurol. 2018 Feb 2;8:708.
11. Leone C, Kalron A, Smedal T, Normann B, Wens I, Eijnde BO, et al. Effects of Rehabilitation on Gait Pattern at Usual and Fast Speeds Depend on Walking Impairment Level in Multiple Sclerosis. Int J MS Care [Internet]. 2018 Sep 1 [cited 2022 Feb 8];20(5):199. Available from: /pmc/articles/PMC6200116/
12. Pau M, Corona F, Coghe G, Marongiu E, Loi A, Crisafulli A, et al. Quantitative assessment of the effects of 6 months of adapted physical activity on gait in people with multiple sclerosis: a randomized controlled trial. Disabil Rehabil [Internet]. 2018 Jan 16 [cited 2022 Feb 8];40(2):144–51. Available from: https://pubmed.ncbi.nlm.nih.gov/28084119/
13. Negahban H, Monjezi S, Mehravar M, Mostafaee N, Shoeibi A. Responsiveness of postural performance measures following balance rehabilitation in multiple sclerosis patients. J Bodyw Mov Ther [Internet]. 2018 Apr 1 [cited 2022 Feb 6];22(2):502–10. Available from: https://pubmed.ncbi.nlm.nih.gov/29861258/
14. Callesen J, Dalgas U, Brincks J, Cattaneo D. How much does balance and muscle strength impact walking in persons with multiple sclerosis? - A cross-sectional study. Mult Scler Relat Disord [Internet]. 2019 Apr 1 [cited 2022 Feb 10];29:137–44. Available from: https://pubmed.ncbi.nlm.nih.gov/30711879/
15. Cofré Lizama LE, Khan F, Lee PVS, Galea MP. The use of laboratory gait analysis for understanding gait deterioration in people with multiple sclerosis. Mult Scler [Internet]. 2016 Dec 1 [cited 2022 Feb 12];22(14):1768–76. Available from: https://pubmed.ncbi.nlm.nih.gov/27364324/
16. Pau M, Porta M, Coghe G, Cocco E. What gait features influence the amount and intensity of physical activity in people with multiple sclerosis? Medicine (Baltimore) [Internet]. 2021 Mar 5 [cited 2022 Feb 9];100(9):e24931. Available from: https://pubmed.ncbi.nlm.nih.gov/33655958/
17. Wajda DA, Motl RW, Sosnoff JJ. Three-Month Test-Retest Reliability of Center of Pressure Motion During Standing Balance in Individuals with Multiple Sclerosis. Int J MS Care [Internet]. 2016 Mar 1 [cited 2022 Feb 8];18(2):59–62. Available from: https://meridian.allenpress.com/ijmsc/article/18/2/59/33270/Three-Month-Test-Retest-Reliability-of-Center-of
18. Karst GM, Venema DM, Roehrs TG, Tyler AE. Center of pressure measures during standing tasks in minimally impaired persons with multiple sclerosis. J Neurol Phys Ther [Internet]. 2005 [cited 2022 Feb 6];29(4):170–80. Available from: https://pubmed.ncbi.nlm.nih.gov/16388684/
19. Severini G, Manca M, Ferraresi G, Caniatti LM, Cosma M, Baldasso F, et al. Evaluation of Clinical Gait Analysis parameters in patients affected by Multiple Sclerosis: Analysis of kinematics. Clin Biomech (Bristol, Avon) [Internet]. 2017 Jun 1 [cited 2022 Feb 6];45:1–8. Available from: https://pubmed.ncbi.nlm.nih.gov/28390935/
20. Filli L, Sutter T, Easthope CS, Killeen T, Meyer C, Reuter K, et al. Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time. Sci Reports 2018 81 [Internet]. 2018 Mar 21 [cited 2022 Feb 6];8(1):1–13. Available from: https://www.nature.com/articles/s41598-018-22676-0
21. Comber L, Sosnoff JJ, Galvin R, Coote S. Postural control deficits in people with Multiple Sclerosis: A systematic review and meta-analysis. Gait Posture [Internet]. 2018 Mar 1 [cited 2022 Feb 6];61:445–52. Available from: https://pubmed.ncbi.nlm.nih.gov/29486362/
22. Quijoux F, Vienne-Jumeau A, Bertin-Hugault F, Zawieja P, Lefèvre M, Vidal PP, et al. Center of pressure displacement characteristics differentiate fall risk in older people: A systematic review with meta-analysis. Ageing Res Rev [Internet]. 2020 Sep 1 [cited 2022 Feb 6];62. Available from: https://pubmed.ncbi.nlm.nih.gov/32565327/
23. Howcroft J, Lemaire ED, Kofman J, McIlroy WE. Elderly fall risk prediction using static posturography. PLoS One [Internet]. 2017 Feb 1 [cited 2022 Feb 6];12(2). Available from: https://pubmed.ncbi.nlm.nih.gov/28222191/
24. Lee YJ, Liang JN, Chen B, Aruin AS. Characteristics of medial-lateral postural control while exposed to the external perturbation in step initiation. Sci Reports 2019 91 [Internet]. 2019 Nov 14 [cited 2022 Feb 6];9(1):1–10. Available from: https://www.nature.com/articles/s41598-019-53379-9
25. Yiou E, Artico R, Teyssedre CA, Labaune O, Fourcade P. Anticipatory postural control of stability during gait initiation over obstacles of different height and distance made under reaction-time and self-initiated instructions. Front Hum Neurosci. 2016 Sep 7;10(SEP2016):449.
26. Kahl O, Wierzbicka E, Dębińska M, Mraz M, Mraz M. Compensatory image of the stability of people with multiple sclerosis and atrial vertigo based on posturography examination. Sci Reports 2021 111 [Internet]. 2021 Mar 29 [cited 2022 Feb 6];11(1):1–11. Available from: https://www.nature.com/articles/s41598-021-85983-z
27. Prosperini L, Castelli L. Spotlight on postural control in patients with multiple sclerosis. Degener Neurol Neuromuscul Dis [Internet]. 2018 Apr [cited 2022 Feb 6];8:25–34. Available from: https://pubmed.ncbi.nlm.nih.gov/30050386/
28. Prosperini L, Fortuna D, Giannì C, Leonardi L, Pozzilli C. The diagnostic accuracy of static posturography in predicting accidental falls in people with multiple sclerosis. Neurorehabil Neural Repair [Internet]. 2013 Jan [cited 2022 Feb 12];27(1):45–52. Available from: https://pubmed.ncbi.nlm.nih.gov/22593115/
29. Cameron MH, Nilsagard Y. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol [Internet]. 2018 Jan 1 [cited 2022 Feb 6];159:237–50. Available from: https://pubmed.ncbi.nlm.nih.gov/30482317/
30. Andreu-Caravaca L, Ramos-Campo DJ, Chung LH, Rubio-Arias J. Dosage and Effectiveness of Aerobic Training on Cardiorespiratory Fitness, Functional Capacity, Balance, and Fatigue in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil [Internet]. 2021 Sep 1 [cited 2022 Feb 9];102(9):1826–39. Available from: https://pubmed.ncbi.nlm.nih.gov/33567335/
31. Farrell JW, Merkas J, Pilutti LA. The Effect of Exercise Training on Gait, Balance, and Physical Fitness Asymmetries in Persons With Chronic Neurological Conditions: A Systematic Review of Randomized Controlled Trials. Front Physiol [Internet]. 2020 Nov 12 [cited 2022 Feb 6];11. Available from: https://pubmed.ncbi.nlm.nih.gov/33281619/
32. Hochman L. Effects of Functional Electrical Stimulation Cycling versus Cycling Only on Walking Performance and Quality of Life in Individuals with Multiple Sclerosis: A Randomized, Clinical Pilot Study. Dep Phys Ther Student Theses, Diss Capstones [Internet]. 2017 Dec 31 [cited 2022 Feb 6]; Available from: https://nsuworks.nova.edu/hpd_pt_stuetd/75
33. Ali AS, Darwish MH, Shalaby NM, Abbas RL, Soubhy HZ. Efficacy of core stability versus task oriented trainings on balance in ataxic persons with multiple sclerosis. A single blinded randomized controlled trial. Mult Scler Relat Disord [Internet]. 2021 May 1 [cited 2022 Feb 10];50. Available from: http://www.msard-journal.com/article/S2211034821001322/fulltext
34. Campbell E, Coulter EH, Mattison PG, Miller L, McFadyen A, Paul L. Physiotherapy Rehabilitation for People With Progressive Multiple Sclerosis: A Systematic Review. Arch Phys Med Rehabil [Internet]. 2016 Jan 1 [cited 2022 Feb 10];97(1):141-151.e3. Available from: https://pubmed.ncbi.nlm.nih.gov/26281954/
35. Çakt BD, Nacir B, Genç H, Saraçoǧlu M, Karagöz A, Erdem HR, et al. Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study. Am J Phys Med Rehabil [Internet]. 2010 Jun [cited 2022 Feb 6];89(6):446–57. Available from: https://pubmed.ncbi.nlm.nih.gov/20216060/
36. Sosnoff J, Motl RW, Snook EM, Wynn D. Effect of a 4-week period of unloaded leg cycling exercise on spasticity in multiple sclerosis. NeuroRehabilitation [Internet]. 2009 [cited 2022 Feb 6];24(4):327–31. Available from: https://pubmed.ncbi.nlm.nih.gov/19597270/
2. Stevens V, Goodman K, Rough K, Kraft GH. Gait impairment and optimizing mobility in multiple sclerosis. Phys Med Rehabil Clin N Am [Internet]. 2013 Nov [cited 2022 Feb 6];24(4):573–92. Available from: https://pubmed.ncbi.nlm.nih.gov/24314677/
3. Ali AS, Darwish MH, Shalaby NM, Abbas RL, Soubhy HZ. Efficacy of core stability versus task oriented trainings on balance in ataxic persons with multiple sclerosis. A single blinded randomized controlled trial. Mult Scler Relat Disord [Internet]. 2021 May 1 [cited 2022 Feb 6];50. Available from: https://pubmed.ncbi.nlm.nih.gov/33652233/
4. Wilkins A. Cerebellar Dysfunction in Multiple Sclerosis. Front Neurol [Internet]. 2017 Jun 28 [cited 2022 Feb 6];8(JUN):312. Available from: /pmc/articles/PMC5487391/
5. Dujmovic I, Radovanovic S, Martinovic V, Dackovic J, Maric G, Mesaros S, et al. Gait pattern in patients with different multiple sclerosis phenotypes. Mult Scler Relat Disord [Internet]. 2017 Apr 1 [cited 2022 Feb 6];13:13–20. Available from: https://pubmed.ncbi.nlm.nih.gov/28427694/
6. Aliabadi S, Khanmohammadi R, Olyaei G, Ghotbi N, Talebian S, Moghadasi AN. Comparison of the Position Sense of the Knee Joint in Patients With Multiple Sclerosis and Healthy Controls. J Mod Rehabil [Internet]. 2019 Nov 27 [cited 2022 Feb 6];13(1):59–64. Available from: https://jmr.tums.ac.ir/index.php/jmr/article/view/230
7. Backus D, Moldavskiy M, Sweatman WM. Effects of Functional Electrical Stimulation Cycling on Fatigue and Quality of Life in People with Multiple Sclerosis Who Are Nonambulatory. Int J MS Care [Internet]. 2020 Jul 1 [cited 2022 Feb 6];22(4):193. Available from: /pmc/articles/PMC7446631/
8. Barclay A, Paul L, MacFarlane N, McFadyen AK. The effect of cycling using active-passive trainers on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe Multiple Sclerosis (MS); a feasibility study. Mult Scler Relat Disord [Internet]. 2019 Sep 1 [cited 2022 Feb 6];34:128–34. Available from: https://pubmed.ncbi.nlm.nih.gov/31260943/
9. Soltanpour H, Kalantari M, Modern MR-J of, 2018 undefined. Inter-rater Reliability, Test-retest Reliability, and Internal Consistency of the Persian Version of Dynamic Gait Index in Patients With Multiple Sclerosis. jmr.tums.ac.ir [Internet]. 2018 [cited 2022 Feb 6];12(4). Available from: http://jmr.tums.ac.ir/index.php/jmr/article/view/176
10. Shanahan CJ, Boonstra FMC, Cofré Lizama LE, Strik M, Moffat BA, Khan F, et al. Technologies for Advanced Gait and Balance Assessments in People with Multiple Sclerosis. Front Neurol. 2018 Feb 2;8:708.
11. Leone C, Kalron A, Smedal T, Normann B, Wens I, Eijnde BO, et al. Effects of Rehabilitation on Gait Pattern at Usual and Fast Speeds Depend on Walking Impairment Level in Multiple Sclerosis. Int J MS Care [Internet]. 2018 Sep 1 [cited 2022 Feb 8];20(5):199. Available from: /pmc/articles/PMC6200116/
12. Pau M, Corona F, Coghe G, Marongiu E, Loi A, Crisafulli A, et al. Quantitative assessment of the effects of 6 months of adapted physical activity on gait in people with multiple sclerosis: a randomized controlled trial. Disabil Rehabil [Internet]. 2018 Jan 16 [cited 2022 Feb 8];40(2):144–51. Available from: https://pubmed.ncbi.nlm.nih.gov/28084119/
13. Negahban H, Monjezi S, Mehravar M, Mostafaee N, Shoeibi A. Responsiveness of postural performance measures following balance rehabilitation in multiple sclerosis patients. J Bodyw Mov Ther [Internet]. 2018 Apr 1 [cited 2022 Feb 6];22(2):502–10. Available from: https://pubmed.ncbi.nlm.nih.gov/29861258/
14. Callesen J, Dalgas U, Brincks J, Cattaneo D. How much does balance and muscle strength impact walking in persons with multiple sclerosis? - A cross-sectional study. Mult Scler Relat Disord [Internet]. 2019 Apr 1 [cited 2022 Feb 10];29:137–44. Available from: https://pubmed.ncbi.nlm.nih.gov/30711879/
15. Cofré Lizama LE, Khan F, Lee PVS, Galea MP. The use of laboratory gait analysis for understanding gait deterioration in people with multiple sclerosis. Mult Scler [Internet]. 2016 Dec 1 [cited 2022 Feb 12];22(14):1768–76. Available from: https://pubmed.ncbi.nlm.nih.gov/27364324/
16. Pau M, Porta M, Coghe G, Cocco E. What gait features influence the amount and intensity of physical activity in people with multiple sclerosis? Medicine (Baltimore) [Internet]. 2021 Mar 5 [cited 2022 Feb 9];100(9):e24931. Available from: https://pubmed.ncbi.nlm.nih.gov/33655958/
17. Wajda DA, Motl RW, Sosnoff JJ. Three-Month Test-Retest Reliability of Center of Pressure Motion During Standing Balance in Individuals with Multiple Sclerosis. Int J MS Care [Internet]. 2016 Mar 1 [cited 2022 Feb 8];18(2):59–62. Available from: https://meridian.allenpress.com/ijmsc/article/18/2/59/33270/Three-Month-Test-Retest-Reliability-of-Center-of
18. Karst GM, Venema DM, Roehrs TG, Tyler AE. Center of pressure measures during standing tasks in minimally impaired persons with multiple sclerosis. J Neurol Phys Ther [Internet]. 2005 [cited 2022 Feb 6];29(4):170–80. Available from: https://pubmed.ncbi.nlm.nih.gov/16388684/
19. Severini G, Manca M, Ferraresi G, Caniatti LM, Cosma M, Baldasso F, et al. Evaluation of Clinical Gait Analysis parameters in patients affected by Multiple Sclerosis: Analysis of kinematics. Clin Biomech (Bristol, Avon) [Internet]. 2017 Jun 1 [cited 2022 Feb 6];45:1–8. Available from: https://pubmed.ncbi.nlm.nih.gov/28390935/
20. Filli L, Sutter T, Easthope CS, Killeen T, Meyer C, Reuter K, et al. Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time. Sci Reports 2018 81 [Internet]. 2018 Mar 21 [cited 2022 Feb 6];8(1):1–13. Available from: https://www.nature.com/articles/s41598-018-22676-0
21. Comber L, Sosnoff JJ, Galvin R, Coote S. Postural control deficits in people with Multiple Sclerosis: A systematic review and meta-analysis. Gait Posture [Internet]. 2018 Mar 1 [cited 2022 Feb 6];61:445–52. Available from: https://pubmed.ncbi.nlm.nih.gov/29486362/
22. Quijoux F, Vienne-Jumeau A, Bertin-Hugault F, Zawieja P, Lefèvre M, Vidal PP, et al. Center of pressure displacement characteristics differentiate fall risk in older people: A systematic review with meta-analysis. Ageing Res Rev [Internet]. 2020 Sep 1 [cited 2022 Feb 6];62. Available from: https://pubmed.ncbi.nlm.nih.gov/32565327/
23. Howcroft J, Lemaire ED, Kofman J, McIlroy WE. Elderly fall risk prediction using static posturography. PLoS One [Internet]. 2017 Feb 1 [cited 2022 Feb 6];12(2). Available from: https://pubmed.ncbi.nlm.nih.gov/28222191/
24. Lee YJ, Liang JN, Chen B, Aruin AS. Characteristics of medial-lateral postural control while exposed to the external perturbation in step initiation. Sci Reports 2019 91 [Internet]. 2019 Nov 14 [cited 2022 Feb 6];9(1):1–10. Available from: https://www.nature.com/articles/s41598-019-53379-9
25. Yiou E, Artico R, Teyssedre CA, Labaune O, Fourcade P. Anticipatory postural control of stability during gait initiation over obstacles of different height and distance made under reaction-time and self-initiated instructions. Front Hum Neurosci. 2016 Sep 7;10(SEP2016):449.
26. Kahl O, Wierzbicka E, Dębińska M, Mraz M, Mraz M. Compensatory image of the stability of people with multiple sclerosis and atrial vertigo based on posturography examination. Sci Reports 2021 111 [Internet]. 2021 Mar 29 [cited 2022 Feb 6];11(1):1–11. Available from: https://www.nature.com/articles/s41598-021-85983-z
27. Prosperini L, Castelli L. Spotlight on postural control in patients with multiple sclerosis. Degener Neurol Neuromuscul Dis [Internet]. 2018 Apr [cited 2022 Feb 6];8:25–34. Available from: https://pubmed.ncbi.nlm.nih.gov/30050386/
28. Prosperini L, Fortuna D, Giannì C, Leonardi L, Pozzilli C. The diagnostic accuracy of static posturography in predicting accidental falls in people with multiple sclerosis. Neurorehabil Neural Repair [Internet]. 2013 Jan [cited 2022 Feb 12];27(1):45–52. Available from: https://pubmed.ncbi.nlm.nih.gov/22593115/
29. Cameron MH, Nilsagard Y. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol [Internet]. 2018 Jan 1 [cited 2022 Feb 6];159:237–50. Available from: https://pubmed.ncbi.nlm.nih.gov/30482317/
30. Andreu-Caravaca L, Ramos-Campo DJ, Chung LH, Rubio-Arias J. Dosage and Effectiveness of Aerobic Training on Cardiorespiratory Fitness, Functional Capacity, Balance, and Fatigue in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil [Internet]. 2021 Sep 1 [cited 2022 Feb 9];102(9):1826–39. Available from: https://pubmed.ncbi.nlm.nih.gov/33567335/
31. Farrell JW, Merkas J, Pilutti LA. The Effect of Exercise Training on Gait, Balance, and Physical Fitness Asymmetries in Persons With Chronic Neurological Conditions: A Systematic Review of Randomized Controlled Trials. Front Physiol [Internet]. 2020 Nov 12 [cited 2022 Feb 6];11. Available from: https://pubmed.ncbi.nlm.nih.gov/33281619/
32. Hochman L. Effects of Functional Electrical Stimulation Cycling versus Cycling Only on Walking Performance and Quality of Life in Individuals with Multiple Sclerosis: A Randomized, Clinical Pilot Study. Dep Phys Ther Student Theses, Diss Capstones [Internet]. 2017 Dec 31 [cited 2022 Feb 6]; Available from: https://nsuworks.nova.edu/hpd_pt_stuetd/75
33. Ali AS, Darwish MH, Shalaby NM, Abbas RL, Soubhy HZ. Efficacy of core stability versus task oriented trainings on balance in ataxic persons with multiple sclerosis. A single blinded randomized controlled trial. Mult Scler Relat Disord [Internet]. 2021 May 1 [cited 2022 Feb 10];50. Available from: http://www.msard-journal.com/article/S2211034821001322/fulltext
34. Campbell E, Coulter EH, Mattison PG, Miller L, McFadyen A, Paul L. Physiotherapy Rehabilitation for People With Progressive Multiple Sclerosis: A Systematic Review. Arch Phys Med Rehabil [Internet]. 2016 Jan 1 [cited 2022 Feb 10];97(1):141-151.e3. Available from: https://pubmed.ncbi.nlm.nih.gov/26281954/
35. Çakt BD, Nacir B, Genç H, Saraçoǧlu M, Karagöz A, Erdem HR, et al. Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study. Am J Phys Med Rehabil [Internet]. 2010 Jun [cited 2022 Feb 6];89(6):446–57. Available from: https://pubmed.ncbi.nlm.nih.gov/20216060/
36. Sosnoff J, Motl RW, Snook EM, Wynn D. Effect of a 4-week period of unloaded leg cycling exercise on spasticity in multiple sclerosis. NeuroRehabilitation [Internet]. 2009 [cited 2022 Feb 6];24(4):327–31. Available from: https://pubmed.ncbi.nlm.nih.gov/19597270/
| Files | ||
| Issue | Vol 16 No 4 (2022) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v16i4.10763 | |
| Keywords | ||
| Multiple sclerosis (MS) Gait analysis Rehabilitation Ataxia Exercise | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Rahimibarghani S, Emami-Razavi SZ, Naser Moghadasi A, Azadvari M, Shojaee Fard M, Rahimi-Dehgolan S. Quantitative Changes in Gait Parameters after Cycling among Multiple Sclerosis Patients with Ataxia: A Pilot Study. jmr. 2022;16(4):355-363.
