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Clinical Rehabilitation, Vol. 21, No. 7, 595-602 (2007)
DOI: 10.1177/0269215507075492

Breathing-enhanced upper extremity exercises for patients with multiple sclerosis

F.K. Mutluay

Neurology Department, Cerrahpasa School of Medicine,fatmamutluay{at}yahoo.com

R. Demir

Institute of Cardiology, Cardiopulmonary Physiotherapy Department

S. Ozyilmaz

Institute of Cardiology, Cardiopulmonary Physiotherapy Department

A.T. Caglar

Neurology Department, Cerrahpasa School of Medicine

A. Altintas

Neurology Department, Cerrahpasa School of Medicine

H.N. Gurses

Institute of Cardiology, Cardiopulmonary Physiotherapy Department, Istanbul University, Istanbul, Turkey

Objective: To explore the effectiveness of breathing-enhanced upper extremity exercises on the respiratory function of patients with multiple sclerosis.

Design: Randomized controlled study of six-week duration.

Subjects: Forty patients with multiple sclerosis (age 39.2 ± 7 years; Kurtzke Expanded Disability Status Scale scores: 4.51 ± 1.55) randomly divided into two groups.

Methods: The training group followed a six-week home training programme designed to strengthen accessory respiratory muscles. Controls performed no exercises. All subjects submitted to baseline and post-training tests of spirometry, respiratory muscle strength and 6-minute walking. They were also assessed with pulmonary dysfunction and exertion fatigue indices.

Results: Spirometry revealed clear improvement in forced expiratory volume in 1 second (FEV 1) (+13%, P = 0.003) resulting in higher FEV1/FVC (forced vital capacity) (+8.5%, P = 0.03). Maximal inspiratory pressure (P Imax) increased by +7.1% but not significantly. Maximal expiratory pressure (P Emax) and FVC were significantly higher (by +7.1%, P = 0.0066 and +4.8%, P = 0.036 respectively) with respect to baseline measures. Pulmonary dysfunction was reduced (—9%, P = 0.002) while 6-minute walking distance was longer (+16%, P = 0.029) at equal exertion fatigue level.

Conclusions: The programme improved most pulmonary performance measures and had clinical significance. Its sustained application may prevent respiratory complications frequently observed in the later stages of multiple sclerosis.


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[Abstract] [PDF]