Mobility
Sosnoff JJ, Socie MJ, Boes MK, et al. Mobility, balance and falls in persons with multiple sclerosis. PLoS One. 2011; 6(11):e28021
This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with MS. It suggests that those who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year.
Allen DD, Wagner JM. Assessing the gap between current movement ability and preferred movement ability as a measure of disability. Phys Ther. 2011; 91(12):1789-803.
The aim of this study was to examine a potential measure of disability, the gap between current movement ability and preferred movement ability, as recorded with the Movement Ability Measure (MAM).
Sosnoff JJ, Gappmaier E, Frame A, Motl RW. Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther. 2011; 35(3):129-32.
Participants were 34 ambulatory persons with a definite diagnosis of MS. 15 participants had spasticity of the gastroc-soleus muscles based on modified Ashworth scale scores. It was concluded that spasticity in the gastroc-soleus muscles appears to have negative effect on mobility and balance in persons with MS.
Plow MA, Finlayson M, Cho C. Correlates of stages of change for physical activity in adults with multiple sclerosis. Res Nurs Health. 2011; 34(5):378-88.
This paper examined the relative importance of health (symptoms and mobility impairments) and the Transtheoretical Model (TTM) constructs (behavioral and cognitive processes of change) in influencing stages of change placement for physical activity in a sample of 303 persons with MS using discriminant function analysis.
Phan-Ba R, Pace A, Calay P, et al. Comparison of the timed 25-foot and the 100-meter walk as performance measures in multiple sclerosis. Neurorehabil Neural Repair. 2011; 25(7):672-9.
This study aimed to define and validate a new test that would overcome the limitations of current gait evaluations in MS and ultimately better correlate with the maximum walking distance (MWD).
Cavanaugh JT, Gappmaier VO, Dibble LE, et al. Ambulatory activity in individuals with multiple sclerosis. J Neurol Phys Ther. 2011; 35(1):26-33.
The purpose was to examine the impact of MS disability on physical activity behaviors involving ambulation. They also explored relationships among ambulatory activity parameters and clinical measures of gait, balance, and fatigue. They concluded that individuals with MS are not necessarily sedentary, but few may achieve recommended daily physical activity levels. The study findings suggest that disability status should direct physical activity interventions.
Hayes HA, Gappmaier E, LaStayo PC. Effects of high-intensity resistance training on strength, mobility, balance, and fatigue in individuals with multiple sclerosis: a randomized controlled trial. J Neurol Phys Ther. 2011; 35(1):2-10.
Resistance exercise via negative, eccentrically induced work (RENEW) has been shown to be associated with improvements in strength, mobility, and balance in multiple clinical populations. However, the addition of eccentric training to standard exercises did not result in significantly greater lower extremity strength gains in this group of individuals with MS. Also, this training was not as effective as standard exercise alone in improving balance or the ability to ascend and descend stairs.
Broekmans T, Roelants M, Feys P, et al. Effects of long-term resistance training and simultaneous electro-stimulation on muscle strength and functional mobility in multiple sclerosis. Mult Scler. 2011; 17(4):468-77.
This study aimed to examine the effect(s) of unilateral long-term (20 weeks) standardized resistance training with and without simultaneous electro-stimulation on leg muscle strength and overall functional mobility. They found that long-term light to moderately intense resistance training improved muscle strength in persons with MS but simultaneous electro-stimulation did not further improve training outcome.
Freeman JA, Gear M, Pauli A, et al. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Mult Scler 2010; 16(11):1377-84.
Core stability training is popular in the management of people with multiple sclerosis; however, scientific evidence to support its effectiveness is scarce. A multi-centre series of eight single case studies was undertaken. This study provides preliminary evidence of the effectiveness of an 8-week core stability training programme in improving balance and mobility in ambulant people with MS.
Katalinic OM, Harvey LA, Herbert RD, et al. Stretch for the treatment and prevention of contractures. Cochrane Database of Systematic Reviews 2010; (9): CD 007455.
Aimed at determining the effects of stretch on contractures in people with, or at risk of, contractures. Randomised controlled trials and controlled clinical trials of stretch applied for the purpose of treating or preventing contractures were included in the review. It was concluded that stretch does not have clinically important effects on joint mobility if performed for less than seven months. The effects of stretch performed for periods longer than seven months was not investigated.
Wunderer K, Schabrun SM, Chipchase LS. Effects of whole body vibration on strength and functional mobility in multiple sclerosis. Physiother Theor Pract 2010; 26 (6): 374-384
The aim of this study was to examine the effectiveness of regular whole body vibration (WBV) training on lower limb muscle strength and functional mobility in individuals with multiple sclerosis. Concludes that regular WBV training can improve lower limb strength and mobility in some individuals with multiple sclerosis but further high-quality studies are needed.
Souza A, Kelleher A, Cooper R, et al. Multiple sclerosis and mobility-related assistive technology: Systematic review of literature. J Rehabil Res Dev 2010; 47 (3): 213-224.
Multiple sclerosis (MS) causes a wide variety of neurological deficits, with ambulatory impairment the most obvious cause of disability. To facilitate mobility, persons with MS frequently use mobility assistive technology (MAT), such as canes, crutches, walkers, wheelchairs, and scooters. Article systematically reviews the published literature on MAT use among persons with MS.
Weikert M, Motl RW, Suh Y, et al. Accelerometry in persons with multiple sclerosis: Measurement of physical activity or walking mobility? J Neurol Sci 2010; 290(1-2):6-11.
Examines the hypothesis that accelerometer movement counts represent a measure of both physical activity and walking mobility in individuals with MS. Suggests that accelerometers are measuring both physical activity and walking mobility in persons with MS, whereas self-report instruments are measuring either physical activity or walking mobility in this population.
Sutliff MH. Contribution of impaired mobility to patient burden in multiple sclerosis. Cur Med Res Opin 2010; 26(1):109-119.
Reviews the contribution of mobility impairment to patient-reported outcomes in persons with MS. Findings highlight the need for more comprehensive assessments of walking impairment in patients with MS and further evaluation from the patient's perspective.
Zwibel HL. Contribution of impaired mobility and general symptoms to the burden of multiple sclerosis. Adv Ther 2009; 26(12):1043-1057.
Reviews the contribution of walking impairment, fatigue, spasticity, depression, and pain, to quality of life (QOL) of the patient and economic burden of MS. Suggests that impaired mobility and symptoms such as fatigue, pain, depression, and spasticity are important contributory factors to the observed reduction in QOL, and in some cases, increased costs, associated with MS. Highlights need for greater recognition of the presence and effects of these disabilities, and effective targeted treatment options for specific impairments, potentially resulting in improved QOL and reduced indirect costs.
Widener GL, Allen DD, Gibson-Horn C. Randomized clinical trial of balance-based torso weighting for improving upright mobility in people with multiple sclerosis. Neuroreh Neural Rep 2009; 23(8):784-791.
Investigates whether balance-based torso weighting (BBTW) has immediate effects on upright mobility in people with multiple sclerosis. Concludes that BBTW can have immediate advantages over a non-weighted condition for gait velocity and over a standardized weighted condition for a functional activity in people with multiple sclerosis (MS) who are ambulatory but have balance and mobility abnormalities.
Snook EM, Motl RW, Gliottoni RC. The effect of walking mobility on the measurement of physical activity using accelerometry in multiple sclerosis. Clin Rehabil 2009; 23(3):248-258.
Examines whether accelerometry provides a measure of physical activity, walking ability or both in a sample of individuals with multiple sclerosis. Data suggests that accelerometers are measuring both physical activity and walking mobility in individuals with multiple sclerosis, whereas self-report measures are measuring physical activity in individuals with multiple sclerosis, including those with ambulatory impairment.
Snook EM, Motl RW. Effect of exercise training on walking mobility in multiple sclerosis: A meta-analysis. Neurorehab Neural Rep 2009; 23(2):108-116.
Study examined the overall effect of exercise training interventions on walking mobility among individuals with multiple sclerosis. Concludes that the cumulative evidence supports that exercise training is associated with a small improvement in walking mobility among individuals with multiple sclerosis.
Brittle N, Brown M, Mant J, et al. Short-term effects on mobility, activities of daily living and health-related quality of life of a Conductive Education programme for adults with multiple sclerosis, Parkinson's disease and stroke. Clin Rehabil 2009; 22(4):329-337.
Evaluates the impact of 10 sessions of Conductive Education on mobility, functional independence and health-related quality of life in adults with multiple sclerosis, Parkinson's disease and stroke. Non-significant trends towards improved physical and mental function were demonstrated by other outcome measures across all three diagnoses.
Giesser B, Beres-Jones J, Budovitch A, et al. Locomotor training using body weight support on a treadmill improves mobility in persons with multiple sclerosis: A pilot study. Mult Scler 2007; 13 (2): 224-231
Investigated the potential benefits and tolerability of locomotor training using body weight support on the treadmill (LTBWST) in persons with multiple sclerosis (MS). Methods: Four persons with primarily spinal cord MS and severely impaired ambulation (Expanded Disability Status Scale score 7.0-7.5) were enrolled in LTBWST. Subjects completed an average of 40 training sessions over several months. Subjects showed improvement in muscle strength, spasticity, endurance, balance, walking speed, and quality of life at the end of the training sessions, and could tolerate training without fatigue or other adverse effects
Wiles CM, Newcombe RG, Fuller KJ, Jones A, Price M. Use of videotape to assess mobility in a controlled randomized crossover trail of physiotherapy in chronic multiple sclerosis. Clin Rehabil 2003; 17(3): 256-63.
A trial to see whether videotapes of mobility can be assessed as successfully as an interactive session with a patient. Video evidence suggested physiotherapy had less clear benefit than ‘live’ assessments. More objective measures of habitual mobility were also required.
Wiles CM, Newcombe R, Fuller KJ, Shaw S, Furnival-Doran J, Pickersgill TP, Morgan A.Controlled randomised crossover trial of the effects of physiotherapy on mobility in chronic multiple sclerosis.J Neurol Neurosurg Psychiatry 2001;70(2):2174-9.
Trial of home-based physiotherapy, hospital-based physiotherapy or no therapy, measured by a range of assessments including the Rivermead Mobility Index. Any physiotherapy was better than no therapy, and patients improved significantly on all measures. Hospital physiotherapy was cheaper than home therapy, and no difference in benefit was discerned by therapists or patients depending on where physiotherapy was received.
Lord SE, Wade DT, Halligan PW.A comparison of two physiotherapy approaches to improve walking in multiple sclerosis: a pilot randomized controlled study. Clin Rehabil 1998;12(6):477-86.
Compareda a facilitation (impairment-based) approach with a task-oriented (disability-focused) approach to physiotherapy for people with MS. Outcomes were measured on a range of assessments. Following treatment, patients in both groups showed significant overall improvement, but there was no clear difference between approaches.