Category Archives: Multiple Sclerosis

Galileo-Training helps MS

J Neurol Sci. 2016 Oct 15;369:96-101. doi: 10.1016/j.jns.2016.08.013. Epub 2016 Aug 5

 Vibration training improves disability status in multiple sclerosis: A pretest-posttest pilot study.

Yang F1, Estrada EF2, Sanchez MC2.

Abstract
The purpose of this study was to examine the effects of an 8-week vibration training program on changing the disability level in people with multiple sclerosis (MS).

Twenty-five adults with clinically-confirmed MS underwent an 8-week vibration training on a side-alternating vibration platform. The vibration frequency and peak-to-peak displacement were set at 20Hz and 2.6mm, respectively. Prior to and following the training course, the disability status was assessed for all participants characterized by the Patient Determined Disability Steps (PDDS) and MS Functional Composite (MSFC) scores.

The training program significantly improved the PDDS (3.66±1.88 vs. 3.05±1.99, p=0.009) and the MSFC scores (0.00±0.62 vs 0.36±0.68, p<0.0001). All three MSFC components were improved: lower extremity function (9.37±4.92 vs. 8.13±4.08s, p=0.011), upper extremity function (dominant hand: 27.81±5.96 vs. 26.20±5.82s, p=0.053; non-dominant hand: 28.47±7.40 vs. 27.43±8.33s, p=0.059), and cognitive function (30.55±13.54 vs. 36.95±15.07 points, p=0.004).

Our findings suggested that vibration training could be a promising alternative modality to reduce the disability level among people with MS.

 

KEYWORDS:
Mobility; Multiple Sclerosis Functional Composite; Patient Determined Disability Status; Side-alternating vibration Copyright © 2016 Elsevier B.V. All rights reserved.

PMID: 27653872 DOI: 10.1016/j.jns.2016.08.013

 

Whole-body Vibration Research Reduces Falls, Helps MS Symptoms

UTEP News Service – Originally published April 3, 2015 – By Laura L. Acosta

The first time 68-year-old Carmen Sandoval climbed on the whole-body vibration machine in The University of Texas at El Paso’s Stanley E. Fulton Biomechanics and Motor Behavior Laboratory, she wasn’t sure how standing on the machine while it oscillated for five minutes was going to help improve her physical fitness.

Two months later, Sandoval’s muscle strength and bone density have increased, and she feels lighter on her feet. That has helped her chase more fly balls while playing softball with Senior Moments, an El Paso women’s slow-pitch softball team.

As part of the whole-body vibration study, Carmen Sandoval walks on a special treadmill, which simulates slipping by suddenly changing the moving direction of the belt. Participants are strapped into a harness to prevent injury. Photo by J.R. Hernandez / UTEP News Service

As part of the whole-body vibration study, Carmen Sandoval walks on a special treadmill, which simulates slipping by suddenly changing the moving direction of the belt. Participants are strapped into a harness to prevent injury. Photo by J.R. Hernandez / UTEP News Service

“It gives me more blood circulation in my legs,” Sandoval said. “I feel more energized and I don’t feel heavy on my legs.”

Sandoval is taking part in one of two studies by Feng Yang, Ph.D., an assistant professor in the Department of Kinesiology at UTEP, who is researching the impact of whole-body vibration training on adults 65 years and older and on people with multiple sclerosis, or MS.

In whole-body vibration therapy, a person stands on a vibration platform. As the machine vibrates, the transmission of mechanical vibrations and oscillations to the human body forces all muscles to contract and relax tens of times each second, and leads to physiological and neuromuscular changes that can reduce falls among individuals at greater fall risk.

In November, Yang received a $78,148 grant from The Retirement Research Foundation to investigate if whole-body vibration training can prevent real-life falls in Hispanic older adults. His co-principal investigators are Loretta Dillon, DPT, clinical associate professor in the Department of Physical Therapy, and Xiaogang Su, Ph.D., associate professor in the Department of Mathematical Sciences.

Yang, along with Dillon and Su,  also were awarded a separate $43,297 pilot grant from the National Multiple Sclerosis Society to use the technique to study its effect on preventing falls in individuals with MS.

“Whole-body vibration is a relatively novel training approach which we can use to reduce the risk of falls for older adults or for people with movement disorders,” explained Yang, the lab’s director since 2013. “This vibration can increase muscle strength and improve the body balance and it can also improve the function in mobility, sensation, bone density and all those factors that are closely related to falls.”

The Centers for Disease Control and Prevention reports that falls are the leading cause of both fatal and nonfatal injuries among older adults, and the consequences of falls are very costly.

For his study, Yang developed an eight-week training program for 100 adults ages 65 years and older to investigate whether or not whole-body vibration training can reduce their risk of falling and if the training is still effective three months after they finish the program. Since June 2014, about 50 older adults have participated in the 18-month study.

Participants use the whole-body vibration machine for five minutes, three times a week for eight weeks.

To test if the training has improved their resistance to falls, participants walk on a special treadmill, which simulates a slipping sensation by suddenly changing the moving direction of the belt. Participants are strapped into a harness to prevent injury.

Thirty reflective markers are attached to their skin on different parts of the body, which allow their movements to be recorded using the lab’s eight-camera high-speed motion capture system. The captured motion data will be utilized to analyze the improvement in fall resistance skills resulting from the vibration training.

The goal is to see how a person regains balance after a slip without falling to the ground.

Carmen Sandoval stands on the whole body vibration machine in UTEP’s Biomechanics and Motor Behavior Laboratory. Feng Yang, kinesiology assistant professor, is studying the effects of whole-body vibration on adults 65 years and older and people with multiple sclerosis. Photo by J.R. Hernandez / UTEP News Service

Carmen Sandoval stands on the whole body vibration machine in UTEP’s Biomechanics and Motor Behavior Laboratory. Feng Yang, kinesiology assistant professor, is studying the effects of whole-body vibration on adults 65 years and older and people with multiple sclerosis. Photo by J.R. Hernandez / UTEP News Service

“It (feels) like when we really stumble because we don’t know when we’re going to stumble,” Sandoval said after the treadmill stopped suddenly and she was jolted backward before regaining her composure.

Yang also evaluates the participants’ progress by measuring their muscle strength, bone density, sensation, range of motion, fear of falling, and functional mobility. All participants’ real-life fall incidences also are monitored.

Yang said the results of the study so far have been encouraging. Besides the significant improvements in all risk factors of falls among the participants, their slip-related falls on the treadmill and the fall incidences in everyday living have been reduced by about 70 percent and 30 percent, respectively.

He is currently recruiting 40 participants for his multiple sclerosis study. The National Multiple Sclerosis Foundation estimates that more than 400,000 people in the U.S. have MS. This project has particular significance for the El Paso region, which has been identified as a nationally-recognized cluster of MS by the society.

“We also want to prevent falls for patients with MS because their fall risk is even higher,” Yang said. “Their muscles are weak, their balance and sensation are impaired and MS also affects their mobility. All of those factors contribute to falls.”

Through whole-body vibration training, Yang hopes to develop a training paradigm that involves the least amount of physical activity for individuals with MS to reduce their risk of falls.

Yang is looking for participants with mild to moderate MS who have fallen at least once in the past six months for his study. Participants will take part in whole-body vibration training for five minutes a day, three days a week for four weeks.

Before the training begins, participants will be assessed to determine how many times they have fallen in the last six months. Their fall risk factors, including body balance, functional mobility, muscle strength, fear of falling and sensorimotor skills, also will be evaluated before and after the training to document any improvement.

Yang and his collaborators also are planning to apply vibration therapy to individuals with other movement dysfunctions, such as stroke and Parkinson’s disease. The long-term goal of their research is to develop cost-efficient yet effective community-based fall prevention training programs and to reduce the costs to individuals and the health care system resulting from falls among the elderly and populations with movement impairments.

Helping Yang achieve that goal are 10 research assistants from the undergraduate and graduate kinesiology programs at UTEP. They include: Chelsea Villa, Joshua Padilla, Westin Humble, Amy Lucero, Joe Anthony Rodriguez, Carlos Lopez, Maria Sanchez, JaeEun Kim, Jose Munoz and Edson Estrada.

In January 2014, Villa began working with Yang in the biomechanics lab as an undergraduate research assistant. She graduated from UTEP in December 2014 and plans to start the Doctor of Physical Therapy program in May.

From gathering medical histories, testing the participants and analyzing data, Villa said her experience working with Yang will help prepare her to become a better physical therapist.

“I know how important clinical-based research is when applied to the real world,” Villa said. “That’s the whole reason why research is done: to see what works and what doesn’t. Sometimes we think something does work and then we do the research and it turns out that it doesn’t. I know now what information is important to analyze and what information is not.”

To participate in either study, contact Yang at 915-747-8228 or 915-747-6010 or by email at fyang@utep.edu.

Multiple Sclerosis

Positive effects of Galileo side-alternating vibration on MS

Multiple sclerosis (MS) is a complex, progressive inflammatory, degenerative, and autoimmune demyelinating disease of the central nervous system (CNS) that causes a wide range of signs and symptoms.  The most common signs and symptoms of MS are sensory changes, fatigue, balance disturbances, gait problems, spasticity, motor weakness, ataxia, and impaired muscular performance. Fatigue, often severe, affects about 85% of MS patients which causes decreased mobility, leads to impaired functional capacity and subsequently reduced physical activity and sporting. So this life style which reduces mobility can lead to secondary sequels such as obesity, osteoporosis, and/or cardiovascular damage.

The exposure to heat during the physical exercise can lead to worsening symptoms. Exercise programs must be designed to activate working muscles but avoid overload that results in conduction block.

Various forms of exercise training have been found to be well tolerated and to improve symptoms in people with MS. Traditionally, these programs have focused on aerobic exercise and resistance training, but, over the last several years, whole body vibration (WBV) has become increasingly popular as a method of exercise both for people with neurological disorders and for the general population.

Whole body vibration (WBV) is an efficient training method to improve muscle strength. It has been demonstrated that WBV is safe and an effective method for improving postural control in elderly subjects. In addition, studies have shown positive effects of WBV on postural control, balance, mobility, strength and endurance in MS.

To prevent exacerbation due to intense physical activity, moderate intensity exercise programs are suggested. The combination of resistance training with WBV can increase the severity of training without rapid increase of body temperature or cause fatigue that could induce exacerbation.

Consequences of MS:

  • Muscle weakness
  • Fatigue
  • Reduced capability and motivation to perform exercise / training
  • Secondary effects of immobility
  • Spasticity
  • Contractions

MS training goals:

  • Improve muscle force
  • Improve high muscle power (stair climbing, stand up from a chair)
  • Stretching to prevent contraction
  • Improve coordination (using less force but higher power)
  • Improve balance

What kind of training is needed?

  • Training of the neurological system and muscle system
  • Reflex based (independent of motivation)
  • Not exhausting for the cardiovascular system
  • Training of neuromuscular communication as it is necessary for daily activities
  • Short training time
  • Low impact on joints, ligaments and tendon
  • Training stimulus has to be adjusted in a wide range because the degree of immobility in MS varies a lot.

Condition effects:

  • Improvement in timed up and go test
  • Improvement of chair rising
  • Improvement of balance
  • Higher gait speed and walking distance

Studies – Multiple Sclerosis

 

 

 

Females With MS Improve

Asian J Sports Med. 2012 Dec. 3 (4):279-84.

Resistance training and vibration improve muscle strength and functional capacity in female patients with multiple sclerosis.

Eftekhari E, Mostahfezian M, Etemadifar M, Zafari A.

Source:  Department of Physical Education and Sport Sciences, Najafabad Branch, Islamic Azad University, Isfahan, Iran.

Abstract

PURPOSE:  The purpose of this study was to evaluate the effect of an eight-week progressive resistance training and vibration program on strength and ambulatory function in multiple sclerosis (MS) patients.

METHODS:  Twenty-Four female MS patients with the following demographics: age 27-45 years, and expanded disability status scale (EDSS) 2-4, participated in this study. The subjects were randomly allocated to one of two groups. The exercise group (n = 12) trained according to a progressive program, mainly consisting of resistance training and vibration, three times a week for eight weeks and compared with subjects in the control group (n = 12) that received no intervention. Subjects completed one set of 5-12 reps at%50-70 maximal voluntary contraction (MVC). After 5-10 minutes rest, six postures on plate vibration were done. Isotonic MVC of knee extensors, abduction of the scapula and downward rotation of the scapular girdle muscle groups were predicted by using the Brzycki formula. Right leg balance (RLB), left leg balance (LLB), and walking speed (10-Meter Walk Test) were assessed before and after the training program. Descriptive statistics and Co-variance were used for analyzing data.

RESULTS:  After eight weeks of training the exercise group showed significant increase in MVC of Knee extensors (32.3%), Abduction of the scapula (24.7%) and Downward Rotation Scapular (39.1%) muscle groups, RLB (33.5%), LLB (9.5%), and decrease in 10-Meter Walk Test (10MWT) (9.3%), (P<0.05).

CONCLUSIONS:  The results of this study indicated this type of training can cause improvements in muscle strength and functional capacity in patients with multiple sclerosis

KEYWORDS:  Multiple Sclerosis, Resistance Training, Whole Body Vibration

PMID: 23342227

 

MS Maintain Balance & Posture

Effects of vibrotherapy on postural control, functionality and fatigue in multiple sclerosis patients

Neurologia. 2011 Jun 22. Department of de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España

Introduction:  Postural and balance disorders, functionality impairment and fatigue, are the most incapacitating problems in multiple sclerosis (MS) patients. Whole Body Vibration (WBV), through the transmission of mechanical stimuli, appears to be a useful therapeutic tool in the treatment of neurological diseases. The objective of this study is to assess the effect of the WBV on postural control, balance, functionality and fatigue in patients with MS.

Materials & Methods:  A total of 34 patients with mild-moderate MS were randomised into a control group and an intervention group. For the intervention group, the protocol consisted of 5 consecutive days, daily series of 5 periods of 1minute of duration of WBV at a frequency of 6Hz. Posturographic assessment using the Sensory Organization Test (SOT) and Motor Control Test (MCT), the Timed Get Up and Go Test, 10 metres Test, the Berg Balance Scale and Krupp’s Fatigue Severity Scale were used before and after intervention.

Results:  The analysis showed improvements in the intervention group for conditions SOT 1, SOT 3 and latency in MCT. In the comparison between groups, only the latency or reaction time in MCT improved significantly in favour of the intervention group (from 173.78±12.46 to 161.25±13.64ms; P=.04). No side-effects were found.

Conclusions:  The results of this pilot study show that WBV can improve, in the short-term, the time of response to recover the uprightness after sudden disturbances, appearing as a possible therapeutic tool maintaining balance and posture.

Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

PMID:21703724

MS Improve Standing Time & Balance

Is 8 weeks of side-alternating WBV a safe & acceptable modality to improve functional performance in Multiple Sclerosis patients

Disabil Rehabil. 2011 Oct 12. School of Sport and Exercise, Massey University , Palmerston North , New Zealand.

Purpose:  To examine whether an 8-week period of side-alternating whole-body vibration (WBV) exercise is an acceptable and effective exercise intervention to improve and maintain functional performance in multiple sclerosis people.

Methods:  A total of 15 participants with MS (11 women [mean age 50.2 ± 6.9 years; body mass 65.7 ± 19.2 kg; height 165.3 ± 6.1 cm; EDSS 3.5 ± 0.9] and 4 males [mean age 50.5 ± 5.2 years; body mass 85.3 ± 16.0 kg; height 175.3 ± 3.2 cm; EDSS 3.4 ± 0.5]) were selected for this study. Quality of life, timed up-and-go, functional reach, standing balance and 10-m walk test were performed prior to and after 4 and 8 weeks of vibration exercise, and 2 weeks after cessation of vibration exercise.

Results:  There was no evidence of vibration exercise producing any anxiety or discomfort. Compared with baseline measurements, the 10-m walk test showed significant improvements in 2, 8 and 10 m times at 8 week (p < 0.05) and 2 week post-vibration (p < 0.05). Timed up-and-go demonstrated a significant and positive time effect (p < 0.05). Standing balance showed significant improvements from baseline, at 4- (p < 0.05) and 2-weeks post-vibration (p < 0.05).

Conclusion:  This is the first study to investigate side-alternating WBV as an exercise training modality for MS people. From an active MS population, this study has shown that WBV training not only improved the standing balance and walking time but there were also no adverse effects from using this modality.

PMID:21992525

SUMMARY STUDY:   Patients with multiple sclerosis improved the SF36 questionnaire for quality of life, timed up and go test, functional reach test, standing balance and 10 m walk test. (see slide) The improvements persisted 2 weeks after the end of training. No adverse side effects were observed.

MSSpasticity Compared with baseline measurements, the 10-m walk test showed significant improvements in 2, 8 and 10 m times at 8 week and 2 week post-vibration. Timed up-and-go demonstrated a significant and positive time effect. Standing balance showed significant improvements from baseline, at 4- and 2-weeks post-vibration