ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2020 June;56(3):279-85

DOI: 10.23736/S1973-9087.20.06191-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Standardized, comprehensive, hospital-based circuit training in people with multiple sclerosis: results on feasibility, adherence and satisfaction of the training intervention

Isabelle LEHMANN ¹, Irène THALER ¹, Gere LUDER ¹, Ulrike DAMM ², Charlotte WÄLTI ², Saskia STEINHEIMER ³, Martin L. VERRA ¹, Rene M. MÜRI ^{3, 4}, Thomas NYFFELER ^{2, 3, 4}, Tim VANBELLINGEN ^{2, 4}, Christian P. KAMM ^{2, 3} ✉

¹ Department of Physiotherapy, Insel Group, Inselspital, Bern University Hospital, Bern, Switzerland; ² Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland; ³ Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland; ⁴ ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland

BACKGROUND: We developed a standardized, comprehensive, ambulatory, hospital-based neurorehabilitation program (“MS-Fit”) to improve disability, activities of daily living and quality of life in people with multiple sclerosis (PwMS).
AIM: The aim of this study was to assess feasibility, adherence and satisfaction of the training intervention.
DESIGN: Prospective multicenter cohort study analysis.
SETTING: Ambulatory, hospital-based study.
POPULATION: PwMS, aged 18 to 75 years, complaining about multiple sclerosis-related disability affecting activities of daily living and/or quality of life.
METHODS: A standardized, ambulatory, hospital-based circuit training consisting of six workstations (aerobic exercise training, strength upper limbs, balance, manual dexterity, reactivity, strength and flexibility lower limbs) was performed two hours, twice weekly, for two months in groups of two to six participants supervised by experienced physiotherapists. Physiotherapists adapted the type and intensity of training according to the participants’ individual performance using a training booklet. Program satisfaction and adherence were evaluated using a questionnaire and the attendance rate (clinicaltrials.gov Identifier: NCT02440516).
RESULTS: Fifty-five participants started (mean age 52.82 years±10.68 standard deviation, range 29-74; 69% female; median Expanded Disability Status Scale 3.5, range 1.0-7.0) and 49 (89%) finished the training program. Main reasons to drop out during the training were lack of time, travel problems, social issues or Uthoff’s phenomenon during the summer. All participants finalizing the training achieved >80% (mean 92.26%, ±7.59) attendance rate and sent back the questionnaire. Overall participant’s satisfaction was high with a median of 9 points (range 4-10) on a Likert Scale from 0-10. Program quality was rated “good” with an overall median score of 39/50 points (range 26-50) and 95% of the participants would recommend the program to others.
CONCLUSIONS: MS-Fit is a feasible training program with high patient satisfaction and adherence. It enables high intensity ambulatory training and can be easily reproduced due to its standardized nature.
CLINICAL REHABILITATION IMPACT: MS-FIT enables a standardized ambulatory high intensity training that is easily reproducible. Participants benefit from group training and from individual adaption of the training through professional supervision.

KEY WORDS: Multiple sclerosis; Rehabilitation; Neurological rehabilitation; Circuit-based exercise