Feasibility of Low-load Resistance Training Using Blood Flow Restriction for People With Multiple Sclerosis and Marked Mobility Restriction
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Multiple Sclerosis
- Sponsor
- University of Colorado, Denver
- Enrollment
- 15
- Locations
- 1
- Primary Endpoint
- Change in knee extension muscle strength
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The Primary Aim of this research study is to determine the feasibility of 8 weeks of physical therapy strengthening exercises using blood flow restriction (BFR) in people with multiple sclerosis (MS) who have moderate-to-severe walking problems. BFR training involves placing a cuff on the leg being exercised in order to restrict blood flow. The cuff is attached to a specialized device that automatically detects the appropriate amount of pressure to place on the limb. Testing will occur before and after the 8-week treatment period.
Detailed Description
The Primary Aim of this research study is to determine the feasibility of 8 weeks of physical therapy strengthening exercises using blood flow restriction (BFR) in people with multiple sclerosis (MS) who have moderate-to-severe walking problems. BFR training involves placing a cuff on the leg being exercised in order to restrict blood flow. The cuff is attached to a specialized device that automatically detects the appropriate amount of pressure to place on the limb. Testing will occur before and after the 8-week treatment period. Specific Aim 1: Determine the feasibility of BFR by assessing recruitment rate, retention, adherence, satisfaction, and safety. Hypothesis: Feasibility will be demonstrated by: 1) enrolling 20 participants in 8 months, 2) retaining at least 16 (80%) participants, 3) 80% adherence to intervention, 4) 90% satisfaction with intervention, and 5) no serious adverse events related to the intervention. Specific Aim 2: Determine changes in knee and hip extension, hip abduction, and ankle plantarflexion muscle strength after the 8-week intervention. Hypothesis: Following intervention there will be clinically important within-group strength changes that correspond to established minimal detectable change values and which can be characterized as having at least a moderate effect size as defined by Cohen's d. Exploratory Aim: Explore changes in functional mobility (30-Second Sit-to-Stand, Berg Balance Scale, Timed 25-Foot Walk. 10-day average activity level) and self-report measures (12-Item MS Walking Scale, Modified Fatigue Impact Scale, MS Impact Scale-29, and Patient-Specific Functional Scale) after the 8-week intervention.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adults ages 18-70
- •Neurologist-confirmed diagnosis of multiple sclerosis
- •Expanded Disability Status Scale (EDSS) 6.0 to 7.0
- •EDSS 6.0: unilateral assistance (cane or crutch) required to walk at least 100 meters with or without resting
- •EDSS 6.5: Bilateral assistance (cane or crutch) required to walk at least 20 meters with or without resting
- •EDSS 7.0: unable to walk 5 meters even with aid, essentially restricted to wheelchair; wheels self and transfers alone; up and about in wheelchair some 12 hours a day
Exclusion Criteria
- •EDSS 7.5 or greater: Restricted to wheelchair for all mobility, unable to walk more than a few steps, even with walking aid
- •EDSS 5.5 or less: Able to walk more than 100 meters without walking aid or rest
- •Unable to provide consent or follow simple directions
- •Prior history of Deep Venous Thrombosis/ Pulmonary Embolism
- •History of peripheral vascular disease, thrombophilia or other clotting disorders
- •Patient report of easy bruising
- •Any comorbid conditions or pain that substantially affects physical function or would interfere with the participant's ability to safely complete rehabilitation (e.g. neurologic, vascular, cardiac problems, orthopedic, or ongoing medical treatments) as determined by a neurologist of physical therapist
- •Severe lower extremity spasticity as defined as Modified Ashworth scale \> 2
- •Currently undergoing supervised resistance training with a physical therapist or other exercise professional
- •Use of Blood Flow Restriction currently or in the previous 3 months prior to enrollment
Outcomes
Primary Outcomes
Change in knee extension muscle strength
Time Frame: Measured at Baseline (Week 0) and Post Test (Week 9)
Knee extension muscle strength measured by hand-held dynamometry
Change in hip abduction muscle strength
Time Frame: Measured at Baseline (Week 0) and Post Test (Week 9)
Hip abduction muscle strength measured by hand-held dynamometry
Change in ankle plantarflexion muscle strength
Time Frame: Measured at Baseline (Week 0) and Post Test (Week 9)
Ankle plantarflexion muscle strength measured by hand-held dynamometry
Secondary Outcomes
- Change in 30-second sit-to-stand completions(Measured at Baseline (Week 0) and Post Test (Week 9))
- Change in Berg Balance Scale(Measured at Baseline (Week 0) and Post Test (Week 9))
- Change in activity level(Measured at Baseline (Week 0) and Post Test (Week 9))
- Change in MS Patient-Specific Function Scale(Measured at Baseline (Week 0) and Post Test (Week 9))
- Change in timed 25-foot walk(Measured at Baseline (Week 0) and Post Test (Week 9))
- Change in 12-Item MS Walking Scale(Measured at Baseline (Week 0) and Post Test (Week 9))
- Change in Modified Fatigue Impact Scale(Measured at Baseline (Week 0) and Post Test (Week 9))
- Change in MS Impact Scale-29(Measured at Baseline (Week 0) and Post Test (Week 9))