ALERT Mobilit y
Not your
granddad’s rehab
by Amy Paturel, MS, MPH
Researchers are working on new ways to
improve balance, dexterity and mobility in MS.
Less than 15 years ago, physicians advised people
with MS to minimize activity, suggesting that a
rapid heart rate would not only cause fatigue, but
might also raise the body’s core temperature.
“People with MS used to be told, ‘Don’t exer-
cise, don’t sweat, don’t do anything,’ ” said Barbara
Giesser, MD, clinical director of the MS Program at
UCLA. “Then, in 1996, Dr. Jack Petajan published
a study showing that people with MS not only tol-
erate exercise, they show improvements in fatigue,
functional ability and quality of life.”
Using that study as a springboard, five top MS
rehab specialists discuss strategies they are currently
investigating.
balance,” said Fay Horak, PhD, professor of Neurology at Oregon Health & Science University. Dr.
Horak and her colleagues have developed wireless
sensors that evaluate exactly how mobility is compromised. The information means professionals can
provide people with targeted therapy.
The devices are about the size and weight of a
watch. There are small velocity and acceleration
sensors inside. “From a simple test like getting
up from a chair, walking across a room, turning
around and sitting back down, we get something
like 72 numbers that assess stability and mobility,” Dr. Horak said. “Even when the stopwatch
time is normal and the MS is mild, we can pick
up some early measures of balance and gait
problems.” Data from these devices also provide
neurologists with an accurate measurement of
changes following a pharmacological or lifestyle
intervention.
Balance measurement
Problems with gait and balance are very common
among people with MS, but it’s difficult to evaluate
where the disabilities lie. “People use stopwatches
to assess gait speed, but there’s no good measure for
Resistance training
Lesley White, PhD, associate professor in the
Department of Kinesiology at the University of
Georgia, published a 2005 study showing that
people with MS were able to perform resistance
exercises for the lower body using typical gym
equipment without negative side effects.
“Resistance training can enhance muscle
strength and endurance and reduce fatigue, and
it doesn’t elevate body temperature to the same
degree as aerobic exercise,” Dr. White said. “We
know that people with MS lose muscle over time,
In Dr. White’s new study,
people with MS will complete
a 16-week exercise program for
both the upper and lower body,
training three days a week. They
will do progressive resistance
Five top MS rehab
specialists discuss
strategies they are currently
investigating.
