Innovative training method in patients with Multiple Sclerosis and Spinal Cord Injury, a pilot study.

In neurorehabilitation, Multiple Sclerosis (MS) and Spinal Cord Injury (SCI)
are highly prevalent conditions. It has been shown that these patients often
have a reduced fitness level and experience severe fatigue, which interferes
with many aspects of daily life functioning. However, the effects achieved with
training programs in people with MS and SCI are generally heterogeneous, not
large, do not lead to reduction of fatigue, or are not extensively studied.
Libra Rehabilitation & Audiology developed an innovative whole-body training
program, aimed at improving fitness using mainly functional exercises, three
types of strength training with free weights, cardio training and functional
skills training. We expect this training program to lead to improvements in
fitness in people with MS or incomplete SCI, resulting in improvements in
fatigue and quality of life.

The main objective of this pilot study is to explore the changes in physical
fitness in patients with MS or SCI who participate in this training program.
Secondary, we will explore the changes in walking efficiency, fatigue, quality
of life, and the feasibility of the program.

This study is an observational cohort pilot study. Patients will participate in
this innovative training program. One week before (pre-treatment), one week
after (post-treatment) and eight weeks after (follow-up) the training program
participants will be tested.

The training program (intervention) consists of: three weeks of observation
period, 12 weeks training period, following a follow-up period of 8 weeks. The
training period consists of three days per week cardio training, strength
training, functional skills training, and once a week physiotherapy. Finally, a
total of three consults at the Sportloket will be conducted, to maintain
physical activity after the training program.

Participants will follow the innovative training program as usual care, because
this is since two years the regular rehabilitation protocol at Libra
Rehabilitation & Audiology, location Blixembosch. The training program consists
of the 12 week training program as described above. Extra burden will be the
three assessments, consisting of 1) progressive cardiopulmonary exercise test
including respiratory exchange analysis, 2) 6 minute walking test (comfortable
speed) including respiratory exchange analysis, 3) physical performance tests,
4) maximal muscle strength tests (handgrip and leg press), 5) questionnaires:
Fatigue Severity Scale (FSS), Short Form Survey 36 (SF-36) and a questionnaire
developed to test feasibility (maintaining physically active, possible negative
effects (e.g. injuries, overtraining), time schedule, intensity, and
experiences during the training) for both MS and SCI. In addition, we will use
the Multiple Sclerosis Impact Scale (MSIS-29) in participants with MS.
Assessments have a duration of two and a half hours per patient, resulting in a
total of seven and a half hour for three assessment periods. Assessments
periods will be conducted over three days and in consideration of sufficient
rest periods. The research group has experience in previous projects with
similar assessments (Learn to Move (cerebrale parese): MEC-2009-079;
Subarachnoidale Bloeding: MEC-2008-288; Neuro-oncologie: MEC 2015-577).
Furthermore, Libra Rehabilitation & Audiology has extensive experience with
this innovative training program and physical fitness tests. A strict protocol
is applied to ensure safety of testing.