title: Breathing-enhanced upper extremity exercises for patients with multiple sclerosis.
abstract: OBJECTIVE
  To explore the effectiveness of breathing-enhanced upper extremity exercises on the respiratory function of patients with multiple sclerosis.
  
  
  METHODS
  Randomized controlled study of six-week duration.
  
  
  METHODS
  Forty patients with multiple sclerosis (age 39.2 +/- 7 years; Kurtzke Expanded Disability Status Scale scores: 4.51 +/- 1.55) randomly divided into two groups.
  
  
  METHODS
  The training group followed a six-week home training programme designed to strengthen accessory respiratory muscles. Controls performed no exercises. All subjects submitted to baseline and post-training tests of spirometry, respiratory muscle strength and 6-minute walking. They were also assessed with pulmonary dysfunction and exertion fatigue indices.
  
  
  RESULTS
  Spirometry revealed clear improvement in forced expiratory volume in 1 second (FEV1) (+13%, P = 0.003) resulting in higher FEV1/FVC (forced vital capacity) (+8.5%, P = 0.03). Maximal inspiratory pressure (P (Imax)) increased by +7.1% but not significantly. Maximal expiratory pressure (P(Emax)) and FVC were significantly higher (by +7.1%, P = 0.0066 and +4.8%, P = 0.036 respectively) with respect to baseline measures. Pulmonary dysfunction was reduced (-9%, P = 0.002) while 6-minute walking distance was longer (+16%, P = 0.029) at equal exertion fatigue level.
  
  
  CONCLUSIONS
  The programme improved most pulmonary performance measures and had clinical significance. Its sustained application may prevent respiratory complications frequently observed in the later stages of multiple sclerosis.
authors: Neurology Department, Cerrahpasa School of Medicine, Turkey. fatmamutluay@yahoo.com
authors: F K
authors: FK
authors: Mutluay
authors: R
authors: R
authors: Demir
authors: S
authors: S
authors: Ozyilmaz
authors: A T
authors: AT
authors: Caglar
authors: A
authors: A
authors: Altintas
authors: H N
authors: HN
authors: Gurses
mesh_terms: D000328:Adult; D001945:Breathing Exercises; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000628:therapy*; D005082:Physical Exertion / Q000502:physiology; D012129:Respiratory Function Tests; D012648:Self Care; D016896:Treatment Outcome; D034941:Upper Extremity