title: Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study.
abstract: OBJECTIVE
  To evaluate the effects of cycling progressive resistance training combined with balance exercises on walking speed, balance, fatigue, fear of falling, depression, and quality of life in patients with multiple sclerosis.
  
  
  METHODS
  In this prospective randomized controlled trial, 45 patients were randomized into two exercise training (n = 30) groups and one control (n = 15) group. The patients in training group 1 (n = 15) underwent progressive resistance training on a bicycle ergometer and balance exercise, whereas group 2 (n = 15) patients received a home-based lower-limb strengthening and balance exercise. Outcome measures, including the duration of exercise, tolerated maximum workload, timed up and go test, Dynamic Gait Index, functional reach, Falls Efficacy scale, 10-m walk test, Fatigue Severity Scale, Beck Depression Inventory, and Short Form 36 scores, were assessed initially and at 8 wks.
  
  
  RESULTS
  After dropouts, the whole study group consisted of 20 women and 13 men (mean age, 37.9 +/- 10.43 yrs). In training group 1, duration of exercise, tolerated maximum workload, timed up and go test, Dynamic Gait Index, functional reach, falls efficacy scale, 10-m walk test, Fatigue Severity scale, and Beck Depression Inventory scores, and in group 2, the mean duration of exercise, tolerated maximum workload, and Falls Efficacy scale scores were significantly improved after the training program (P < 0.05). There were no significant improvements in any of the outcome measurements in the control group (P > 0.05). In between-group comparisons, improvements in outcome measures of group 1 patients were significantly higher than those in other groups, except for 10-m walking test. Group 1 patients showed statistically significant improvement in physical functioning and role-physical functioning scales of the Short Form 36 (P < 0.01 and P < 0.05, respectively), and group 2 patients showed statistically significant improvement in only physical functioning scale of Short Form 36 (P < 0.05) after 8 wks.
  
  
  CONCLUSIONS
  Specific exercise programs, including cycling progressive resistance training, may improve balance, fatigue, and depression and reduce fear of falling in patients with multiple sclerosis without worsening multiple sclerosis signs and symptoms.
authors.affiliation: Ministry of Health Ankara Training and Research Hospital, Department of Second Physical Medicine and Rehabilitation, Ankara, Turkey.
authors.forename: Burcu Duyur
authors.initials: BD
authors.lastname: Cakt
authors.forename: Bariş
authors.initials: B
authors.lastname: Nacir
authors.forename: Hakan
authors.initials: H
authors.lastname: Genç
authors.forename: Meryem
authors.initials: M
authors.lastname: Saraçoğlu
authors.forename: Aynur
authors.initials: A
authors.lastname: Karagöz
authors.forename: Hatice Rana
authors.initials: HR
authors.lastname: Erdem
authors.forename: Ufuk
authors.initials: U
authors.lastname: Ergün
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D001642:Bicycling; D004185:Disability Evaluation; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000534:rehabilitation*; D053580:Muscle Strength / Q000502:physiology; D004856:Postural Balance / Q000502:physiology; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D012016:Reference Values; D055070:Resistance Training / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome