title: Comparison of functional exercise capacity, pulmonary function and respiratory muscle strength in patients with multiple sclerosis with different disability levels and healthy controls.
abstract: OBJECTIVE
  To compare functional exercise capacity, pulmonary function and respiratory muscle strength in fully ambulatory patients with multiple sclerosis with different disability levels and healthy controls, and to elucidate the determinant factors of functional exercise capacity.
  
  
  METHODS
  Forty-three fully ambulatory patients with multiple sclerosis and 30 healthy controls were included in the study. Patients were grouped according to Expanded Disability Status Scale (EDSS); Group I (EDSS 0-2), Group II (EDSS 2.5-4.5). Functional exercise capacity was evaluated using a six-minute walk test, and measurement of pulmonary function, and maximal inspiratory and expiratory pressures (MIP, MEP). The Pulmonary Index was used as a clinical predictor of respiratory dysfunction.
  
  
  RESULTS
  Respiratory muscle strength was lower in multiple sclerosis groups compared with controls, but the difference in MIP and %MIP did not reach statistical significance in Group I. The six-minute walk test distance was significantly shorter and peak expiratory flow was lower in multiple sclerosis groups (p < 0.05). Of the variance in the six-minute walk test distance, 75% was explained by EDSS (R2 = 0.55, p < 0.001), difference in heart rate (R2 = 0.06, p = 0.007), age (R2 = 0.05, p = 0.009) and gender (R2 = 0.09, p = 0.003).
  
  
  CONCLUSIONS
  Respiratory muscles are weakened, functional exercise capacity is reduced and pulmonary function is affected even in the early phase of multiple sclerosis. Ambulatory patients with multiple sclerosis who have a higher level of disability have lower pulmonary function, respiratory muscle strength and functional capacity than less disabled ones and controls. Neurological disability level, age, gender and heart rate difference on exertion are the determinants of functional exercise capacity.
authors.affiliation: Department of Physiotherapy and Rehabilitation, Gazi University, Faculty of Health Sciences, Ankara, Turkey. bosnakmeral@hotmail.com
authors.forename: Meral
authors.initials: M
authors.lastname: Bosnak-Guclu
authors.forename: Arzu Guclu
authors.initials: AG
authors.lastname: Gunduz
authors.forename: Bijen
authors.initials: B
authors.lastname: Nazliel
authors.forename: Ceyla
authors.initials: C
authors.lastname: Irkec
mesh_terms: D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000534:rehabilitation; D053580:Muscle Strength / Q000502:physiology*; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology*