title: Effect of combination exercise therapy on walking distance, postural balance, fatigue and quality of life in multiple sclerosis patients: a clinical trial study.
abstract: BACKGROUND
  Multiple Sclerosis (MS) is a demyelinating disease of the nervous system which has numerous disabling effects on patients.
  
  
  OBJECTIVE
  This study aimed at investigating the short- and long-term effects of a period of combination exercise therapy on walking distance, balance, fatigue and quality of life in multiple sclerosis patients referred to the physiotherapy clinic of Iran's Multiple Sclerosis Society in 2013.
  
  
  METHODS
  This study was a randomized controlled clinical trial on 59 patients divided into the intervention (n = 39) and control groups (n = 20). The intervention group received 10 weeks of combination therapy including aerobic, strengthening, balancing and stretching exercises. A week before, a week later and a year after the beginning of the exercises, both groups of patients received BBSS, six minute walking, Family Support Services (FSS), Expanded Disability Status Scale (EDSS) and quality of life tests. The scores of two groups were then compared using statistical tests such as repeated measures ANOVA test.
  
  
  RESULTS
  THE RESULTS INDICATED SIGNIFICANT CHANGES IN THE INTERVENTION GROUP IN COMPARISON TO THE CONTROL GROUP IN THE SECOND PHASE OF THE STUDY COMPARING TO THE FIRST ONE FOR ALL TESTS EXCEPT EDSS (MEAN DIFFERENCE SCORES OF EDSS: -0.13), P-value = 0.60; FSS: -6.9, P-value = 0.02, Mental Quality of Life (QOL): 16.36, P-value = 0.001; Physical QOL: 12.17, P-value = 0.001, six minute walking: 137.2, P-value < 0.0001; and Berg: 3.34, P-value < 0.0001. These changes were not significant in the second phase of the study comparing to the third one; however, they were again significant in the third phase comparing to the first phase of the study (P < 0.05).
  
  
  CONCLUSIONS
  Exercise has significant effect on improving symptoms of multiple sclerosis, and cessation of exercise may cause recurrence of symptoms in the intervention group with a slope similar to that of the control group. Therefore, continuous rather than short period exercises have valuable symptomatic and supportive relief effects in patients.
authors: Hayat-e-no Physiotherapy Clinic, Iran's Multiple Sclerosis Society, Tehran, IR Iran.
authors: Bahram
authors: B
authors: Sangelaji
authors: Neurology Department, Mostafa Khomeini Hospital, Shahed University, Tehran, IR Iran.
authors: Seyed Massood
authors: SM
authors: Nabavi
authors: Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran ; Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Fatemeh
authors: F
authors: Estebsari
authors: Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran.
authors: Mohammad Reza
authors: MR
authors: Banshi
authors: Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, IR Iran.
authors: Hamideh
authors: H
authors: Rashidian
authors: Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IR Iran.
authors: Ensiyeh
authors: E
authors: Jamshidi
authors: Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran.
authors: Maryam
authors: M
authors: Dastoorpour
keywords: Exercise Therapy; Fatigue; Multiple Sclerosis; Quality of Life