title: Treadmill Training or Progressive Strength Training to Improve Walking in People with Multiple Sclerosis? A Randomized Parallel Group Trial.
abstract: OBJECTIVE
  The most effective treatment approach to improve walking in people with multiple sclerosis (MS) is not known. The aim of this trial was to assess the efficacy of treadmill training and progressive strength training on walking in people with MS.
  
  
  METHODS
  A single blinded randomized parallel group trial was carried out. Eligible participants were adults with MS with Expanded Disability Status Scale score ≤6. A total of 29 participants were randomized and 28 received the allocated exercise intervention, treadmill (n = 13) or strength training (n = 15). Both groups exercised 30 minutes, three times a week for 8 weeks. Primary outcome was The Functional Ambulation Profile evaluated by the GAITRite walkway. Secondary outcomes were walking work economy and balance control during walking, measured by a small lightweight accelerometer connected to the lower back. Testing was performed at baseline and the subsequent week after completion of training.
  
  
  RESULTS
  Two participants were lost to follow-up, and 11 (treadmill) and 15 (strength training) were left for analysis. The treadmill group increased their Functional Ambulation Profile score significantly compared with the strength training group (p = .037). A significant improvement in walking work economy (p = .024) and a reduction of root mean square of vertical acceleration (p = .047) also favoured the treadmill group.
  
  
  CONCLUSIONS
  The results indicate that task-specific training by treadmill walking is a favourable approach compared with strength training to improve walking in persons with mild and moderate MS. Implications for Physiotherapy practice, this study adds knowledge for the decision of optimal treatment approaches in people with MS. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Clinical Services, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Siri Merete
authors.initials: SM
authors.lastname: Braendvik
authors.affiliation: Clinical Services, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Teija
authors.initials: T
authors.lastname: Koret
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Clinical Services, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
authors.affiliation: Sør-Trøndelag University College, Department of Physical Therapy, Trondheim, Norway.
authors.forename: Håvard
authors.initials: H
authors.lastname: Lorås
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Neurology, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Bråthen
authors.affiliation: Department of Neurology, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Harald Olav
authors.initials: HO
authors.lastname: Hovdal
authors.affiliation: Clinical Services, St. Olavs University Hospital, Trondheim, Norway.|The K.G. Jebsen Center of Exercise in Medicine/Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Inger Lise
authors.initials: IL
authors.lastname: Aamot
mesh_terms: D000328:Adult; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; 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; D009664:Norway; D011446:Prospective Studies; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
keywords: multiple sclerosis; strength; treadmill; walking