Arm Ergometry to Improve Mobility in Progressive Multiple Sclerosis (AMBOS)—Results of a Pilot Randomized Controlled Trial

Background: Walking disability is one of the most frequent and burdening symptoms of progressive multiple sclerosis (MS). Most of the exercise intervention studies that showed an improvement in mobility performance were conducted in low to moderately disabled relapsing–remitting MS patients with interventions using the legs. However, MS patients with substantial walking disability hardly can perform these tasks. Earlier work has indicated that aerobic arm training might also improve walking performance and could therefore be a therapeutic option in already moderately disabled progressive MS patients.Methods: Patients with progressive MS and EDSS 4–6.5 were randomized using a computer-generated algorithm list to either a waitlist control group (CG) or an intervention group (IG). The IG performed a 12-week home-based, individualized arm ergometry exercise training program. Maximum walking distance as measured by the 6-min walking test (6MWT) was the primary endpoint. Secondary endpoints included aerobic fitness, other mobility tests, cognitive functioning, as well as fatigue and depression.Results: Of n = 86 screened patients, 53 with moderate disability (mean EDSS 5.5, SD 0.9) were included and data of 39 patients were analyzed. Patients in the IG showed strong adherence to the program with a mean of 67 (SD 26.4) training sessions. Maximum work load (Pmax) increased in the training group while other fitness indicators did not. Walking distance in the 6MWT improved in both training and waitlist group but not significantly more in trained patients. Similarly, other mobility measures showed no differential group effect. Cognitive functioning remained unchanged. No serious events attributable to the intervention occurred.Conclusion: Although maximum work load improved, 3 months of high-frequency arm ergometry training of low to moderate intensity could not show improved walking ability or cognitive functioning in progressive MS compared to a waitlist CG.The study was registered at www.clinicaltrials.gov (NCT03147105) and funded by the local MS self-help organization.

Health impacts of seated arm ergometry training in patients with a diabetic foot ulcer: protocol for a randomised controlled trial

IntroductionOnce diagnosed with a diabetic foot ulcer (DFU), patients are advised to offload, keeping pressure off the foot in order to facilitate ulcer healing. An increase in offloading is often accompanied by reductions in physical activity which can worsen the overall health of patients.While unable to perform traditional forms of upright activity, one mode of exercise that would allow patients to be physically active while adhering to offloading instruction is seated arm ergometry. The merits of tailored aerobic exercise in DFU remain unexplored.Methods and analysisThis is a prospective open-label randomised controlled trial. Participants will be randomised to one of two groups, an exercise intervention group or control. The intervention group are required to undertake arm ergometry training at a moderate intensity (65%–75% HRpeak), three times per week for 12 weeks as individually prescribed by an exercise physiologist, while the control group will continue to receive standard care alone. Assessment of outcome measures will occur at baseline and after the intervention period, these will include: a seated VO2 peak test, a blood sample, a short physical performance battery, a dual-energy X-ray absorptiometry scan and completing a range of health-based questionnaires. The above will be used to determine: cardiorespiratory fitness, metabolic health, physical function, body composition and quality of life, respectively. Ulcer area will also be measured as an approximate marker of ulcer healing.Ethics and disseminationThis trial has been approved by ‘Yorkshire & The Humber—Leeds West Research Ethics Committee’ (19/YH/0269). Trial results will be published in peer-reviewed journals and through conference presentations.Trial registration numberISRCTN16000053. Registered in accordance with WHO Trial Registration Data Set (version 1.3.1).

Upper Limb Aerobic Training versus Chest Physical Therapy in Asthmatic Children Rehabilitation

With asthma, children have a significant impairment in ventilatory functions which lead to impairment in functional capacity and developing lung infections. The purpose of this study was to evaluate the effect of treadmill training versus arm ergometry on ventilatory functions in children with asthma. Children for 16 weeks of training - 40 asthmatic children of both sexes participated in this study. They were classified randomly into 2 groups of equal number. (Group A) 20 children received chest physical therapy, (Group B) 20 children received arm ergometry training. Discovery diagnostic spirometer was used to measure the ventilatory functions. Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV1), Maximum voluntary ventilation (MVV) and Peak Expiratory Flow Rate (PEFR). The pre-treatment results showed that there were no significant differences in all measured parameters among both groups, The post-treatment results revealed that there was a significant improvement in both groups of the patient’s ventilatory function “FVC, FEV1 and PEFR”