Oct 22, 2012
Women participating in a small study of progressive resistance (weight) training improved significantly in walking, and reported improvements in quality of life as well. The study, funded by the National MS Society, used standard measures to evaluate the effects of the program, along with in-depth interviews of the participants to determine the full effects on quality of life. Peter R. Giacobbi, Jr., PhD (University of Arizona, Tucson), Lesley J. White, PhD (University of Georgia, Athens) and colleagues report their findings in Adapted Physical Activity Quarterly (2012;29:224).
Background: In addition to being essential to general health and well-being, exercise is helpful in managing many MS symptoms. Research also is increasing indicating that exercise can benefit the quality of life of people with MS. Standard measures used to determine the effectiveness of exercise interventions may be geared to specific symptoms, and may not capture the full effects on quality of life. In this study, the researchers focused, in particular, on patient-reported outcomes and on factors that facilitated or were barriers to participation in exercise programs over time.
The Study: Eight women between the ages of 40 to 63 years participated in the study, and they had been diagnosed with relapsing-remitting MS 2 to 16 years before enrolling in the study. Assessments of walking (mobility, leg function, and exercise tolerance) and interviews were conducted before the study, after a four-month progressive resistance training program, and approximately 8 months later. During the training period, participants performed three supervised exercise sessions per week in a university-based fitness center using conventional weight-lifting machines. Trainers had previous experience working with people with MS. Training protocols were individualized to accommodate individuals’ differences in fitness and to accommodate day-to-day variability in fatigue.
The interview questions focused on the participants’ physical activity, sport, and exercise program experiences; the impact of MS on daily life and on participating in physical activity; and attitudes about the resistance training intervention and factors that impeded or enhanced participation. The last interview focused on the degree to which physical activity behavior was maintained 8 months after the intervention and factors that facilitated or impeded continued involvement. Interviews lasted 20 to 60 minutes and were recorded.
Results: Walking performance improved by more than 13%. Interviews indicated that all participants reported enhanced muscle endurance or delayed muscle fatigue, as well as strength. These experiences impacted performance of a variety of daily life tasks. “I have not used any of those electrical carts in any of the big stores in a long time now,” commented one participant, while another noted, “Since I’ve been doing this I’ve been having stuff [to do] every single day of the week. In the past I would do something one day and then rest the next day.”
Six participants reported improved physical capabilities that impacted daily tasks such as yard work, shopping, and chores around the house. Seven perceived a social impact, including making new friends, camaraderie with the other participants and research staff, being less of a burden on caregivers, and the development of a support network. Six claimed they had positive emotional responses due to the exercise program that included pride of accomplishment and a better mood. “I smile a lot more and that’s good,” noted one woman.
At the 8-month follow-up interviews, participants reported that they did not maintain as intensive of a physical activity routine, suggesting the importance of the social support and benefits within and outside the exercise facility.
Conclusions: This small study suggests that supervised resistance training may promote improvements in quality of life for women with relapsing remitting MS. It also suggests that providing supportive structures and relationships facilitates engagement in physical exercise.