Dataset Information

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial.

ABSTRACT: People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect.This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training; 2 Comparing core stability training with standardised physiotherapy exercise; 3 Exploring underlying mechanisms of change associated with this interventionThis is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control). All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12), the Functional Reach (forwards and lateral), a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC) Scale. In addition, ultrasound imaging of the abdominal muscles will be performed before and after intervention to assess changes in abdominal musculature at one of the four centres (Plymouth).This pragmatic trial will assess the effect of these exercise programmes on ambulatory people with MS. It may not be possible to extrapolate the conclusions to those who are non-ambulatory.ClinicalTrials.gov: NCT01414725.

SUBMITTER: Freeman J

PROVIDER: S-EPMC3364845 | biostudies-literature | 2012 Apr

REPOSITORIES: biostudies-literature

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Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial.

Freeman Jennifer J Fox Esther E Gear Margaret M Hough Alan A

BMC neurology 20120405

<h4>Background</h4>People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance ...[more]

PMID: 22480437

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Project description:BackgroundVisual information comprises one of the most salient sources of information used to control walking and the dependence on vision to maintain dynamic stability increases following a stroke. We hypothesize, therefore, that rehabilitation efforts incorporating visual cues may be effective in triggering recovery and adaptability of gait following stroke. This feasibility trial aims to estimate probable recruitment rate, effect size, treatment adherence and response to gait training with visual cues in contrast to conventional overground walking practice following stroke.Methods/designA 3-arm, parallel group, multi-centre, single blind, randomised control feasibility trial will compare overground visual cue training (O-VCT), treadmill visual cue training (T-VCT), and usual care (UC). Participants (n = 60) will be randomly assigned to one of three treatments by a central randomisation centre using computer generated tables to allocate treatment groups. The research assessor will remain blind to allocation. Treatment, delivered by physiotherapists, will be twice weekly for 8 weeks at participating outpatient hospital sites for the O-VCT or UC and in a University setting for T-VCT participants.Individuals with gait impairment due to stroke, with restricted community ambulation (gait speed <0.8m/s), residual lower limb paresis and who are able to take part in repetitive walking practice involving visual cues (i.e., no severe visual impairments, able to walk with minimal assistance and no comorbid medical contraindications for walking practice) will be included.The primary outcomes concerning participant enrolment, recruitment, retention, and health and social care resource use data will be recorded over a recruitment period of 18 months. Secondary outcome measures will be undertaken before randomisation (baseline), after the eight-week intervention (outcome), and at three months (follow-up). Outcome measures will include gait speed and step length symmetry; time and steps taken to complete a 180° turn; assessment of gait adaptability (success rate in target stepping); timed up and go; Fugl-Meyer lower limb motor assessment; Berg balance scale; falls efficacy scale; SF-12; and functional ambulation category.DiscussionParticipation and compliance measured by treatment logs, accrual rate, attrition, and response variation will determine sample sizes for an early phase randomised controlled trial and indicate whether a definitive late phase efficacy trial is justified.Trial registrationClinicaltrials.gov, NCT01600391.

Project description:Although core stability (CS) training is largely used to enhance motor performance and prevent musculoskeletal injuries, the lack of methods to quantify CS training intensity hinders the design of CS programs and the comparison and generalization of their effects. The aim of this study was to analyze the reliability of accelerometers integrated into smartphones to quantify the intensity of several CS isometric exercises. Additionally, this study analyzed to what extent the pelvic acceleration data represent the local stability of the core structures or the whole-body postural control. Twenty-three male and female physically-active individuals performed two testing-sessions spaced one week apart, each consisting of two 6-second trials of five variations of frontal bridge, back bridge, lateral bridge and bird-dog exercises. In order to assess load intensity based on the postural control challenge of CS exercises, a smartphone accelerometer and two force platforms were used to measure the mean pelvic linear acceleration and the mean velocity of the centre of pressure displacement, respectively. Reliability was assessed through the intra-class correlation coefficient (ICC3,1) and the standard error of measurement (SEM). In addition, Pearson coefficient was used to analyze the correlation between parameters. The reliability analysis showed that most CS exercise variations obtained moderate-to-high reliability scores for pelvic acceleration (0.71<ICC<0.88; 13.23%?SEM?22.99%) and low-to-moderate reliability scores for centre of pressure displacement (0.24<ICC<0.89; 9.88%?SEM?35.90%). Regarding the correlation analysis, correlations between pelvic acceleration and centre of pressure displacement were moderate-to-high (0.52?r?0.81). Based on these results, smartphone accelerometers seem reliable devices to quantify isometric CS exercise intensity, which is useful to identify the individuals' CS status and to improve the dose-response characterization of CS programs.

Dataset Information

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial.

Publications

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial.

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