Training to restore walking and promote nervous system repair in multiple sclerosis: A randomized controlled trial to determine the importance of intensity
Summary: New research suggests that the brain’s ability to repair and reorganize still exists in people with MS and that aerobic exercise seems to help preserve brain and spinal cord tissue in animal studies of MS. This research aims to understand if intense aerobic exercise combined with large amounts of walking practice can improve walking in people with MS, but also, if it will boost the brain’s ability to repair and reorganize itself.
Project Description: Studies in people with MS and in MS animal models suggest that higher intensity training may be important in order to foster neuroplasticity and brain repair. The goal of this project is to test an intervention designed to help people with MS who have difficulty walking. The intervention uses what we know about the importance of practicing a skill that we want to learn or improve, with specialized aerobic exercise designed for people with MS. Dr. Michelle Ploughman and team has developed a novel cool room treadmill training (CRTT) method that helps people with MS tolerate higher intensities of training. In this randomized controlled trial, patients will be randomly assigned to either CRTT with harness support (high intensity) or to self-paced treadmill (low intensity) for 3 months. They will measure the effects on walking, repair of MS lesions and activation of brain networks. Importantly, this will be the first study to examine whether men and women have different responses to the intervention, which is important information in order to tailor the right treatment to the right person.
Potential Impact: Difficulty walking can negatively impact almost every aspect of a person’s life including work, family life and personal relationships, yet there is very little research that targets walking difficulties in MS. If this intervention is successful, it could change the way rehabilitation is delivered to people with MS and would also change the long-term progression of the disease. People with MS who develop walking problems will have a new option for recovery that does not rely on strategies to compensate for their deficits (walkers, canes, wheelchairs) but rather helps them maintain or regain function. This investigation will tell us about the biological and neurological aspects of brain repair that are connected to walking recovery in people with MS.
Project Status: In progress