Effects of High-intensity Gait Training on Fatigue, Gait, and Neuroplasticity in People With Multiple Sclerosis

Summary

Nearly 1 million individuals in the United States have multiple sclerosis, which causes fatigue and problems with walking. Fatigue and walking problems are poorly treated, but exercise training, particularly high-intensity walking exercise, may help. This provide insight into whether high-intensity walking exercise can improve fatigue and walking problems in people with multiple sclerosis, which could improve quality of life and reduce economic burden.

Eligibility

Inclusion Criteria:

* Age ≥21 years
* Multiple sclerosis diagnosis
* Stable disease-modifying therapy (DMT) over the past 6 months
* Walking dysfunction (i.e., abnormal gait pattern, Expanded Disability Status Scale (EDSS) score of 4-6.5, and/or Patient-determined disease steps (PDDS) score of 3-6)
* Able to walk for 6 minutes at self-paced speed. Handheld assistive device is acceptable.
* Symptomatic fatigue (Fatigue Severity Score ≥ 4)

Exclusion Criteria:

* Adults unable to consent
* Pregnant women
* Prisoners
* Multiple sclerosis relapse within the last 30 days
* Other neurological disorders besides multiple sclerosis
* Cardiorespiratory or metabolic diseases (e.g., cardiac arrhythmia, uncontrolled hypertension or diabetes, chronic emphysema)
* Significant cognitive or communication impairment (Mini-Mental State Examination (MMSE)\<21), which could impede the understanding of the purpose of procedures of the study or prevent the patient from performing the ankle-tracking task.
* Severe osteoporosis
* Failure to pass the graded exercise stress test
* Implanted cardiac pacemaker
* Metal implants in the head or face
* Unexplained, recurring headaches
* History of seizures or epilepsy
* Currently under medication that could increase motor excitability and lower seizure threshold
* Skull abnormalities or fractures
* Concussion within the last 6 months

Conditions1

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