Randomized Controlled Trial to Examine the Impact of Aquatic Exercise Training on Functional Capacity, Balance, and Perceptions of Fatigue in Female Patients With Multiple Sclerosis

Abstract

OBJECTIVE: To assess the effects of an 8-week aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS). DESIGN: Randomized controlled design. SETTING: Referral center of an MS society. PARTICIPANTS: Women (N=32; mean age +/- SD, 36.4+/-8.2y) with diagnosed relapsing-remitting MS. After undergoing baseline testing by a neurologist, participants were allocated to either an intervention (aquatic training program, n=17) or a control group (n=15). INTERVENTIONS: The intervention consisted of an 8-week aquatic training program (3 supervised training sessions per week; session duration, 45-60min; 50-75 estimated maximum heart rate). MAIN OUTCOME MEASURES: Six-minute walk test (6-MWT), balance (Berg Balance Scale BBS), and perceptions of fatigue (Modified Fatigue Impact Scale; MFIS) at baseline and after the 8-week intervention. Differences over time between the experimental and control groups were assessed by a 2x2 (group by time) repeated-measures analysis of variance. RESULTS: Thirty-two women completed the 8-week aquatic training intervention (experimental group, n=17; control group, n=15). All outcome measures improved in the experimental group: 6-MWT performance (pretest mean +/- SD, 451+/-58m; posttest mean +/- SD, 503+/-57m; P<.001); BBS (pretest mean +/- SD, 53.59+/-1.70; posttest mean +/- SD, 55.18+/-1.18; P<.001), and MFIS (pretest mean +/- SD, 43.1+/-14.6; posttest mean +/- SD, 32.8+/-5.9; P<.01). A significant group-by-time interaction was evident between the experimental and control groups for 6-MWT (P<.001, partial eta(2) etap(2)=.551), BBS (P<.001, etap(2)=.423), and MFIS (P<.001, etap(2)=.679). CONCLUSIONS: Aquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS.