Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

Effect of Eight Weeks of Selective MELT Exercises on Balance, Speed of Walking, ‎Quality of Life and Expanded Disability Status Scale in Women with Multiple Sclerosis

Document Type : Original Article

Authors
M Karimi
R Mahdavinezhad
Department of Sport Injuries and Corrective Exercise, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
10.22038/jpsr.2021.47334.2094
Abstract
Purpose:
Multiple sclerosis (MS) is a chronic autoimmune disease affecting the myelinated axons of the central nervous system causing neurological deterioration. People with this disease have low functional capacity, physical ability, balance and quality of life due to the symptoms. There are a variety of treatments for managing symptoms other than medication. The purpose of the present study was to investigate the effect of eight weeks of selective MELT exercises on balance, speed of walking, quality of life and expanded disability status scale in women with multiple sclerosis.
Methods:
In this quasi-experimental study, 20 women with MS were randomly divided into two groups of 10 patients, experimental (with mean and standard deviation of age, 42.5 ± 1.8 years, height 168.5 ± 10.6 cm and weight, 72.7 ± 10.6 kg) and control (With mean and standard deviation of age, 39.8 ± 2.06 years, height 166.6 ± 08.08 cm and weight, 71.04 ± 11.2 kg). The MELT selected training program were included various exercises to release myofascial tissue, eight weeks with a frequency of 3 sessions per week and 1 hour each session. In addition, static and dynamic balance with foot scanner, walking speed by distance traveled 8 meters, quality of life using MSQOL-54 quality of life questionnaire, and the result of expanded disability (Expanded Disability Status Scale; EDSS) was evaluated by a neurologist. Data were analyzed using repeated-measures analysis of variance test at the mean level of p <0. 05.
Results:
The results showed that in the experimental group, static balance (p=0.024), dynamic (p=0.004), walking speed (p=0.001) and quality of life (p=0.001) after eight weeks improved while the Extended Physical Impairment Scale (EDSS) did not change between the two groups.
Conclusion:
Considering the specificity of MELT exercises and the effect of these exercises on the release of patients' myofacial tissue, it seems that the exercise program used in the present study can be used as a therapeutic intervention to improve static and dynamic balance, walking speed and quality of life in women with multiple sclerosis. However, due to the lack of research in this field, further research on the effect of these exercises in patients with multiple sclerosis is recommended.
Keywords
MELT exercise
Balance
Speed of gait
Quality of life
Multiple sclerosis
  1. Merritt's Neurology 10th Edition: by H. Houston Textbook of Neurology Merritt (Editor), Lewis P. Rowland (Editor), Randy Rowland By Lippincott    Williams & Wilkins Publishers. June 2000: 586
  2. Ashtari F, Shaygannzhad V, Heidari F, M. A. Estimating the prevalence of familial disease in Multiple sclerosis in Isfahan. Isfahan University of Medical Science Journal 2011; 138: 555-561. [Persian]
  3. Mahdizadeh A, Lokzadeh S, Riyahi A, Hosseini S A, Jalili N. The Investigation of Factors Affecting the Gait of the Patients Suffering From Multiple Sclerosis. J rehab 2019; 20 (1): 64-73. [Persian]
  4. Bakke A, Myhr K, Grønning M, Nyland H. Bladder, bowel and sexual dysfunction in patients with multiple sclerosis--a cohort study. Scandinavian journal of urology and nephrology Supplementum 1996; 179: 61-66.
  5. Bjarnadottir O, Konradsdottir A, Reynisdottir K, Olafsson E. Multiple sclerosis and brief moderate exercise. A randomised study. Multiple Sclerosis Journal 2007; 13(6): 776-782.
  6. Krupp LB, Rizvi SA. Symptomatic therapy for underrecognized manifestations of multiple sclerosis. Neurology 2002; 58(8 suppl 4): S32-S39.
  7. Murphy R, O’Donoghue S, Counihan T, McDonald C, et al.Neuropsychiatric syndromes of multiple sclerosis. J Neurol Neurosurg Psychiatry 2017; 88(8): 697-708.
  8. Cotterill N, Sullivan A, Norton C, Wilkins Aet al. Conservative interventions for urinary or faecal incontinence, or both, in adults with multiple sclerosis. The Cochrane database of systematic reviews 2018; 2018(10): CD013150.
  9. Zenzola A, De Mari M, De Blasi R, Carella A, Lamberti P. Paroxysmal dystonia with thalamic lesion in multiple sclerosis. Neurological sciences 2001; 22(5): 391-394.
  10. Shanazari Z. Marandi M. Sports and MS. First Edition, Isfahan: 1392, Amokhteh Publications. [Persian]
  11. Docu A, Damian M, Barbu A, Caricumacu N. Effect of physical recuperation patients with Multiple Sclerosis. Series physical Education and Sport 2009; 161-163.
  12. Lesley J, Rudolph H. Exercise and Multiple Sclerosis. Sports Med 2004; 34 (15). 1077-1100.
  13. James Stephens. Dominique DuShuttle .Carla Hatcher. Jenifer Shmunes .Christine Slaninka.Use of Awareness Through Movement Improves Balance and Balance Confidence in People with Multiple Sclerosis: A Randomized Controlled Study. Neurology Report 2001; 25: 39-49.
  14. Soltani M. The effect of selected aerobic exercises in water on improving the balance of patients with multiple sclerosis. Mashhad Midwifery Nursing 2009; 9(21): 107-113. [Persian]
  15. Smeltzer SC, Bare B. Textbook of medical-surgical nursing, ‎ Lippincott Williams & Wilkins. 243-253.
  16. Madani H, navipoor H. Effect of self-care program on the self-esteem of multiple sclerosis patients. Journal of advances in medical and biomedical research 2002; 10(40): 35-39.
  17. Janardhan V, Bakshi R. Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. Journal of the neurological sciences 2002; 205(1): 51-58.
  18. Nabavi sm, poorfarzam sh, ghassemi h. Clinical course and prognosis of 203 patients with ms in shahid mostafa khomeini hospital, tehran 2002. Tehran univ med j 2006; 64 (7): 90-97. [persian]
  19. Eftekhari e., nikbakht h.a., rabiei katayoun, etemadifar m.. Effect of endurance training on aerobic power and quality of life in female patients with multiple sclerosis. Olympic 2008; 16(1 (serial 41) :37-46. [persian]
  20. Sanjana F, Chaudhry H, Findley T. Effect of MELT method on thoracolumbar connective tissue: The full study. Journal of Bodywork and Movement Therapies 2017; 21(1): 179-185.
  21. Hitzmann S. The Melt Method: A Breakthrough Self-treatment System to Eliminate Chronic Pain, Erase the Signs of Aging, and Feel Fantastic in Just 10 Minutes a Day!:Textbook. Harper Collins; 2013.
  22. Alphonsus KB, Su Y, D’Arcy C. The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complementary therapies in medicine 2019; 43: 188-195.
  23. Cella D, Dineen K, Arnason B, Reder A, Webster K, Karabatsos G, et al. Validation of the functional assessment of multiple sclerosis quality of life instrument. Neurology 1996; 47(1): 129-139.
  24. Shanazari Z, Marandi S.M, ShayeganNejad V. The Effect of Pilates Exercises and Aquatic Training on Walking Speed in Women with Multiple Sclerosis. J Res Dev Nurs Midwifery 2013-2014; 11(2): 10-17. [Persian]
  25. Sadeghi, Samaneh, Mahdavi Nejad, Reza, Kamali, Atefeh. Determining the effectiveness of central stability exercises on balance and gait speed of blind students. Research in Sports Rehabilitation 2016; 4 (7): 21-30 [Persian]
  26. Barbara G, Vickrey B. Multiple Sclerosis Quality of Life (MSQOL)-54 Instruments. UCLA Department of Neurology Retrieved Feb 1995; 20: 2013.
  27. Ramari C, Moraes AG, Tauil CB, von Glehn F, Motl R, de David AC. Knee flexor strength and balance control impairment may explain declines during prolonged walking in women with mild multiple sclerosis. Mult Scler Relat Disord. 2018 Feb;20:181-185.
  28. Guner S, Inanici F. Yoga therapy and ambulatory multiple sclerosis Assessment of gait analysis parameters, fatigue and balance. J Bodyw Mov Ther 2015;19(1): 72-81.
  29. Nilsagrad E, Von Koch L.  Nilsson M, Forsberg AS. Balance exercise program reduced falls in people with multiple sclerosis, Arch Phys Med Rehabil. 2014; 95(12): 2428-34.
  30. Tarakci E, Yeldan I, Huseyinsinoglu BE, Zenginler Y, Eraksoy M. Group exercise training for balance, functional status, spasticity, fatigue and quality of life in multiple sclerosis: a randomized controlled trial.  Clin Rehabil 2013;27(9):813-822.
  31. Freeman J, Fox E, Gear M, Hough A. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for multiple center and amazed controlled trail. BMC neurology 2012; 12(1): 19.
  32. Cattaneo D, Jonsdottir J, Zokchi M. Effect of balance exercise on people with multiple sclerosis: a pilot study. Clinical rehabilitation 2007; 21(9): 771-781.
  33. Ezabadi, A., Alijani, E., Moeini Shabestari, M. The Effect Of 8 Weeks Aquatic Aerobic Training On Speed Of Walking And Expanded Disability Statues Scale (EDSS) In Women With Multiple Sclerosis. Journal of Sport Biosciences 2015; 7(3): 489-502.
  34. Farayin M., Alizadeh B., Mousavi Nejad M. Evaluation of the effect of six weeks of selected balance training on mobility speed and balance in MS patients. Special sports letter 2014; 10(7): 854-865. [Persian]
  35. Kargarfard M, Mehrabi M, Hamidi-Tehrani J, R. R. Changes in speed, endurance and balance in women with multiple sclerosis after 4 and 8 weeks of aquatic exercise training. Journal of Isfahan Medical School 2013; 31(256): 1628-1639. [Persian]
  36. Fayyazi B, Parno AS, Ahsan B. The effect of aerobic exercise on fatigue and quality of life in women with multiple sclerosis. Community-oriented nursing and midwifery 2016; Issue 79: 30-40. [Persian]
  37. Hooshmandi Z, Yavari Kermani M. The effect of endurance training on quality of life and disability in patients with multiple sclerosis. International Conference on Sports Science 2015; 2: 31-42. [Persian]
  38. Honarvar, S., Rahnama, N., Nouri, R. effects of six weeks massage on the balance, fatigue and quality of life in patients with MS. Journal for Research in Sport Rehabilitation 2015; 2(4): 23-30. [Persian]
  39. Taghizadeh F, Nourian A, Nourshahi M, A. S. The effects of the interval aerobic training on the quality of life and physical disability status scale in patients with multiple sclerosis (M.S). Journal of Applied Exercise Physiology 2014; 9(17): 95-106.
  40. Alphonsus KB, Su Y, D’Arcy C. The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complementary therapies in medicine 2019; 43: 188-195.
  41. Apel A, Greim B, König N, Zettl UK. Frequency of current utilisation of complementary and alternative medicine by patients with multiple sclerosis. Journal of neurology 2006; 253(10):1331-1336.
Journal of Paramedical Sciences & Rehabilitation
Volume 10, Issue 3
Autumn 2021
Pages 59-73