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Oxygen Cost During Mobility Tasks and Its Relationship to Fatigue in Progressive Multiple Sclerosis

Published:April 23, 2019DOI:https://doi.org/10.1016/j.apmr.2019.03.017

      Highlights

      • People with progressive multiple sclerosis (MS) consume 2.81 times more energy during mobility tasks.
      • Accumulation of oxygen cost and fatigue suggest deconditioning in persons with MS.
      • Oxygen cost of walking is a significant predictor of fatigue in progressive MS.

      Abstract

      Objective

      To compare the oxygen costs of mobility tasks between individuals with progressive multiple sclerosis (MS) using walking aids and matched controls and to determine whether oxygen cost predicted fatigue.

      Design

      Cross-sectional descriptive.

      Setting

      A rehabilitation research laboratory.

      Participants

      A total of 14 adults with progressive MS (mean age ± SD [y], 54.07±8.46) using walking aids and 8 age- and sex-matched controls without MS (N=22).

      Interventions

      Participants performed 5 mobility tasks (rolling in bed, lying to sitting, sitting to standing, walking, climbing steps) wearing a portable metabolic cart.

      Main Outcome Measures

      Oxygen consumption ( V ˙ o2) during mobility tasks, maximal V ˙ o2 during graded maximal exercise test, perceived exertion, and task-induced fatigue were measured on a visual analog scale before and after mobility tasks.

      Results

      People with progressive MS had significantly higher oxygen cost in all tasks compared to controls (P<.05): climbing steps (3.60 times more in MS), rolling in bed (3.53), walking (3.10), lying to sitting (2.50), and sitting to standing (1.82). There was a strong, positive correlation between task-induced fatigue and oxygen cost of walking, (ρ [13]=0.626, P=.022).

      Conclusions

      People with progressive MS used 2.81 times more energy on average for mobility tasks compared to controls. People with progressive MS experienced accumulation of oxygen cost, fatigue, and exertion when repeating tasks and higher oxygen cost during walking was related to greater perception of fatigue. Our findings suggest that rehabilitation interventions that increase endurance during functional tasks could help reduce fatigue in people with progressive MS who use walking aids.

      Keywords

      List of abbreviations:

      GXT (graded exercise testing), MS (multiple sclerosis), VAS (visual analog scale), V˙o2 (oxygen consumption per unit time), V˙o2max (maximal oxygen consumption), RPE (rating of perceived exertion)
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