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Date of Award
Spring 2020
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Shannon Diallo, PA-S
Abstract
Introduction: Multiple Sclerosis is an autoimmune disease which damages and causes inflammation of the myelin in the central nervous system causing weakness, fatigue, numbness, impaired balance, and ultimately impairments that are irreversible. Of these symptoms excessive fatigue, impaired balance and weakness prove to be the most debilitating. There are many FDA approved immunomodulatory drugs on the market to treat the course and symptoms of the disease, yet pharmacologic therapy alone does not constitute optimal care for patients with MS. Providers must institute a training program through physical therapy to improve fatigue, weakness and ambulation. Therefore, this review analyzes aquatic therapy [I] in adults 21-75 years old with Multiple Sclerosis [P] to reduce the severity of fatigue, weakness and quality of life [O] compared to patients performing resistance training therapy [C].
Methods: A literature search was performed in November 2018 in PubMed and Google Scholar. A total of seven articles were chosen based on their relevance to the research question, study design, outcome measurements and results.
Results: The evidence collected by each of these studies showed improvements of many symptoms of patients with multiple sclerosis with both aquatic therapy and resistance training programs. However, most studies only analyzed one or two of the symptoms targeted in review of the research question. One study analyzed the effects of an aquatic exercise program and it showed significantly reduced pain levels and improvement of fatigue and quality of life with no adverse effects, and also demonstrated continued improvement at their four and ten week follow ups. One study showed that resistance training program showed significant improvement in muscle strength, walking speed and cognition but did not show significant improvements in fatigue and quality of life. Overall four studies compared aquatic therapy to a control group which showed great improvements in their fatigue and overall quality of life, and three studies compared resistance training programs yet had conflicting results on long term treatment and improvement of fatigue, weakness, and overall quality of life.
Discussion: All of the articles analyzed showed significant positive results, but outcomes measured among the studies differed. A limited sample population, lack of long-term data due to adequate treatment times, and a failure of adequate follow ups to assess the programs effect on its disease progression prevent the results from achieving clinical significance. Due to the problems found in each of these studies there is no real efficacy in choosing one exercise program over the other. There were no negative health outcomes from the exercise programs and further research is encouraged to find the best course of treatment.
Conclusion: Physical therapy was once thought to be harmful to patients with multiple sclerosis, yet based on recent research it shows otherwise. The seven studies reviewed in this meta-analysis compared the use of aquatic therapy and resistance training and how they improved the symptoms of multiple sclerosis such as fatigue, weakness and overall quality of life. However, insufficient statistical data and different outcome measurements prevent findings to achieve a clinical significance. Patients with multiple sclerosis and providers treating multiple sclerosis should instill an exercise program through physical therapy because the results show that it benefits the patient with daily life by improving fatigue, weakness, and quality of life. Future research should aim to focus on comparing these different exercise programs to assess which will result in the best outcomes for this patient population.
Recommended Citation
Burns, John, "Efficacy of Aquatic Therapy Compared to Resistance Training Program In Multiple Sclerosis in Patients 21-75 Years Old" (2020). Capstone Showcase. 62.
https://scholarworks.arcadia.edu/showcase/2020/pa/62
Efficacy of Aquatic Therapy Compared to Resistance Training Program In Multiple Sclerosis in Patients 21-75 Years Old
Introduction: Multiple Sclerosis is an autoimmune disease which damages and causes inflammation of the myelin in the central nervous system causing weakness, fatigue, numbness, impaired balance, and ultimately impairments that are irreversible. Of these symptoms excessive fatigue, impaired balance and weakness prove to be the most debilitating. There are many FDA approved immunomodulatory drugs on the market to treat the course and symptoms of the disease, yet pharmacologic therapy alone does not constitute optimal care for patients with MS. Providers must institute a training program through physical therapy to improve fatigue, weakness and ambulation. Therefore, this review analyzes aquatic therapy [I] in adults 21-75 years old with Multiple Sclerosis [P] to reduce the severity of fatigue, weakness and quality of life [O] compared to patients performing resistance training therapy [C].
Methods: A literature search was performed in November 2018 in PubMed and Google Scholar. A total of seven articles were chosen based on their relevance to the research question, study design, outcome measurements and results.
Results: The evidence collected by each of these studies showed improvements of many symptoms of patients with multiple sclerosis with both aquatic therapy and resistance training programs. However, most studies only analyzed one or two of the symptoms targeted in review of the research question. One study analyzed the effects of an aquatic exercise program and it showed significantly reduced pain levels and improvement of fatigue and quality of life with no adverse effects, and also demonstrated continued improvement at their four and ten week follow ups. One study showed that resistance training program showed significant improvement in muscle strength, walking speed and cognition but did not show significant improvements in fatigue and quality of life. Overall four studies compared aquatic therapy to a control group which showed great improvements in their fatigue and overall quality of life, and three studies compared resistance training programs yet had conflicting results on long term treatment and improvement of fatigue, weakness, and overall quality of life.
Discussion: All of the articles analyzed showed significant positive results, but outcomes measured among the studies differed. A limited sample population, lack of long-term data due to adequate treatment times, and a failure of adequate follow ups to assess the programs effect on its disease progression prevent the results from achieving clinical significance. Due to the problems found in each of these studies there is no real efficacy in choosing one exercise program over the other. There were no negative health outcomes from the exercise programs and further research is encouraged to find the best course of treatment.
Conclusion: Physical therapy was once thought to be harmful to patients with multiple sclerosis, yet based on recent research it shows otherwise. The seven studies reviewed in this meta-analysis compared the use of aquatic therapy and resistance training and how they improved the symptoms of multiple sclerosis such as fatigue, weakness and overall quality of life. However, insufficient statistical data and different outcome measurements prevent findings to achieve a clinical significance. Patients with multiple sclerosis and providers treating multiple sclerosis should instill an exercise program through physical therapy because the results show that it benefits the patient with daily life by improving fatigue, weakness, and quality of life. Future research should aim to focus on comparing these different exercise programs to assess which will result in the best outcomes for this patient population.