High Intensity Interval Gait Training vs Moderate Intensity Continuous Gait training in Multiple Sclerosis: Impact on gait and balance

Abstract

Background and Purpose

High Intensity Interval Gait Training (HIIGT) has been shown to improve walking performance in neurologic conditions such as stroke but its impact on Multiple Sclerosis (MS) has not been well examined. The current standard of care for gait training for persons with MS (pwMS) is Moderate Intensity Continuous Gait Training (MICGT). The purpose of this study was to compare the impact of HIIGT to MICGT on gait and balance performance in pwMS.

Methods

Ambulatory pwMS were randomized into either a HIIGT or a MICGT condition. Participants in the HIIGT condition alternated 30 seconds of maximum effort fast walking with one minute of seated rest for 25 minutes. The MICGT group walked for 20 continuous minutes at a comfortable pace. Training was performed twice a week for 6 weeks. Primary outcome measures are the 6-minute walk test (6MWT) and the Functional Gait Assessment (FGA).

Results

To date 12 subjects (7 male, age 54.2, EDSS 3.4) have completed the study. 6MWT distances improved from 413 to 507 meters in the HIIGT group and from 445 to 473m in the MICGT group (MDC=88 meters). The HIIGT improved in FGA from 16.7 to 23.0 while the MICGT improved from 17.8 to 19.2.(MDC=6). Data collection is currently ongoing and is expected to conclude by 12/25. No adverse events were reported by either group.

Discussion

Both groups improved but the MDC for both primary outcome measures was only exceeded in the HIIGT group. Despite concerns about fatigue common in MS, the HIIGT sessions were well tolerated. Although the training was not specific to balance, subjects who underwent HIIGT improved balance performance, suggesting that the impact of HIIGT may extend beyond walking. These finding suggests that HIIGT may be a more effective physical therapy intervention for pwMS than the current standard of care.