Evaluation of Muscle Performance and Cardiopulmonary Fitness in Patients with Multiple Sclerosis

Multiple sclerosis (MS) is a neurological disease characterized by a variety of potentially debilitating symptoms. The manner in which the disease affects each individual is unique. Many individuals with MS have minimal neuromuscular impairment and remain ambulatory throughout their lives, whereas others experience more rapid disease progression and loss of functional independence. Although appropriate exercise testing and training could potentially improve clinical treatment and rehabilitation outcome, very little research has focused on understanding how MS affects basic physiologic responses during exercise. Objective measurements of muscle function and cardiopulmonary (aerobic) fitness have indicated variable results depending upon the disease severity. Patient-specific information is important for establishing realistic guidelines for therapeutic exercise programs. It appears that appropriate training can improve both skeletal muscle function and cardiopulmonary fitness. However, current clinical indices of neurologic function do not consider physical capability as part of the criteria. Thus, it seems desirable to supplement these criteria with objective tests of exercise performance. Special precautions and considerations for exercise testing of individuals with MS need to be incorporated to ensure safety and accurate interpretation of data.