MULTİPL SKLEROZDA EKSENTRİK VE KONSENTRİK EGZERSİZ EĞİTİMİNİN HEMODİNAMİK YANITLAR, FONKSİYONEL KAPASİTE VE YORGUNLUK ÜZERİNE ETKİLERİNİN KARŞILAŞTIRILMASI

Öz

Amaç: Çalışmada, Multipl Skleroz (MS) hastalarında eksentrik ve konsentrik egzersiz eğitiminin (EEE ve KEE), hemodinamik yanıtlar, fonksiyonel kapasite ve yorgunluk üzerine etkilerinin karşılaştırılması amaçlandı.
Yöntem: Çalışmaya 22 MS hastası dahil edildi. Hastalar rastgele olarak koşubandında EEE (-% 10 eğimle yokuş aşağı yürüme) ve KEE (+% 10 eğimle yokuş yukarı yürüme) gruplarına ayrıldı. Eğitim, sekiz hafta süre ile 2 gün/hafta ve 30 dakika/gün olarak uygulandı. Her eğitim seansı öncesi ve sonrası oksijen saturasyonu ve hemodinamik yanıtlar ölçüldü ve “double-product” değerleri hesaplandı. Modifiye Borg Skalası (MBS) ile algılanan yorgunluk şiddeti değerlendirildi. Eğitim öncesi ve sonrasında fonksiyonel kapasite altı dakika yürüme testi (6DYT) ile, yorgunluk ise, Yorgunluk Şiddet (YŞÖ) ve Yorgunluk Etki Ölçeği (YEÖ) ile değerlendirildi.
Sonuçlar: EEE grubunda kalp hızı 5., 9., 12., 13. ve 16. seans, sistolik kan basıncı 7. ve 13. seans, diastolik kan basıncı 2., 5., 6., 11., 12. ve 13. seans, “double product” değeri 5., 7., 9., 11., 12., 13., 15., ve 16. seans, oksijen saturasyonu fark değeri 6., ve 8. seanslarda anlamlı olarak daha düşük bulundu (p<0,05). MBS puanı, EEE grubunda 13. seansta anlamlı olarak daha düşüktü (p<0,05). Her iki grupta tedavi sonrasında, 6DYT mesafesinde artış, YŞÖ ve YEÖ’de ise, anlamlı azalma olduğu görüldü (p<0,05). Gruplar arasında eğitim sonrası, 6DYT mesafesi, YŞÖ ve YEÖ değerleri birbirine benzerdi (p>0,05).
Tartışma: MS hastalarında EEE düşük hemodinamik yanıtlar, enerji harcama düzeyleri ve daha az yorgunluk oluşturması açısından avantajlı bir egzersiz türü olabilir. Cinsiyet dağılımının homojen olduğu, ileri çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Egzersiz
• Hemodinamikler
• Multipl Skleroz

A COMPARISON OF THE EFFECTS OF ECCENTRIC AND CONCENTRIC EXERCISE TRAINING ON HEMODYNAMIC RESPONSE, FUNCTIONAL CAPACITY, AND FATIGUE IN PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

Purpose: The aim was to compare the hemodynamic response, functional capacity, and fatigue in
eccentric and concentric exercise training (EET and CET, respectively) in MS.
Methods: Twenty-two patients with MS were included in the study. Individuals were randomly assigned
as EET (downhill walking with -10% slope) and CET (uphill walking with +10% slope) exercise on a
treadmill. The training was applied for eight weeks, 30 min/day, 2 days/week. Hemodynamic responses
were measured, and double-product values were calculated before and after the sessions. Perceived
fatigue was evaluated using the Modified Borg Scale (MBS). Functional capacity was evaluated using
6-minute walk test (6MWT) before and after the training. Fatigue was assessed using Fatigue Severity
Scale (FSS) and Fatigue Impact Scale (FIS).
Results: In the EET group, heart rate at session 5, 9, 12, 13, and 16, systolic blood pressure session 7
and 13, diastolic blood pressure at session 2, 5, 6, 11, 12, and, double product at session 5, 7, 9, 11, 12,
13, 15, and 16, and oxygen saturation session 6 and 8 were found to be significantly lower (p<0.05). In
the EET group, the MBS score was lower at session 13 (p<0.05). In both groups, a significant increase
in 6MWT distance and a significant decrease in FSS and FIS scores were observed (p<0.05). The 6MWT
distance, FSS, and FIS scores were similar between the groups (p>0.05).
Conclusion: The EET may be advantageous since it causes less fatigue due to lower hemodynamic
responses and energy consumption in MS. Further study with homogeneous gender distribution is
needed.

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