EFEITOS DE UM PROGRAMA DE EXERCÍCIOS MULTICOMPONENTES NA CAPACIDADE FUNCIONAL DE PESSOAS COM ESCLEROSE MÚLTIPLA

Abstract

Multiple Sclerosis (MS) is an autoimmune disease that causes demyelination of neurons in the Central Nervous System (CNS), resulting in reduced nerve impulse conduction and functional impairment, depending on the affected area. This study aimed to evaluate the effects of a multicomponent therapeutic exercise program on the functionality of individuals with MS. The selected participants were individuals diagnosed with MS who were part of the extension project “Somos Múltiplos: Atenção Fisioterapêutica na Esclerose Múltipla” of the Integrated Health Institute (INISA). The therapeutic program included land-based exercises (twice a week) and aquatic therapy sessions (once a week). The variables analyzed in this study were: the 2-Minute Walk Test (2MWT) and the Timed Up and Go test (TUG); handgrip muscle strength (dynamometry); the Modified Fatigue Impact Scale (MFIS); and, to assess the impact of the disease, the Modified Multiple Sclerosis Impact Scale (MSIS-29). Assessments were performed before the start of the project (March 2024) and at its conclusion (November 2024). Exclusion criteria included the occurrence of relapses during the program and an Expanded Disability Status Scale (EDSS) score greater than 5.5. An inclusion criterion was attendance greater than 50% of the therapeutic program. The results showed an overall improvement in functional parameters after the intervention. Despite the increase in the mean distance covered in the 2-Minute Walk Test (2MWT), the difference was not statistically significant (p = 0.050). Handgrip strength increased from 23.86 kgf to 24.94 kgf; however, this difference was not statistically significant (p = 0.561). The execution time of the Timed Up and Go (TUG) test decreased from 18.76 s to 15.28 s, but the difference between pre- and post-protocol moments was not statistically significant (p = 0.050). Regarding fatigue, a reduction in the Modified Fatigue Impact Scale (MFIS) scores was observed; however, the difference was not statistically significant for the reduction of fatigue symptoms (p = 0.421). On the other hand, the Multiple Sclerosis Impact Scale-29 (MSIS-29) revealed a statistically significant decrease in the perceived impact of the disease, with a reduction in the median score from 86 to 62 points, indicating a statistically significant difference (p = 0.019), reinforcing the effectiveness of the intervention protocol.

In conclusion, the multicomponent exercise program promoted positive outcomes in the functional parameters of participants with Multiple Sclerosis, with the main gain being the absence of functional losses in the sample during the study. Therefore, the multicomponent exercise program proved to be effective in preserving functional capacity without increasing fatigue, maintaining handgrip strength, preserving mobility, and reducing the psychosocial impact of the disease, reinforcing the value of non-pharmacological interventions in the management of the subjective impact of Multiple Sclerosis.