Date of Degree

5-2015

Document Type

Capstone Project

Degree Name

D.P.T.

Program

Physical Therapy

Advisor

Herb Karpatkin

Subject Categories

Physical Therapy

Abstract

Background: Persons with MS (pwMS) are limited in their mobility due to thermosensitivity. Exercising at a sufficient volume and intensity to increase mobility can result in increased core temperatures and resultant worsening of symptoms. The use of cooling garments to lower core temperature has been found to be a successful means of allowing pwMS to exercise for longer periods. Previous studies have relied on precooling for an extended period of time prior to activity, to achieve improved exercise performance. Cooling during the performance itself, or pericooling, may allow for similar performance gains to be realized without spending the time needed for precooling.

Objectives: The purpose of this study is to examine the effects of pericooling on the Six Minute Walk Test (6MWT) performance in pwMS. It was hypothesized that pwMS would have better 6MWT performance while wearing a cooling vest then compared to a noncooled condition. If our hypothesis were correct, it would suggest that pwMS could achieve improved exercise performance without engaging in precooling activities.

Methods: A randomized crossover design was used. Patients were randomized into cooled or uncooled conditions. Cooled subjects would perform a 6MWT, donning a commercially available cooling vest immediately prior to the walk. Walks would be performed once a week for three weeks. Total 6MWT distance and minute-by-minute distance was recorded. Fatigue during the walk was measured using the Visual Analog Scale of Fatigue. Uncooled subjects would perform the identical protocol without a cooling device. Following the three walks in one condition, subjects would undergo a two-week washout period and then repeat the same protocol in whatever condition they did not experience initially.

Results: Six females with mild MS (EDSS 2.67) completed the study. Pericooling resulted in walking significantly, (F (1,17) = 4.63, p = .046, partial η2 = .214) farther in the cooled condition (1257’) than in the uncooled condition (1154’). There was no significant difference in VAFS scores between the 2 conditions.

Conclusions: Pericooling, delivered via a commercially available cooling vest resulted in better 6MWT scores than an uncooled condition in pwMS. As most studies of cooling in MS utilize cooling prior to an activity, these results indicate an alternative and less time consuming means of achieving the beneficial effects of cooling.

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