Randomized Controlled Trial to Examine the Impact of Aquatic Exercise Training on Functional Capacity, Balance, and Perceptions of Fatigue in Female Patients With Multiple Sclerosis

Arch Phys Med Rehabil. 2018 Feb;99(2):234-241. doi: 10.1016/j.apmr.2017.06.015. Epub 2017 Jul 20.


Objective: To assess the effects of an 8-week aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS).

Design: Randomized controlled design.

Setting: Referral center of an MS society.

Participants: Women (N=32; mean age ± SD, 36.4±8.2y) with diagnosed relapsing-remitting MS. After undergoing baseline testing by a neurologist, participants were allocated to either an intervention (aquatic training program, n=17) or a control group (n=15).

Interventions: The intervention consisted of an 8-week aquatic training program (3 supervised training sessions per week; session duration, 45-60min; 50%-75% estimated maximum heart rate).

Main outcome measures: Six-minute walk test (6-MWT), balance (Berg Balance Scale [BBS]), and perceptions of fatigue (Modified Fatigue Impact Scale; [MFIS]) at baseline and after the 8-week intervention. Differences over time between the experimental and control groups were assessed by a 2×2 (group by time) repeated-measures analysis of variance.

Results: Thirty-two women completed the 8-week aquatic training intervention (experimental group, n=17; control group, n=15). All outcome measures improved in the experimental group: 6-MWT performance (pretest mean ± SD, 451±58m; posttest mean ± SD, 503±57m; P<.001); BBS (pretest mean ± SD, 53.59±1.70; posttest mean ± SD, 55.18±1.18; P<.001), and MFIS (pretest mean ± SD, 43.1±14.6; posttest mean ± SD, 32.8±5.9; P<.01). A significant group-by-time interaction was evident between the experimental and control groups for 6-MWT (P<.001, partial eta2p2]=.551), BBS (P<.001, ηp2=.423), and MFIS (P<.001, ηp2=.679).

Conclusions: Aquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS.

Trial registration: ClinicalTrials.gov NCT02882724.

Keywords: Exercise; Fatigue; Multiple sclerosis; Rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Disability Evaluation
  • Exercise Therapy / methods*
  • Fatigue / physiopathology*
  • Female
  • Humans
  • Hydrotherapy / methods*
  • Multiple Sclerosis / physiopathology*
  • Multiple Sclerosis / rehabilitation*
  • Postural Balance / physiology*
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT02882724