NIH Grant to Test ‘Shaky’ Treadmill Training to Prevent Falls With MS

Marquette University scientists building on pilot dynamic treadmill study

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by Margarida Maia, PhD |

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A research team at Marquette University has received a $3.34 million grant from the National Institutes of Health (NIH) to test whether high-intensity exercise on a “shaky” treadmill — one that moves unexpectedly — can help people with multiple sclerosis (MS) retain a sense of balance and walk faster.

The project, “High-intensity, dynamic-stability gait training in people with multiple sclerosis,” will be led by Brian Schmit, PhD, a professor and chair of the biomedical engineering department jointly run at the Milwaukee university and the Medical College of Wisconsin.

Funding is provided by the National Center for Medical Rehabilitation Research, part of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

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“Our team will evaluate the individual and combined effects of high-intensity exercise and balance perturbations during treadmill training in people with MS,” Schmit said in a university press release. Schmit also co-directs the Falk Center for Neurorehabilitation Engineering Research at Marquette University.

“There are still unmet rehabilitation needs for people with MS, and this project has the potential for substantial public health improvement,” Schmit added.

Dynamic treadmill training mimics walking on an uneven terrain

While approved MS treatments can help to slow progression, problems with movement and coordination, loss of balance, and fatigue remain common disease symptoms. They can make it hard for people to go about their day and carry out certain tasks.

Other complementary treatment approaches are reported to help patients in maintaining a certain level of function, and in preventing falls and the complications they can cause.

One such approach is aerobic exercise. Done regularly, it may not just boost general health and well-being but also ease some of the symptoms of MS. In previous work, high-intensity strength exercise was seen to ease fatigue in MS patients showing at least moderate fatigue on a validated scale.

Schmit and colleagues at Marquette University and Indiana University will test how engaging in high-intensity exercise on a dynamic treadmill with unexpected movements may help MS patients with balance and walking speed and pace.

In a prior pilot study (NCT04719494), the Marquette researchers confirmed the feasibility of dynamic balance treadmill training in people with MS.

The training is based on a new treadmill system, developed at Marquette, that places a treadmill on a motion base to simulate walking on an uneven terrain. “We are able to simulate uneven terrain through movements of the walking surface while maintaining a safe walking environment,” university scientists with that pilot study reported.

Building on this work and research showing the beneficial effects of high-intensity training in people with other neurological disorders, the researchers plan to test the dynamic treadmill training alone or combined with high-intensity exercise.

Their goal is to improve patients’ balance and walking, both in the lab and in the outside world.

“We hope this will lead to two developments,” Schmit said.

“The first is to reduce falls by enhancing balance while walking, which will get better with repeated practice walking on a surface that moves unexpectedly. The second,” he added, “is to improve strength, coordination, and heart and lung capacity to be able to walk faster and farther.”

Joining Schmit in the new study are two other Marquette professors: Allison Hyngstrom, PhD, and Naveen Bansal, PhD.

Hyngstrom is chair and professor of physical therapy in the College of Health Sciences. Bansal is a professor of mathematical and statistical sciences in the Klingler College of Arts and Sciences and will take on a consultant role in the project.

Co-leading the project will be T. George Hornby, PhD, a professor of physical medicine and rehabilitation at Indiana University, who will be joined by other researchers there.

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