Correlation of Lower Limb Muscle Strength with Functional Mobility and Quality of Life in Patients with Multiple Sclerosis

Main Article Content

Alisson Blass Fraga Luciano Palmeiro Rodrigues Bruna Maciel Catarino


Introduction: Multiple sclerosis (MS) generates physical deficits such as muscle weakness of the lower limbs and reduced functional mobility, thus presenting a decline in the patients' quality of life.

Objective: Correlate the muscle strength of lower limbs with functional mobility and quality of life in patients with multiple sclerosis.

Methodology: Correlational, ex post facto retrospective study. Data from 49 patients with multiple sclerosis were used, chosen from an existing database of the Neurofunctional Physiotherapy Outpatient Clinic of the Hospital de Clínicas de Porto Alegre. The tests analyzed for the study were: The 5-repetition sit-to-stand (STS) test (5STS - lower limb muscle strength) and Timed up And Go (TUG - functional mobility), in addition to the Multiple Sclerosis Impact Scale (MSIS-29 - quality of life) in individuals with MS.

Results: The average time that patients performed the 5STS was 15.39 (± 8.65) seconds. In the TUG, the average was 11.50 (± 8.40) seconds. Regarding the MSIS-29 scale, the percentage in the physical domain was 37.83% (± 25.10%) and in the psychological domain 45.18% (± 28.92%). A positive correlation was found between the time to perform the 5STS test and the time to perform the TUG (r=,566 p<,000). A positive correlation was also found between 5STS and the physical domain of MSIS-29 (r=,351 p<,0014).

Conclusion: The greater the muscular strength of the lower limbs, the greater the functional mobility and the quality of life in the physical environment of these patients.

Keywords: Multiple Sclerosis, Lower Extremity, Muscle Strength, Mobility Limitation, Quality of Life, Physical Therapy Specialty

Article Details

How to Cite
FRAGA, Alisson Blass; RODRIGUES, Luciano Palmeiro; CATARINO, Bruna Maciel. Correlation of Lower Limb Muscle Strength with Functional Mobility and Quality of Life in Patients with Multiple Sclerosis. Medical Research Archives, [S.l.], v. 10, n. 10, oct. 2022. ISSN 2375-1924. Available at: <>. Date accessed: 19 june 2024. doi:
Research Articles


1. GOLDENBERG, M. M. Multiple sclerosis review. Pharmacy and Therapeutics, v. 37, n. 3, p. 175, 2012.
2. KUBSIK-GIDLEWSKA, A. M. Rehabilitation in multiple sclerosis. Advances in Clinical and Experimental Medicine, v. 26, n. 4, p. 709-715, 2017. (
3. KAUFMANN, M. et al. 60/30: 60% of the morbidity-associated multiple sclerosis disease burden comes from the 30% of persons with higher impairments. Frontiers in Neurology, v. 11, p. 156, 2020. (
4. CHIARAVALLOTI, N. D.; DELUCA, J. Cognitive impairment in multiple sclerosis. The Lancet Neurology, v. 7, n. 12, p. 1139-1151, 2008. (
5. HAUSER, S. L.; OKSENBERG, J. R.; BARANZINI, S. E. Multiple sclerosis. In: Rosenberg's Molecular and Genetic Basis of Neurological and Psychiatric Disease. p. 1001-1014, 2015.
6. YALACHKOV, Y. et al. Determinants of quality of life in relapsing-remitting and progressive multiple sclerosis. Multiple Sclerosis and Related Disorders, v. 30, p. 33-37, 2019. (
7. DEBOLT, L. S.; MCCUBBIN, J. A. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, v. 85, n. 2, p. 290-297, 2004. (
8. BOHANNON, R. W. Test-retest reliability of the five-repetition sit-to-stand test: a systematic reviewof the literature involving adults. The Journal of Strength & Conditioning Research, v. 25, n. 11, p. 3205-3207, 2011. (
9. MOLLER, A. B. et al. Validity and variability of the 5-repetition sit-to-stand test in patients with multiple sclerosis. Disability and Rehabilitation, v. 34, n. 26, p. 2251-2258, 2012. (
10. MOTL, R. W.; LEARMONTH, Y. C., Disability Progression and its association with walking impairment in multiple sclerosis. Neurodegenerative Disease Management, v. 332, n. 6, p. 491-500, 2014. (
11. BENNETT, S. E. et al. Validity and reliability of four clinical gait measures in patients with multiple sclerosis. International Journal of MS Care, v. 19, n. 5, p. 247-252, 2017. (
12. BAIRD, J. F.; SANDROFF, B. M.; MOTL, R. W. Therapies for mobility disability in persons with multiple sclerosis. Expert Review of Neurotherapeutics, v. 18, n. 6, p. 493-502, 2018. (
13. PODSIADLO, D.; RICHARDSON, S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, v. 39, n. 2, p. 142-148, 1991. (
14. SEBASTIÃO, E. et al. Validity of the timed up and go test as a measure of functional mobility in persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, v. 97, n. 7, p. 1072-1077, 2016. (
15. VAN ASCH, P. Impact of mobility impairment in multiple sclerosis 2-patients’ perspectives. European Neurological Review, v. 6, n. 2, p. 115-120, 2011. (
16. GREEN, G.; TODD, J. ‘Restricting choices and limiting independence’: social and economic impact of multiple sclerosis upon households by level of disability. Chronic Illness, v. 4, n. 3, p. 160-172, 2008. (
17. SALTER, A. R. et al. Impact of loss of mobility on instrumental activities of daily living and socioeconomic status in patients with MS. Current Medical Research and Opinion, v. 26, n. 2, p. 493-500, 2010. (
18. SAILER, M. et al. Multiple Sklerose: Neurorehabilitation und symptomatische Therapie. Die Rehabilitation, v. 58, n. 05, p. 339-350, 2019. (
19. ASTUDILLA, P. et al. Relação entre Fadiga e Qualidade de Vida em Pacientes com Esclerose Múltipla. Revista Neurociências, v. 19, n. 3, p. 525-529, 2011. (
20. ROSIAK, K.; ZAGOŻDŻON, P. Quality of life and social support in patients with multiple sclerosis. Psychiatria Polska, v. 51, n. 5, p. 923-935, 2017.(
21. MINISTÉRIO DA SAÚDE. Qualidade de vida em 5 passos, 2013. Disponibilidade: ( Acesso em: 26. abr. 2021.
22. LOPES, J.; MACIEL, D. R. K.; MATSUO, T. Adaptação transcultural e validação da escala de impacto de esclerose múltipla. Revista Neurociências, v. 19, n. 3, p. 433-440, 2011. (
23. BOHANNON, R. W. et al. Five-repetition sit-to-stand test performance by community-dwelling adults: A preliminary investigation of times, determinants, and relationship with self-reported physical performance. Isokinetics and Exercise Science, v. 15, n. 2, p. 77-81, 2007. (
24. ROMMER, P. S. et al., A. Relapsing and progressive MS: the sex-specific perspective. Therapeutic Advances in Neurological Disorders, v. 13, n. 175628642095649, 2020. (
25. NEGREIROS, A. A. L. V. et al. Clinical and epidemiological profile of patients diagnosed with multiple sclerosis in João Pessoa, Paraíba, Brazil. Arquivos de Neuro-Psiquiatria, v. 73, n. 9, p. 741–745, 2015. (
26. KOCH-HENRIKSEN N.; SORENSEN P. The changing demographic pattern of multiple sclerosis epidemiology. Lancet Neurology, v. 9, n. 5, p. 520-532, 2010. (
27. KAUFMANN, M. et al. Factors associated with time from first-symptoms to diagnosis and treatment initiation of Multiple Sclerosis in Switzerland. Multiple Sclerosis Journal–Experimental, Translational and Clinical, v. 4, n. 4, p. 2055217318814562, 2018. (
28. TULIPANI L. J., et al., Metrics extracted from a single wearable sensor during sit-stand transitions relate to mobility impairment and fall risk in people with multiple sclerosis. Gait & Posture, v. 80, p. 361–366, 2020. (
29. MONG, Y.; TEO, T. W.; NG, S. S. 5-Repetition Sit-to-Stand Test in Subjects With Chronic Stroke: Reliability and Validity. Archives of Physical Medicine and Rehabilitation, v. 91, n. 3, p.407-413, 2010. (
30. KJOLHEDE, T. et al. Relationship between muscle strength parameters and functional capacity in persons with mild to moderate degree multiple sclerosis. Multiple Sclerosis and Related Disorders, v. 4, n. 2, p. 151–158, 2015. (
31. JORGENSEN, M. L. K. et al. Muscle strength and power in persons with multiple sclerosis–a systematic review and meta-analysis. Journal of the Neurological Sciences, v. 376, p. 225-241, 2017. (
32. BLAIR, S. N.; MORRIS, J. N. Healthy Hearts and the universal benefits of being physically active: physical activity and health. Annals of Epidemiology, v. 19, n. 4, p. 253-256, 2009. (
33. HANSEN, D. et al. Is walking capacity in subjects with multiple sclerosis primarily related to muscle oxidative capacity or maximal muscle strength? A pilot study. Multiple Sclerosis International, v. 2014, 2014. (
34. MÃNAGO, M. M. et al. Contributions of ankle, knee, hip, and trunk muscle function to gait performance in people with multiple sclerosis: a cross-sectional analysis. Physical Therapy, v. 98, n. 7, p. 595-604, 2018. (
35. RAMARI, C. et al. The importance of lower-extremity muscle strength for lower-limb functional capacity in multiple sclerosis: Systematic review. Annals of Physical and Rehabilitation Medicine, v. 63, n. 2, p. 123-137, 2020. (
36. GUNER S.; INANICI, F. Yoga therapy and ambulatory multiple sclerosis assessment of gait analysis parameters, fatigue and balance. Journal Bodywork Movement Therapies, v. 19, n. 1, p. 72-81, 2015. (
37. LAROCCA, N. G. Impact of walking impairment in multiple sclerosis. The Patient: Patient-Centered Outcomes Research, v. 4, n. 3, p. 189-201, 2011. (
38. HEESEN, C. et al. Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable. Multiple Sclerosis Journal, v. 14, n. 7, p. 988-991, 2008. (
39. CAMERON, M. H.; WAGNER, J. M. Gait abnormalities in multiple sclerosis: pathogenesis, evaluation, and advances in treatment. Current Neurology and Neuroscience Reports, v. 11, n. 5, p. 507-515, 2011. (
40. WAMSER, E. L. et al. Melhor desempenho no teste timed up and go está associado a melhor desempenho funcional em idosas da comunidade. Geriatrics, Gerontology and Aging, v. 9, n. 4, p. 138-143, 2015.
41. MEYER-MOOCK, S. et al. Systematic literature review and validity evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis. BMC Neurology, v. 14, n. 1, p. 1-10, 2014. (
42. KURTZKE, J. F. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology, v. 33, n. 11, p. 1444-1444, 1983. (
43. MINOSSO, J. S. M. et al. Validation of the Barthel Index in elderly patients attended in outpatient clinics, in Brazil. Acta Paulista de Enfermagem, v. 23, n. 2, p. 218-223, 2010. (
44. CHOW, H. et al. Progressive multiple sclerosis cognitive function and quality of life, Brain and Behavior, v. 8, n. 5, p. 875, 2018. (
45. ALGAHTANI, H. A. et al. Quality of life among multiple sclerosis patients in Saudi Arabia. Neurosciences, v. 22, n. 4, p. 261, 2017. (
46. SANDER, L.; KUGLER, J.; ELSNER, B. Der Einfluss von MS-spezifischen Symptomen auf die gesundheitsbezogene Lebensqualität. Fortschritte der Neurologie· Psychiatrie, v. 88, n. 11, p. 704-712, 2020. (
47. LEBRUN, C.; COHEN, M. Dépression et sclérose en plaques Depression in multiple sclerosis. Revue Neurologique, v. 165, p. S156-S162, 2009.
48. PATTEN, S. B.; MARRIE, R. A.; CARTA, M. G. Depression in multiple sclerosis. International Review of Psychiatry, v. 29, n. 5, p. 463-472, 2017. (
49. ALMEIDA, L. H. R. B. de et al. Ensinando e aprendendo com portadores de Esclerose Múltipla: relato de experiência. Revista Brasileira de Enfermagem, v. 60, n. 4, p. 460-463, 2007. (
50. ZAENKER, P. et al. High-intensity interval training combined with resistance training improves physiological capacities, strength and quality of life in multiple sclerosis patients: a pilot study. European Journal of Physical and Rehabilitation Medicine, v. 54, n. 1, p. 58-67, 2018. (
51. KIERKEGAARD, M. et al. High-intensity resistance training in multiple sclerosis - An exploratory study of effects on immune markers in blood and cerebrospinal fluid, and on mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Journal of the Neurological Sciences, v. 362, p. 251-257, 2016. (
52. BACKUS, D. Increasing Physical Activity and Participation in People With Multiple Sclerosis: A Review. Archives of Prhysical Medicine and Rehabilitation, 97: S210-S 217, 2016. (