Graduation Term

Summer 2025

Degree Name

Master of Science (MS)

Department

School of Kinesiology and Recreation

Committee Chair

Samantha M. McDonald

Committee Member

Kelly R. Laurson

Committee Member

Tyler J. Kybartas

Abstract

INTRODUCTION: Hereditary spastic paraplegia (HSP) refers to a rare group of neurological disorders. The primary symptoms are that of lower extremity skeletal muscle (SKM) weakness and spasticity. Currently, no effective treatments to prevent, reverse, or slow the progression of HSP exist. Exercise is recommended as a non-pharmacological form of symptom management in individuals with HSP due to its positive impact on SKM, functional mobility, and reduction in spasticity. However, current exercise recommendations are not based on scientific evidence, but rather anecdotal evidence since the literature is limited. Current exercise recommendations include several types such as resistance, balance/coordination, and flexibility. Resistance exercises may increase SKM strength, endurance, and mass, balance/coordination exercises may improve functional mobility, and flexibility-based exercises may reduce spasticity and increase range of motion (ROM). Based on the effects of resistance, balance/coordination, and flexibility type exercises, a comprehensive program including all three could potentially be of most benefit in the symptom management of HSP. PURPOSE: To evaluate the effects of a 12-week comprehensive exercise program on an individual with HSP. METHODOLOGY: This case study employed a secondary data analysis of a 12-week comprehensive exercise intervention on a single patient diagnosed with HSP. The frequency of the comprehensive exercise program was three days per week, and each session lasted 50 minutes in duration. Exercise intensity ranged from low to moderate with a focus on moderate intensity as the participant became accustomed to the exercises. Each session consisted of a five-minute aerobic warm-up and 15-minutes each of resistance, balance/coordination, and flexibility exercises. Baseline, 6-week, and 12-week measures were conducted in order to document the effectiveness of the program. Specifically, this study observed outcomes related to lower and upper extremity SKM strength and lower extremity SKM endurance, functional mobility and balance, lower limb spasticity, ROM, quality of life (QOL), and body composition. Outcome measures included the 30-Second Chair Stand for leg strength and endurance, upper limb grip strength, Timed Up and Go (TUG) for mobility, Berg Balance Scale (BBS) of dynamic and static balance, Modified Ashworth Scale (MAS) for abnormal tone and spasticity, goniometry for lower extremity ROM, the SF-36 QOL questionnaire, and body composition analysis via dual-energy x-ray absorptiometry (DEXA). RESULTS: The following changes in outcome measures were obtained over the course of the 12-week intervention, upper limb hand grip increased by R: +2.2 kg (13.3%), L: +1.2 kg (7.9%) and 30-Second Chair Stand assessment increased by +8 Reps (114.3%). Time to completion for the TUG decreased by -6.91s (-40.3%) and total score went up for the BBS by +17 (60.7%). Scores for the MAS went down by one for the bilateral quadriceps and gastrocnemii, and for the left hamstring, but stayed the same for the right hamstring. ROM (°) increased in the hips, knees, and ankles for both the right and left lower limbs. SF-36 scores increased for six of eight constructs, one decreased (Social Functioning), and one stayed the same (Role Limitations due to Emotional Problems). There were decreases in weight: -2.3 kg (-2.5%), BMI: -1 kg/m² (-2.6%), total bone mineral content -41.4g (-1.8%), bone mineral density: -0.019 g/cm2 (-1.5%), T-score: -0.2 (-13.3%), and total lean mass -306g (-0.7%). There were increases in body fat % +0.8 (1.6%), total fat mass +1072g (2.4%), and total mass +725g (0.8%) for body composition values. CONCLUSIONS: The major findings of this case study were that lower and upper extremity strength, lower extremity endurance, functional mobility, balance, ROM in the hips, knees, and ankles, and QOL improved, while lower limb spasticity decreased. The results of this case study suggest that a comprehensive exercise program consisting of a five-minute aerobic warm-up and 15 minutes each of resistance, balance/coordination, and flexibility type exercises performed three times a week for 12 weeks can improve the measured outcomes in an individual with HSP.

Access Type

Thesis-Open Access

DOI

https://doi.org/10.30707/ETD.1763755358.825348

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Available for download on Thursday, September 10, 2026

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Physiotherapy Commons

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