Exercise in the community for people with multiple sclerosis — a follow-up of people with minimal gait impairment Internet-delivered behavioral intervention to increase physical activity in persons with multiple sclerosis: Sustainability and secondary outcomes Enhancing physical activity adherence and well-being in multiple sclerosis: a randomised controlled trial The feasibility and short-term benefits of Blue Prescription: a novel intervention to enable physical activity for people with multiple sclerosis Internet intervention for increasing physical activity in persons with multiple sclerosis Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: rationale and research protocol The effects of a 12-week leisure centre-based, group exercise intervention for people moderately affected with multiple sclerosis: a randomized controlled pilot study Results of a feasibility randomised controlled study of the guidelines for exercise in multiple sclerosis project. Randomized controlled trial of a behavioral intervention targeting symptoms and physical activity in multiple sclerosis Physical rehabilitation has a positive effect on disability in multiple sclerosis patients Increasing Physical Activity in Multiple Sclerosis Using a Behavioral Intervention Exercise in the community for people with minimal gait impairment due to MS: an assessor-blind randomized controlled trial Internet-delivered lifestyle physical activity intervention improves body composition in multiple sclerosis: preliminary evidence from a randomized controlled trial. Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Randomized controlled pilot study of customized pamphlets to promote physical activity and symptom self-management in women with multiple sclerosis Self-efficacy and environmental correlates of physical activity among older women and women with multiple sclerosis. Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study
Background : Although there are many studies evaluating exercise interventions , few studies have evaluated the effect at follow-up . Objectives : This paper presents follow-up data for participants who completed the exercise interventions in a large r and omised controlled trial . Methods : One hundred twenty-one people with multiple sclerosis ( MS ) with minimal gait impairment who completed 10 weeks of community-based exercise interventions  were evaluated by a blinded assessor 12 weeks after the intervention . The primary outcome measure was the Multiple Sclerosis Impact Scale-29 version 2 ( MSIS-29,v2 ) physical component . Other outcomes were the MSIS-29 psychological component , the Modified Fatigue Impact Scale ( MFIS ) and the 6-minute walk test ( 6MWT ) distance . Results : The positive effect on the physical impact of MS was not maintained from baseline to follow-up ( −1.6 , 95 % CI −0.8 , 4.0 , p=0.189 ) . The psychological impact and the impact of fatigue remained significantly improved ( −3.5 , 95 % CI −6.1 , −1.0 , p = 0.006 and −4.68 , 95 % CI −6.9 , −2.5 , p < 0.001 , respectively ) . There was no time effect for the 6MWT ( f = 1.76 , p = 0.179 ) although the trend suggests reversal of the benefits gained from the physiotherapist (PT)- and fitness instructor (FI)-led intervention . Conclusion : The maintained benefit on the psychological impact of MS and fatigue may have important personal and socioeconomic consequences ; however , it is important to find ways to maintain the physical benefits of exercise over the long term Physical activity is associated with many benefits , but persons with multiple sclerosis ( MS ) are less physically active than the general population . There is a critical need for research on methods of increasing and sustaining the physical activity levels of this population . This r and omized controlled trial examined the efficacy of an Internet-delivered and theory-based behavioral intervention that was supplemented with video coaching for increasing and sustaining physical activity over time in persons with MS . Physically inactive , ambulatory persons with MS ( N = 45 ) were r and omly assigned to intervention ( n = 22 ) or control ( n = 23 ) conditions and completed a battery of question naires before , after , and three months after a 12-week intervention period . Data analyses were conducted in PASW 18.0 . Partial eta squared ( ) effect size indicated that there was a large , statistically significant condition-by-time interaction on physical activity ( ) . Cohen 's d effect sizes indicated that the intervention group had a large increase in physical activity after the 12-week trial ( d = .98 ) that was sustained over a three-month follow-up ( d = .79 ) . The current study supports the efficacy of a behavioral intervention for increasing and sustaining physical activity in a sample of persons with MS Individuals with multiple sclerosis ( MS ) are more sedentary than the general population , increasing their propensity for reduced functional ability , mobility , and activities of daily living . Self-efficacy has been one of the most consistent determinants of physical activity across population s , including those with MS . However , no studies exist that have attempted to influence self-efficacy in MS patients , in an effort to improve physical activity participation . We conducted a three-month r and omised , controlled trial ( n = 26 ) , contrasting the effects of an efficacy-enhancement exercise condition and a control exercise condition on exercise adherence , well-being , and affective responses to exercise .  Analyses indicated that individuals in the efficacy enhancement condition attended more exercise sessions , reported greater levels of well-being and exertion , and felt better following exercise than individuals in the st and ard care condition . Regardless of treatment condition , individuals with a stronger sense of exercise self-efficacy , who reported more enjoyment following the exercise sessions , demonstrated significantly greater adherence with the  exercise program  . We believe this to be the first empirical attempt to change physical activity behavior in persons with MS using a well-established theoretical framework to drive the intervention . Continued examination of self-efficacy as a determinant of behavior change in individuals with MS is needed . Multiple Sclerosis 2007 ; 13 : 652 - 659 . Purpose : Participation in physical activity for people with Multiple sclerosis ( MS ) is important but can be difficult to sustain long-term . Facilitators for long-term adherence include choice over activity and control over level of engagement , coupled with support , advice and encouragement from a physiotherapist . This is the basis of Blue Prescription , a novel physiotherapy approach aim ed at optimising long-term adherence with physical activity . We evaluated the feasibility and short-term benefits of Blue Prescription in people with MS . Methods : Twenty-seven people with MS ( mean age : 51 ± 11 years , with a range of MS type and disability ) were assessed at baseline and immediately post-intervention with the MS Impact Scale , MS Self-efficacy Scale , and European Quality of Life Question naire . Change in outcomes were analysed with Wilcoxon signed ranks tests . Results : All participants , irrespective of level of disability , were able to choose a physical activity and to engage in it . The physical component MS Impact Scale score significantly improved by a median change of 6.5 ( 95 % CI = −10.5 to −2.0 ; p = 0.007 ; effect size = 0.38 ) . There were no other significant changes in outcomes . Conclusion : Blue Prescription appears feasible and potentially beneficial , particularly in reducing the negative impacts of MS upon individuals , and thus warrants further evaluation . Implication s for Rehabilitation Facilitators for long-term adherence for disabled people include choice over activity and control over level of engagement , coupled with support , advice and encouragement from a physiotherapist . Blue Prescription is a physiotherapy approach aim ed at optimising long-term adherence with physical activity for people with multiple sclerosis . Blue Prescription appears to reduce the negative impacts of multiple sclerosis upon individuals Background : Physical activity has been associated with improvements in walking mobility and quality of life in persons with multiple sclerosis ( MS ) , and yet this population is largely sedentary and inactive compared with the general population . Objectives : We conducted a pilot , r and omized controlled trial ( RCT ) for examining the effect of an Internet intervention based on social cognitive theory ( SCT ) for favorably increasing physical activity among persons with MS . We further examined variables from SCT as possible mediators of the Internet intervention . Methods : We r and omly allocated 54 persons with MS into either an Internet intervention condition or a waitlist control condition .  The participants completed measures of physical activity , self-efficacy , outcome expectations , functional limitations , and goal setting before and after the 12-week period . Results : The intervention group reported a statistically significant ( p = 0.01 ) and large increase in physical activity over time ( d = 0.72 ) , whereas the control group had a small ( d = 0.04 ) and non-significant change in physical activity ( p = 0.71 ) . The intervention group further reported a statistically significant ( p = 0.001 ) and large increase in goal setting over time ( d = 0.97 ) , whereas the control group had a small ( d = −0.13 ) and non-significant change ( p = 0.17 ) . The change in goal setting over time mediated the effect of the Internet intervention on physical activity behavior . Conclusions : This pilot study sets the stage for a subsequent RCT that includes a larger sample of persons with MS , longer intervention period along with a follow-up , objective measure of physical activity , and secondary outcomes of walking mobility and QOL Background Chronic fatigue and inactivity are prevalent problems among individuals with multiple sclerosis ( MS ) and may independently or interactively have detrimental effects on quality of life and ability to participate in life roles . However , no studies to date have systematic ally evaluated the benefits of an intervention for both managing fatigue and promoting physical activity in individuals with MS . This study involves a r and omized controlled trial to examine the effectiveness of a telehealth intervention that supports individuals with MS in managing fatigue and increasing physical activity levels . Methods / Design A r and omly-allocated , three-parallel group , time-series design with a social support program serving as the control group will be used to accomplish the purpose of the study . Our goal is to recruit 189 ambulatory individuals with MS who will be r and omized into one of three  telehealth interventions : ( 1 ) a contact-control social support intervention , ( 2 ) a physical activity-only intervention , and ( 3 ) a physical activity plus fatigue management intervention . All interventions will last 12 weeks and will be delivered entirely over the phone . Our hypothesis is that , in comparison to the contact-control condition , both the physical activity-only intervention and the physical activity plus fatigue management intervention will yield significant increases in physical activity levels as well as improve fatigue and health and function , with the physical activity plus fatigue management intervention yielding significantly larger improvements . To test this hypothesis , outcome measures will be administered at Weeks 1 , 12 , and 24 . Primary outcomes will be the Fatigue Impact Scale , the Godin Leisure-Time Exercise Question naire ( GLTEQ ) , and Actigraph accelerometers . Secondary outcomes will include the SF-12 Survey , Mental Health Inventory , Multiple Sclerosis Impact Scale , the Community Participation Indicator , and psychosocial constructs ( e.g. , self-efficacy ) . Discussion The proposed study is novel , in that it represents a multi-disciplinary effort to merge two promising lines of research on MS : fatigue management and physical activity promotion . Collectively , the proposed study will be the largest r and omized controlled trial to examine the effects of a lifestyle physical activity intervention in people with MS.Trial registration Objective : To establish the effects of a 12-week , community-based group exercise intervention for people moderately affected with multiple sclerosis . Design : R and omized controlled pilot trial . Setting : Two community leisure centres . Participants : Thirty-two participants with multiple sclerosis r and omized into intervention or control groups . Intervention : The intervention group received 12 weeks of twice weekly , 60-minute group exercise sessions , including mobility , balance and resistance exercises . The control group received usual care . Main outcome measures : An assessor blinded to group allocation assessed participants at baseline , after eight weeks and after 12 weeks . The primary outcome measure was 25-foot ( 7.6 m ) walk time , secondary outcomes assessed walking endurance , balance , physical function , leg strength , body mass index , activity levels , fatigue , anxiety and depression , quality of life and goal attainment . Results : The intervention made no statistically significant difference to the results of participants ’ 25-foot walk time . However the intervention led to many improvements . In the intervention group levels of physical activity improved statistically between baseline and week 8 ( P < 0.001 ) and baseline and week 12 ( P = 0.005 ) . Balance confidence results showed a significant difference between baseline and week 12 ( P = 0.013 ) . Good effect sizes were found for dynamic balance ( d = 0.80 ) , leg strength ( d = 1.33 ) , activity levels ( d = 1.05 ) and perceived balance ( d = 0.94 ) . Conclusion : The results of the study suggest that community-based group exercise classes are a feasible option for people moderately affected with multiple sclerosis , and offer benefits such as improved physical activity levels , balance and leg strength There is increasing recognition that exercise is an efficacious strategy for managing many consequences of multiple sclerosis ( MS ) , yet persons with MS are not engaging in sufficient exercise for accruing health benefits . Poor exercise uptake might be associated with the design of previous research . We conducted a r and omised controlled trial ( RCT ) for examining the feasibility of a 4-month home-based , exercise-training program design ed based on recent physical activity guidelines for MS and supplemented by behavioural strategies for compliance . Feasibility was assessed in the domains of process ( e.g. , recruitment ) , re source ( e.g. , monetary costs ) , management ( e.g. , personnel time requirements ) and scientific outcomes ( e.g. , treatment effect ) . We recruited persons with mild-to-moderate MS who were r and omised into an intervention or wait-list control condition . Intervention participants received a pedometer , elastic resistance b and s , DVD , training manual , calendars , log-book , video coaching calls and newsletters . Participants in both conditions completed home-based assessment s before and after the 4-month period . Ninety-nine persons with MS were assessed for eligibility , and 57 were r and omised . Fifty-one persons completed the study ( 90 % ) . Total costs of the study were US $ 5331.03 . Personnel time to conduct the study totaled 263h . Participants in the intervention group complied fully with 71 % of all exercise sessions . There was a moderate increase in self-reported exercise behaviour of the intervention participants as measured by the Godin Leisure-Time Exercise Question naire ( d≥0.5 ) . The results support the feasibility and acceptability of a home-based exercise intervention based on physical activity guidelines and supplemented with behavioural strategies for adults with mild-to-moderate MS Background : Exercise training is beneficial , but most persons with multiple sclerosis ( MS ) are sedentary and physically inactive . This has prompted a new focus on the promotion of lifestyle physical activity in MS . We previously design ed , tested , and refined a behavioral intervention delivered through the Internet that successfully increased lifestyle physical activity in MS , but have not evaluated the effects on secondary symptomatic and health-related quality of life ( HRQOL ) outcomes . Objective : We conducted a 6-month r and omized controlled trial ( RCT ) that examined the efficacy of an Internet-delivered , behavioral intervention for improving outcomes of fatigue , depression , anxiety , pain , sleep quality , and HRQOL in 82 ambulatory persons with MS . The secondary aim was to replicate previous results regarding change in free-living physical activity . Results : There was a significant and positive effect of the intervention on fatigue severity ( p=.001 , ηρ2=.15 ) and its physical impact ( p=.008 , ηρ2=.09 ) , depression ( p=.006 , ηρ2=.10 ) , and anxiety ( p=.006 , ηρ2=.10 ) . There were non-significant improvements in pain ( p=.08 , ηρ2=.04 ) , sleep quality ( p=.06 , ηρ2=.05 ) , and physical HRQOL ( p=.06 , ηρ2=.05 ) . We replicated our previous results by demonstrating an increase in self-reported physical activity ( p=.001 , ηρ2=.13 ) . Conclusions : Our results support behavioral interventions targeting lifestyle physical activity as an alternative approach for managing symptoms in MS Background : Although physical rehabilitation is commonly administered to MS patients , its efficacy has not been established . Objective : We assessed the efficacy of an inpatient physical rehabilitation program on impairment , disability , and quality of life of MS patients with a r and omized , single-blind , controlled trial . Methods : Fifty ambulatory MS patients were assigned to 3 weeks of inpatient physical rehabilitation ( study treatment ) or exercises performed at home ( control treatment ) . Patients were evaluated at baseline and at 3 , 9 , and 15 weeks by a blinded examining physician . Results : No changes in impairment occurred in either group , as measured by the Exp and ed Disability Status Scale . At the end of the intervention the study group improved significantly in disability , as assessed by the Functional Independence Measure ( FIM ) motor domain , compared with controls ( p = 0.004 ) , and the improvement persisted at 9 weeks ( p = 0.001 ) . The effect size statistic was usually large or moderate in all scale scores of the FIM motor domain at 3 weeks and moderate to fair thereafter . The study group also improved in overall health-related quality of life profile compared with controls ; however , the difference was significant only for the mental composite score at 3 ( p = 0.008 ) and 9 weeks ( p = 0.001 ) . Conclusions : Despite unchanging impairment , physical rehabilitation result ed in an improvement in disability and had a positive impact on mental components of health-related quality of life perception at 3 and 9 weeks The present study adopted an interrupted time-series design for identifying the possibility of behavioral reactivity and examining the effect of an Internet-delivered behavioral intervention for increasing self-reported and objective ly-measured physical activity among persons with multiple sclerosis ( MS ) . Participants ( n = 18 ) wore an accelerometer for 7 days and completed a battery of question naires to measure  physical activity  at 3 time points ( before and after a 3-month period of no treatment and again after a 3-month period of treatment ) . There was a small change in objective ly-measured , but not self-reported , physical activity in the period of no treatment , whereas there was a large increase in self-reported and objective ly-measured physical activity in the period of treatment . These findings both complement and extend previous research and further support the efficacy of the current Internet behavioral intervention for increasing physical activity in persons with MS Background : While there is an increasing body of evidence supporting the efficacy of exercise in people with multiple sclerosis ( MS ) , additional information on the effectiveness of combining aerobic and resistance training , and yoga is required . Objectives : This study evaluated the effectiveness of community exercise interventions for people with MS having minimal gait impairment . Methods : A multi-centred , block-r and omised , assessor-blinded , controlled trial was conducted . Participants were r and omised in groups of eight to physiotherapist (PT)-led exercise ( n = 80 ) , yoga ( n = 77 ) , fitness instructor (FI)-led exercise ( n = 86 ) and they took part in weekly community-based group exercise sessions . Those in the control group were asked not to change of their exercise habits ( n = 71 ) . The primary outcome was the Multiple Sclerosis Impact Scale ( MSIS ) 29v2 physical component , measured before and after the 10-week intervention . Secondary outcomes were the MSIS 29v2 psychological component , the Modified Fatigue Impact Scale ( MFIS ) and the 6-Minute Walk Test ( 6MWT ) . Results : The group x time interaction approached significance for the MSIS-29v2 physical component ( f = 2.48 , p = 0.061 ) and MFIS total ( f = 2.50 , p = 0.06 ) , and it was significant for the MFIS physical subscale ( f = 4.23 , p = 0.006 ) . All three exercise interventions led to a statistically significant improvement on the MSIS-29 psychological component and both the MFIS total and physical subscales , which were greater than the control ( p < 0.05 ) . Only the PT-led and FI-led interventions significantly improved the MSIS-29 physical and 6MWT to levels greater than the control ( p < 0.05 ) . Conclusions : This study provides evidence for the positive effect of exercise on the physical impact of MS and fatigue . The group nature of the classes may have contributed to the positive effects seen on the psychological impact of MS OBJECTIVE To examine the efficacy of a physical activity behavioral intervention for improving outcomes of body composition in persons with multiple sclerosis ( MS ) . DESIGN Secondary analysis of data from a r and omized controlled trial . SETTING University research laboratory . PARTICIPANTS Ambulatory persons with MS ( N=82 ) . INTERVENTION A 6-month , internet-delivered physical activity behavioral intervention design ed to increase lifestyle physical activity , primarily walking . The behavioral intervention was based on principles of social cognitive theory . MAIN OUTCOME MEASURES Whole-body bone mineral content ( BMC ) , bone mineral density ( BMD ) , and soft tissue composition , using dual-energy x-ray absorptiometry . RESULTS There were no significant differences between conditions posttrial on body composition outcomes using the adjusted critical value ( P<.008 ) . There was a significant effect of the intervention on whole-body BMC ( P=.04 , ω(2)<.001 ) and BMD ( P=.01 , ω(2)=.003 ) using the unadjusted critical value ( P<.05 ) . The effect of the intervention on percent body fat ( P=.09 , ω(2)=.001 ) and whole-body fat mass ( P=.05 , ω(2)=.003 ) approached significance using unadjusted criteria . There was not a significant effect on whole-body lean soft tissue ( P=.28 , ω(2)<.001 ) or body mass index ( P=.86 , ω(2)<.001 ) . CONCLUSIONS Our results provide preliminary evidence that an internet-delivered lifestyle physical activity intervention might improve bone health and body composition in MS . Such findings are important considering that physical activity is a modifiable behavior with the potential to confer long-term benefits for the prevention and management of fracture risk and comorbidities among those with MS BACKGROUND Multiple sclerosis ( MS ) is a major cause of chronic , neurological disability , with a significant long-term disability burden , often requiring comprehensive rehabilitation . OBJECTIVES To systematic ally evaluate evidence from published Cochrane Review s of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS ( pwMS ) , to improve patient outcomes , and to highlight current gaps in knowledge . METHODS We search ed the Cochrane Data base of Systematic Review s up to December 2017 , to identify Cochrane Review s that assessed the effectiveness of organised rehabilitation interventions for pwMS . Two review ers independently assessed the quality of included review s , using the Revised Assessment of Multiple Systematic Review s ( R-AMSTAR ) tool , and the quality of the evidence for reported outcomes , using the GRADE framework . MAIN RESULTS Overall , we included 15 review s published in the Cochrane Library , comprising 164 r and omised controlled trials ( RCTs ) and four controlled clinical trials , with a total of 10,396 participants . The included review s evaluated a wide range of rehabilitation interventions , including : physical activity and exercise therapy , hyperbaric oxygen therapy ( HBOT ) , whole-body vibration , occupational therapy , cognitive and psychological interventions , nutritional and dietary supplements , vocational rehabilitation , information provision , telerehabilitation , and interventions for the management of spasticity . We assessed all review s to be of high to moderate method ological quality , based on R-AMSTAR criteria .Moderate- quality evidence suggested that physical therapeutic modalities ( exercise and physical activities ) improved functional outcomes ( mobility , muscular strength ) , reduced impairment ( fatigue ) , and improved participation ( quality of life ) . Moderate- quality evidence suggested that inpatient or outpatient multidisciplinary rehabilitation programmes led to longer-term gains at the levels of activity and participation , and interventions that provided information improved patient knowledge . Low-qualitty evidence suggested that neuropsychological interventions , symptom-management programmes ( spasticity ) , whole body vibration , and telerehabilitation improved some patient outcomes . Evidence for other rehabilitation modalities was inconclusive , due to lack of robust studies . AUTHORS ' CONCLUSIONS The evidence suggests that regular specialist evaluation and follow-up to assess the needs of patients with all types of MS for appropriate rehabilitation interventions may be of benefit , although the certainty of evidence varies across the different types of interventions evaluated by the review s. Structured , multidisciplinary rehabilitation programmes and physical therapy ( exercise or physical activities ) can improve functional outcomes ( mobility , muscle strength , aerobic capacity ) , and quality of life . Overall , the evidence for many rehabilitation interventions should be interpreted cautiously , as the majority of included review s did not include data from current studies . More studies , with appropriate design , which report the type and intensity of modalities and their cost-effectiveness are needed to address the current gaps in knowledge Objective : Investigate the feasibility and potential efficacy of a customized print-based intervention to promote physical activity and symptom self-management in women with multiple sclerosis . Design : A r and omly allocated two-group repeated measures design , with a delayed-treatment contact group serving as the control . Participants were r and omized to receive the intervention immediately ( n = 14 ) or receive it at week 12 ( n = 16 ) . Outcome measures were administered at weeks 1 , 12 , and 24 . Setting : Community-based in metropolitan area . Subjects : Thirty women with multiple sclerosis . Intervention : Prescribing a home-exercise program and following up with customized pamphlets , which are matched to participants ’ stage of readiness to change physical activity behavior and physical activity barriers ( e.g. encouraging self-management of symptoms ) . Main Measures : Physical Activity and Disability Survey-revised , Godin Leisure-Time Exercise Question naire , SF-12 , Symptoms of Multiple Sclerosis Scale , and 6-minute walk test . Results : Intent-to-treat analyses using mixed multivariate analysis of variance ( MANOVA ) were conducted on ( 1 ) physical activity levels and ( 2 ) health and function outcomes . The mixed MANOVAs for physical activity levels and health and function outcomes indicated significant improvements in the immediate group compared with the delayed group ( i.e. condition by time interaction was significant , Wilks ’ λ = 0.59 , F2 , 27 = 9.31 , P = 0.001 and Wilks ’ λ = 0.70 , F4 , 25 = 2.72 , P = 0.052 , respectively ) . The intervention had moderate to large effect sizes in improving physical activity levels ( d = 0.63 to 0.89 ) , perceptions of physical function ( d = 0.63 ) , and 6-minute walk test ( d=0.86 ) . Conclusion : This pilot study indicates that a customized print-based intervention shows promise in improving physical activity levels and health and function in women with multiple sclerosis Physical inactivity is a major health problem in the United States , particularly in elderly and disabled population s. Little research exists examining the relationships between aspects of the built environment and physical activity in older adults and individuals with multiple sclerosis ( MS ) . We adopted a social cognitive perspective to examine the independent roles of perceptions of the environmental , self-efficacy and functional limitations in underst and ing physical activity levels among elderly women and women with MS . Older women ( n=136 ) and women diagnosed with MS ( n=173 ) were recruited to participate in separate cross-sectional studies . Individuals completed a battery of question naires and wore an activity monitor for 7 days . All measures were issued and collected through the mail with the use of self-addressed , pre-paid envelopes . Initial correlational analyses indicated that self-efficacy , functional limitations and environmental perceptions were significantly related to physical activity . Among older women , self-efficacy , functional limitations and street connectivity demonstrated independent contributions to physical activity behavior . Only self-efficacy and functional limitations demonstrated significant associations among women with MS . The prospect i ve contributions of the environment and individual factors to changes in physical activity need to be determined Objective : To determine if exercise benefits patients with multiple sclerosis . Design : R and omized controlled trial . Setting s : Participants exercised at home and also attended exercise classes held in a hospital physiotherapy gym . Subjects : Thirty patients , diagnosed and independently mobile , were recruited in the Dublin area . Intervention : For three months , classes were held twice-weekly and participants exercised independently once-weekly . The control group was monitored monthly and management remained unchanged . Measurements : Measurements were taken at baseline , three and six months . The Modified Fatigue Impact Scale ( MFIS ) , Multiple Sclerosis Impact Scale-29 ( MSIS-29 ) and Functional Assessment of Multiple Sclerosis ( FAMS ) were used to measure fatigue and quality of life ( QOL ) . Heart rate ( HR ) and the Borg 's Rating of Perceived Exertion ( RPE ) were recorded during an incremental exercise test . The change from baseline scores between groups was compared using the Mann — Whitney U-test . Results : Twenty-four participants completed the programme ( n = 12 in each group ) . Based on the change in scores at three months , the exercise group had significantly greater improvements in exercise capacity ( HR : —14 [ -18.5 , -2.5 ] versus 0.5 [ -4 , 5.5 ] , P= 0.009 ) , QOL ( FAMS : 23 [ 9.5 , 42.5 ] versus -3.5 [ -16 , 5 ] , P=0.006 ) and fatigue ( MFIS : -13 [ -20 , -3 ] versus 1 [ -4 , 4.5 ] , P=0.02 ) . At six months , the difference in change scores remained significant for FAMS ( 19 [ 14 , 31 ] versus -4.5 [ -25 , 8 ] , P=0.002 ) and MFIS ( -8.5 [ -19.5 , -1 ] versus 0.5 [ -2.5 , 6.5 ] , P=0.02 ) only . Conclusions : A three-month exercise programme improved participants ' exercise capacity , QOL and fatigue , with the improvements in QOL and fatigue lasting beyond the programme
Our case study successfully enabled us to address the four feasibility metrics , and we provide new information on management feasibility ( i.e. estimate data completeness and estimate data entry ) and scientific outcomes feasibility ( i.e. determining data collection material s appropriateness ) .
Conclusion Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility .
Background Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis ( MS ) .
There is disagreement regarding the strength of this research , perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing .
We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS .