Exercise Effects on Multiple Sclerosis Quality of Life and Clinical–Motor Symptoms

Abstract

Introduction Different therapies can improve clinical and motor symptoms of multiple sclerosis (MS) similarly, but studies comparing the effects of different exercise therapies on clinical and motor outcomes are scant. We compared the effects of exergaming (EXE), balance (BAL), cycling (CYC), proprioceptive neuromuscular facilitation (PNF), and a standard care wait-listed control group (CON) on clinical and motor symptoms and quality of life (QoL) in people with MS (PwMS). Methods PwMS (n = 68, 90% female; age, 47.0 yr; Expanded Disability Status Scale score 5–6) were randomized into five groups. Before and after the interventions (five times a week for 5 wk), PwMS were tested for MS-related clinical and motor symptoms (Multiple Sclerosis Impact Scale-29 (MSIS-29), primary outcome), QoL (EuroQol Five Dimensions Questionnaire), symptoms of depression, gait and balance ability (Tinetti Assessment Tool), static and dynamic balance and fall risk (Berg Balance Scale), walking capacity (6-min walk test), and standing posturography on a force platform. Results EXE, BAL, and CYC improved the MSIS-29 scores similarly. EXE and CYC improved QoL and walking capacity similarly but more than BAL. Only EXE improved gait and balance scores (Tinetti Assessment Tool). EXE and BAL improved fall risk and standing balance similarly but more than CYC. PNF and CON revealed no changes. The EuroQol Five Dimensions Questionnaire moderated the exercise effects on the MSIS-29 scores only in EXE. Changes in QoL and changes in the MSIS-29 scores correlated (R 2 = 0.73) only in EXE. Conclusion In conclusion, BAL and CYC but EXE in particular, but not PNF, can improve clinical and motor symptoms and QoL in PwMS (Expanded Disability Status Scale score 5 to 6), expanding the evidence-based exercise options to reduce mobility limitations in PwMS.

Effects of Exercise Dose and Detraining Duration on Mobility at Late Midlife: A Randomized Clinical Trial

“…Because exercise duration was the dosing factor in the intervention, which was delivered at a high intensity (rate of perceived exertion can reach ∼16 of 20 [17, 18]), we set the 6-minute walk test (6MWT) as the primary outcome. The 6MWT is a reliable and valid measure of walking capacity that is sensitive to change [19].…”

Is Aerobic or Resistance Training the Most Effective Exercise Modality for Improving Lower Extremity Physical Function and Perceived Fatigue in People With Multiple Sclerosis? A Systematic Review and Meta-analysis

“…As seen in table 1, Expanded disability status scale (EDSS) ranged from 1.5-7 while disease duration ranged from 2.7-18.6 years. The duration of AT interventions ranged from 3-26 weeks (involving 9-48 sessions) with the intensity being deemed moderate (n=5) [43][44][45][46][47] , high (n=4) 26,[48][49][50] , or unknown (no information, n=5) 25,[51][52][53][54] . The duration of RT interventions ranged from 8-24 weeks (involving 15-48 sessions) with the intensity being deemed moderate (n=1) 55 , high (n=4) 28,[56][57][58] , or unknown (no information, n=3) 40,59,60 .…”

“…Two 25,60 of the 22 identified RCTs reported a primary outcome that was not based on a sample size calculation. Ten papers 26,28,44,[48][49][50]52,54,55,57 of the 22 identified RCTs reported a primary outcome based on a sample size calculation, with five of these having a primary outcome aligned with the purpose of the present systematic review.…”

“…Five 44,[48][49][50]52 out of the seven 25,43,44,[48][49][50]52 studies investigating performance on a long walking test used this test. The meta-analysis showed an overall moderate effect of AT on the performance during long walking tests, ES=0.37 [-0.04: 0.78], p=0.026, I 2 =43% (Figure 4).…”

“…Of the seven studies 25,43,44,[48][49][50]52 investigating the effect of AT on the long walk tests, three of these 25,43,49 had a large ES. Yet, the meta-analysis showed an overall moderate ES of AT on this outcome (ES=0.37, [-0.04; 0.78]), that appeared quite certain based on CIs.…”