Moving exercise research in multiple sclerosis forward (the MoXFo initiative): Developing consensus statements for research

Abstract

Exercise as a subset of physical activity is a cornerstone in the management of multiple sclerosis (MS) based on its pleotropic effects. There is an exponential increase in the quantity of research on exercise in MS, yet a number of barriers associated with study content and quality hamper rapid progress in the field. To address these barriers and accelerate discovery, a new international partnership of MS-related experts in exercise has emerged with the goal of advancing the research agenda. As a first step, the expert panel met in May 2018 and identified the most urgent areas for moving the field forward, and discussed the framework for such a process. This led to identification of five themes, namely “Definitions and terminology,” “Study methodology,” “Reporting and outcomes,” “Adherence to exercise,” and “Mechanisms of action.” Based on the identified themes, five expert groups have been formed, that will further (a) outline the challenges per theme and (b) provide recommendations for moving forward. We aim to involve and collaborate with people with MS/MS organizations (e.g. Multiple Sclerosis International Federation (MSIF) and European Multiple Sclerosis Platform (EMSP)) in all of these five themes. The generation of this thematic framework with multi-expert perspectives can bolster the quality and scope of exercise studies in MS that may ultimately improve the daily lives of people with MS.

Real-World Goal Setting and Use of Outcome Measures According to the International Classification of Functioning, Disability and Health: A European Survey of Physical Therapy Practice in Multiple Sclerosis

“…Firstly, in the narrative review [ 2 ], drawbacks in current practice and research were defined, one of them being the non-systematic use of many different measures, making it difficult to directly compare the effectiveness of interventions. Secondly, several teams of specialists have tried to develop a core set of clinical functional assessments for MS rehabilitation [ 31 , 32 ], others are working on gaining a consensus to harmonize both assessments and interventions [ 33 ], but still without clear recommendations. Resources, such as the Rehabilitation Measures Database ( ), which details operational instructions and the psychometric properties of many outcome measures, is helpful for facilitating the use of outcome measures in clinical practice and for designing research.…”

ASPIRE trial: study protocol for a double-blind randomised controlled trial of aspirin for overheating during exercise in multiple sclerosis

“…We also plan to publish our findings in peer-reviewed, high-impact journals and aim to encourage other research groups to investigate clinically relevant questions using rigorous experimental designs (see eg, Dalgas et al for a cogent discussion on how to bolster the quality and scope of exercise studies in MS). 48 Positive results will also be shared with medical caregivers, especially MS clinical practitioners. Furthermore, our MS centre at CUIMC distributes a biannual newsletter for patients that reports current research opportunities and highlights published study results to create a 360° feedback loop and acknowledge the essential role of patients in the success of our research.…”

Guest Editorial

“…Also, we now notice strong initiatives such as the IMSFPRN (International MS Falls Prevention Research Network) and MoXFo (Moving Exercise Research in MS Forward) as a result of the frequent encounters within the network. 5,6 Although the organization is based in Europe, RIMS is open to health care professionals and researchers from all over the world and hopes to advocate-and empower advocates, clinicians, and researchers-in different fields worldwide. The organization has therefore been in dialogue and partnerships with international society partners, such as ECTRIMS Projects were performed, sometimes voluntarily with an institution's own resources, sometimes with support of the small but motivational RIMS grant program, or…”