Pragmatic exercise intervention in people with mild to moderate multiple sclerosis: a randomised controlled feasibility study

BACKGROUND People with Multiple Sclerosis (PwMS) are less physically active than the general population and pragmatic approaches designed to equip them with the skills and confidence to participate in long-term physical activity are required. OBJECTIVE The objective of this study was to determine the feasibility of a pragmatic exercise intervention in PwMS. METHODS A voluntary sample of 30 PwMS (male n = 4, female n = 26; mean age = 40 years; range = 24-49 years), with mild to moderate disability (EDSS ≤ 5.5), were recruited from eligible participants attending outpatient clinics. A total of 28 participants were randomised to a 10 week pragmatic exercise intervention (2× supervised and 1× home-based session per week) or usual care. Clinical, functional and quality of life (MSQoL-54) outcomes were assessed at baseline, immediately and 3 months after the intervention. RESULTS Attrition was low (2 participants lost to immediate follow-up and 4 participants lost to 3 month follow-up), with high compliance rates (>75% of all sessions). The intervention group achieved progression of exercise volume (24.3 ± 7.0 to 30.9 ± 5.5 min per session), intensity (60.4 ± 8.8 to 67.7 ± 6.9% HR max) and training impulse (min × average HR=training impulse/load [arbitrary units; AU]) (2600 ± 1105 to 3210 ± 1269AU) during the intervention, whilst significantly increasing(P = 0.050) their physical composite score (MSQOL-54) at 10 weeks and readiness to exercise (P = 0.003) at 3 months compared with usual care. CONCLUSION This pragmatic intervention was feasible for PwMS, but further research is needed to assess its long-term impact on physical activity behaviour.