Effects of exercise on fitness and cognition in progressive MS: a randomized, controlled pilot trial

Abstract

Background: Exercise may have beneficial effects on both well-being and walking ability in multiple sclerosis (MS). Exercise is shown to be neuroprotective in rodents and may also enhance cognitive function in humans. It may, therefore, be particularly useful for MS patients with pronounced neurodegeneration. Objective: To investigate the potential of standardized exercise as a therapeutic intervention for progressive MS, in a randomized-controlled pilot trial. Methods: Patients with progressive MS and moderate disability (Expanded Disability Status Scale (EDSS) of 4-6) were randomized to one of three exercise interventions (arm ergometry, rowing, bicycle ergometry) for 8-10 weeks or a waitlist control group. We analyzed the drop-out rate as a measure of feasibility. The primary endpoint of the study was aerobic fitness. Secondary endpoints were walking ability, cognitive function as measured by a neuropsychological test battery, depression and fatigue. Results: A total of 42 patients completed the trial (10.6% drop-out rate). Significant improvements were seen in aerobic fitness. In addition, exercise improved walking ability, depressive symptoms, fatigue and several domains of cognitive function. Conclusion: This study indicated that aerobic training is feasible and could be beneficial for patients with progressive MS. Larger exercise studies are needed to confirm the effect on cognition. Trial Registration: ISRCTN (trial number 76467492) http://isrctn.org

The importance of a multi-disciplinary perspective and patient activation programmes in MS management

“…Over the past decade, evidence on the beneficial effects of exercise therapy has increased and today it is more and more recommended for patients with MS. [32][33][34][35][36] The beneficial effect appears to be multi-dimensional. Aerobic capacity, 37 walking mobility 38,39 and muscular strength 40 can be improved, but also QoL, 40,41 fatigue, 40,42-44 depression 45,46 and cognition 46 can be positively influenced by exercise ( Figure 4). Besides, it might currently be the only treatment option leading to symptomatic improvement for patients with progressive MS types.…”

Exercise in the management of persons with multiple sclerosis

“…However, a more recent RCT of an aerobic exercise intervention in persons with MS reported improved cognitive function in several neuropsychological domains in subjects who received the exercise intervention, compared with a waiting list control group [Briken et al 2014]. A study using a computer/internet based intervention to increase physical activity behavior demonstrated a clinically significant increase in the Symbol Digit Modalities Test (SDMT) in a subset of subjects with mild disability at the end of the intervention while there was minimal change in this metric in a waiting list control group [Sandroff et al 2014].…”

The role of rehabilitation in multiple sclerosis—is it worth it?

“…Studies have demonstrated the efficacy of a 6-week multidisciplinary rehabilitation program for patients with progressive MS and found improvements in disability, depression, fatigue, social experience and quality of life [6,7].…”

“…Briken et al reported significant improvements in mobility, depression, fatigue, and cognitive function, and Miller et al reported significant improvements in muscle strength and anxiety [6,7].…”