Internet-Supported Physical Exercise Training for Persons with Multiple Sclerosis—A Randomised, Controlled Study

Abstract

Physical exercise is effective in improving functional outcomes in persons with multiple sclerosis (pwMS). We evaluated the feasibility and effectiveness of internet-based exercise training (e-training) for pwMS on health-related quality of life (HrQoL). Secondary outcomes were muscle strength, aerobic capacity, lung function, physical activity, and fatigue. This is a randomised, controlled trial with a wait-list control group. Data were collected at baseline, after three and six months, and analysed using a hybrid linear model. One-hundred twenty-six pwMS participated in the home-based aerobic (1×/week) and strength training (2×/week) intervention that was supervised and documented via an internet-platform. The intervention group received e-training for six months, and the control group received e-training after a three months waiting period. Significant differences between the groups were only observed for muscle strength (knee flexion (effect size ES = 0.3, p = 0.003), knee extension (ES = 0.24, p = 0.015)), peak expiratory flow (ES = 0.2, p = 0.039), and sports activity (ES = 0.33, p = 0.001) after three months. E-training had no effect on HrQoL but did on muscle strength, lung function, and physical activity. It is a promising and feasible approach to facilitate large-scale, yet individual, training support.

Calling Out MS Fatigue: Feasibility and Preliminary Effects of a Pilot Randomized Telephone-Delivered Exercise Intervention for Multiple Sclerosis Fatigue

“…35,36 To our knowledge, this is the first telephone-delivered exercise program for persons with MS. Other telemedicine approaches have been utilized; the protocols for exercises delivered, including frequency, intensity, type of exercise, or tracking confirmation of performed exercises, were heterogeneous. A 12-week study with the Internet delivery of content recommending 2 times per week of strength training and 1 time per week of endurance training targeting health-related quality of life resulted in improved fatigue 37 but included individuals who were both fatigued and not fatigued. Similarly, a 12-week smartphone-delivered program targeting physical activity in persons with MS fatigue resulted in improved fatigue severity 38 but only reminded participants to stay active and did not specifically recommend exercises or guidelines.…”

“…The only difference was the method of delivery (Table 1). Furthermore, this study was not limited to persons with relapsing-remitting MS, 37,38 those taking a particular disease-modifying therapy, 38 and those with a score of less than 4 on Expanded Disability Status Scale, 37,38 as was common in other telemedicine studies. Finally, prior studies using telemedicine approaches have utilized only survey measures of fatigue, measured at a single time point pre-and postintervention.…”

Improving fatigue in multiple sclerosis by smartphone-supported energy management: The MS TeleCoach feasibility study

“…Indeed, appreciation of the MS TeleCoach by its users was confirmed by a post-study evaluation of patient satisfaction in a subset of study completers. As a comparison, a teleconference-delivered fatigue management program for pwMS (Finlayson et al, 2011) reported more than 90% of completers and an internet-supported physical exercise training for pwMS (Tallner et al, 2016) had a completer rate of 61%. With 76% completers, our study had an intermediate percentage of completers.…”

Adherence to Physiotherapy-Guided Web-Based Exercise for Persons with Moderate-to-Severe Multiple Sclerosis

“…describe objective activity levels with accelerometer data. [21][22][23][24] A focus on activity levels may be appropriate for people with mild-to-moderate MS. For people with more advanced disability and in the absence of clear exercise guidelines for those with more advanced MS, it would seem appropriate to first consider participation adherence (i.e., is the person safely participating in regular exercise? ).…”