STUDY: Exercise (aerobic, resistance, yoga) helps MSers a lot... but there's a catch

[ActiveMSers]

This is an interesting 2-part study. The first shows the clear benefit of exercise in MS. The second shows "the catch" that we all are certainly aware of after we start any exercise program. I've put the studies in two separate posts, so you'll want to scroll down. - Dave

Exercise in the community for people with minimal gait impairment due to MS: an assessor-blind randomized controlled trial
M Garrett1
N Hogan1
A Larkin2
J Saunders1
P Jakeman1
S Coote1
1University of Limerick, Ireland
2Multiple Sclerosis Society of Ireland, Galway, Ireland
Susan Coote, Health Sciences Building, University of Limerick, Castletroy, Limerick, Ireland.

Abstract

Background: While there is an increasing body of evidence supporting the efficacy of exercise in people with multiple sclerosis (MS), additional information on the effectiveness of combining aerobic and resistance training, and yoga is required.

Objectives: This study evaluated the effectiveness of community exercise interventions for people with MS having minimal gait impairment.

Methods: A multi-centred, block-randomised, assessor-blinded, controlled trial was conducted. Participants were randomised in groups of eight to physiotherapist (PT)-led exercise (n = 80), yoga (n = 77), fitness instructor (FI)-led exercise (n = 86) and they took part in weekly community-based group exercise sessions. Those in the control group were asked not to change of their exercise habits (n = 71). The primary outcome was the Multiple Sclerosis Impact Scale (MSIS) 29v2 physical component, measured before and after the 10-week intervention. Secondary outcomes were the MSIS 29v2 psychological component, the Modified Fatigue Impact Scale (MFIS) and the 6-Minute Walk Test (6MWT).

Results: The group x time interaction approached significance for the MSIS-29v2 physical component (f = 2.48, p = 0.061) and MFIS total (f = 2.50, p = 0.06), and it was significant for the MFIS physical subscale (f = 4.23, p = 0.006). All three exercise interventions led to a statistically significant improvement on the MSIS-29 psychological component and both the MFIS total and physical subscales, which were greater than the control (p < 0.05). Only the PT-led and FI-led interventions significantly improved the MSIS-29 physical and 6MWT to levels greater than the control (p < 0.05).

Conclusions: This study provides evidence for the positive effect of exercise on the physical impact of MS and fatigue. The group nature of the classes may have contributed to the positive effects seen on the psychological impact of MS.

[ActiveMSers]

The catch....

Exercise in the community for people with multiple sclerosis — a follow-up of people with minimal gait impairment
Maria Garrett1
Neasa Hogan1
Aidan Larkin2
Jean Saunders3
Philip Jakeman4
Susan Coote1
1Department of Clinical Therapies, University of Limerick, Ireland
2Multiple Sclerosis Society of Ireland, Ireland
3Statistical Consulting Unit, University of Limerick, Ireland
4Department of Physical Education and Sports Science, University of Limerick, Ireland
M. Garrett, Health Sciences Building, University of Limerick, Castletroy, Limerick, Ireland.

Abstract

Background: Although there are many studies evaluating exercise interventions, few studies have evaluated the effect at follow-up.
Objectives: This paper presents follow-up data for participants who completed the exercise interventions in a large randomised controlled trial.

Methods: One hundred twenty-one people with multiple sclerosis (MS) with minimal gait impairment who completed 10 weeks of community-based exercise interventions were evaluated by a blinded assessor 12 weeks after the intervention. The primary outcome measure was the Multiple Sclerosis Impact Scale-29 version 2 (MSIS-29,v2) physical component. Other outcomes were the MSIS-29 psychological component, the Modified Fatigue Impact Scale (MFIS) and the 6-minute walk test (6MWT) distance.

Results: The positive effect on the physical impact of MS was not maintained from baseline to follow-up (−1.6, 95% CI −0.8, 4.0, p=0.189). The psychological impact and the impact of fatigue remained significantly improved (−3.5, 95% CI −6.1, −1.0, p = 0.006 and −4.68, 95% CI −6.9, −2.5, p < 0.001, respectively). There was no time effect for the 6MWT (f = 1.76, p = 0.179) although the trend suggests reversal of the benefits gained from the physiotherapist (PT)- and fitness instructor (FI)-led intervention.

Conclusion: The maintained benefit on the psychological impact of MS and fatigue may have important personal and socioeconomic consequences; however, it is important to find ways to maintain the physical benefits of exercise over the long term.