Impact of a Home-Based Exercise Intervention on Fitness and Walking Outcomes in Persons with Multiple Sclerosis: Preliminary Results

Background: Previous research has examined the effect of exercise training interventions on aerobic fitness and mobility disability in persons with multiple sclerosis (MS). Of note, supervised exercise training in a center has improved aerobic fitness and walking outcomes, whereas unsupervised, home-based exercise programs have not yielded the same effect. Such home-based programs may have suffered from poor compliance with the exercise prescription. This may undermine the potential value of exercise for large numbers of persons with MS who cannot undertake supervised, center-based exercise programs. Accordingly, home-based exercise programs that adopt strategies for maximizing compliance might present a novel and efficacious approach for improving aerobic fitness and walking outcomes.

Objectives: We investigated the effects of a novel, home-based exercise intervention on aerobic fitness (i.e., VO_2peak) and walking mobility (i.e., Timed 25-Foot Walk (T25FW) and Six-Minute Walk (6MW)) in persons with MS.

Methods: 20 persons with MS (age of 45±10.1 years, BMI of 25.9±5 kg/m², & 15 females) who had mild disability (mdn EDSS score=3.0) were randomly assigned into aerobic exercise (i.e., cycle ergometry) or attention-control (stretching along with minimal muscle strengthening stimuli) conditions. Both conditions provided standardized exercise programs delivered over a 12-week period and undertaken in the participants’ homes. Participants in both groups further engaged in weekly, one-on-one video chats with a behavioral coach for maximizing compliance. The exercise group performed three days/week of cycle ergometry, initially for 10 minutes/day at 40% VO_2peak and progressing to 30 minutes/day at 60%VO_2peak. The attention-control group performed three days/week of stretching exercises, beginning with one set of five different stretches and progressing to two sets of 10 stretches. Aerobic fitness (i.e., VO_2peak) was assessed using a maximal, incremental exercise test on a cycle ergometer, and walking mobility was assessed using T25FW and 6MW before and after the 12-week period.

Results: There were significant improvements in VO_2peak, T25FW, and 6MW favoring the aerobic exercise condition compared with the attention-control condition. The effect sizes were d=0.39, 0.65, and 0.48 for VO_2peak, T25FW, and 6MW, respectively. 

Conclusions: These preliminary data suggest that a home-based aerobic exercise intervention that maximizes compliance can be effective for increasing aerobic fitness and walking mobility in persons with MS.