Randomized controlled trial of a remotely-delivered exercise training program in older adults with multiple sclerosis: Secondary effects on cognition, symptoms, and quality of life.

BACKGROUND

Older adults with multiple sclerosis (MS) experience co-occurring effects of aging and disease progression, resulting in worsening cognition, symptoms, and quality of life (QOL). There is limited research examining approaches for improving those outcomes in older adults with MS.

OBJECTIVES

We examined the efficacy of a 16-week home-based exercise training program for improving secondary study outcomes of cognition, symptoms, and QOL in older adults with MS.

METHODS

This phase-Ib, randomized controlled trial (RCT) included 51 participants (60.5±6.6 years, 78% females) who were randomized into exercise training (aerobic and resistance) or active control (stretching) conditions. Participants completed laboratory assessments before and after the 16-week programs. Cognitive function was measured using the NIH Toolbox Cognitive Battery. Symptoms of fatigue, depression, anxiety, and pain were assessed using the Fatigue Severity Scale, Modified Fatigue Impact Scale, Hospital Anxiety and Depression Scale, and Short-form McGill Pain Questionnaire, respectively. QOL was measured by the 29-item Multiple Sclerosis Impact Scale and the 36-Item Short Form Health Survey.

RESULTS

Forty-one participants (80.4 %) completed the conditions, with outcome data obtained from 20 exercise and 16 control participants. There were statistically significant improvements in executive function, processing speed, fatigue, and health-related QOL in the exercise group (p < 0.05, d = 0.48-0.66). No significant changes were observed in the control group (p>0.05).

CONCLUSIONS

We provide preliminary evidence on the benefits of exercise training for improving cognition, reducing fatigue impact, and enhancing QOL in older adults with MS who had moderate disability.