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The benefits of exercise and physical activity for people with MS are becoming more apparent. So what stands in the way of exercise and physical activity becoming part of how healthcare providers provide advice to people for managing their MS? Members of the National MS Society Wellness Research Work Group explored this issue and have published recommendations to move the field of MS rehabilitation research forward.

• Background: Physical activity and exercise have been shown to be beneficial to people with MS and are behaviors that contribute to wellness. Research in this area has increased and has shown benefits on immune and nervous system factors, brain structure and function, walking, cognitive performance, fatigue, depression, pain, and quality of life.
• However, many of these trials have been limited in terms of quality, by generally involving small numbers of people and not considering all the factors affecting study outcomes. Healthcare providers and insurers need solid research results and more complete details about these approaches to better integrate recommendations for specific exercise and physical activities as a part of routine care.
• This Paper: Members of the National MS Society Wellness Research Work Group, along with additional experts in exercise and MS, identified the challenges and logistical difficulties of designing and conducting trials of exercise and physical activity in people with MS. They have now published lessons learned and solutions for overcoming these difficulties, as a resource for researchers in the field.
• Here are some issues pinpointed and solutions that the group suggests:
  • Is the research measuring exercise or physical activity? These words are not interchangeable. Researchers should assess them differently, for example, testing exercise training programs using muscle strength and physical activity programs using step counts.
  • What specific factors contribute to the success or failure of a training program? Investigators should use control groups, for example, to determine whether social contact of gathering together for a program influences the outcomes of a program. They should also be careful to examine how participants’ coexisting comorbidities such as high blood pressure or depression may influence outcomes of training programs.
  • Will this work at home? Rehab researchers should keep this question in mind from the start. If they are doing a walking study using a treadmill, how will it translate to walking over ground at home?
  • Most exercise/physical activity studies do not report on safety. Researchers should create a plan for monitoring for safety issues and reporting on them, even if they seem unrelated to the training program.
  • Rehab research lacks diversity in race, ethnicity, age, level of disability, and disease type. Investigators should develop inclusive recruitment plans based on the broad demographics of people who live with MS.

“We want this paper to serve as a roadmap for guiding new researchers, and people who are new to the field of MS rehabilitation research,” noted Kathy M. Zackowski, PhD, OTR, Associate Vice President, Research, at the National MS Society and co-author. “A stronger body of research can lead to exercise and physical activity training programs becoming one pathway to cures for people with MS.”
 
Learn more…
See the exercise and physical activity recommendations this group developed for ALL people with MS
 
“Lessons learned from clinical trials of exercise and physical activity in people with MS – guidance for improving the quality of future research” by Drs. Robert W. Motl,  Bo Fernhall, Kevin K. McCully, Alexander Ng, Mathew Plow, Lara A. Pilutti, Brian M. Sandroff, and Kathleen M. Zackowski is published in MS and Related Disorders 2022 Aug 5;68:104088. This paper is available to read free of charge via Open Access.