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Exercise Experts Provide Roadmap for Improving Research on Exercise and Physical Activity in MS

October 3, 2022

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.

About Multiple Sclerosis

Multiple sclerosis is an unpredictable disease of the central nervous system. Currently there is no cure. Symptoms vary from person to person and may include disabling fatigue, mobility challenges, cognitive changes, and vision issues. An estimated 1 million people live with MS in the United States. Early diagnosis and treatment are critical to minimize disability. Significant progress is being made to achieve a world free of MS.

About the National Multiple Sclerosis Society

The National MS Society, founded in 1946, is the global leader of a growing movement dedicated to creating a world free of MS. The Society funds cutting-edge research for a cure, drives change through advocacy and provides programs and services to help people affected by MS live their best lives. Connect to learn more and get involved:, Facebook, X, formerly known as Twitter, Instagram, YouTube or 1-800-344-4867.


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