Effect of Home‐Based Aerobic Exercise Training on Quality of Life in Multiple Sclerosis

Abstract

IntroductionMultiple sclerosis (MS) is an immune‐mediated autoimmune disease of the central nervous system that results in compromised quality of life (QOL) when compared with non‐disease adults and adults with other chronic, disease conditions. Depression and anxiety represent common determinants of QOL in MS. There is evidence that supervised, aerobic training can improve QOL and depression in MS, but there is little known about home‐based exercise training programs and these outcomes. The focus on home‐based exercise is important, as many individuals with MS perceive accessibility and acceptability of center‐based exercise programs as major barriers of participation.PurposeTo examine the effect of home‐based, aerobic exercise training compared with attention control on QOL in MS.MethodsParticipants with a definite diagnosis of MS were randomly assigned to two groups: exercise (N = 23, 48±12 yrs) and stretching (attention control N=21, 43±13 yrs). Both interventions included 3 days a week of training for 12 weeks with increasing duration and intensity. Both groups had one‐on‐one weekly video chat sessions with an experienced exercise coach designed for maximizing compliance with the prescription using behavioral change principles. Participants completed the Multiple Sclerosis Impact Scale (MSIS‐29) and Hospital Anxiety and Depression Scale (HADS) before and after the 12 week period. Aerobic capacity (VO2peak) was further measured on a cycle ergometer.ResultsThe overall MSIS‐29 score decreased for the exercisers, with no change in the controls; this change was driven by the mental component of the MSIS‐29. There was no difference in HADS score. The average anxiety scores from both groups, pre and post intervention, fell within clinical case range (score 11–21), and the average depression score for both groups are classified as normal (Score 0–7), while the post‐intervention exercisers scores are classified as borderline cases (score 8–10). VO2peak increased in the exercise group, with no change in the stretching group (Table 1).ConclusionOur home‐based exercise intervention yielded an impact on quality of life and VO2peak in our MS cohort. These findings can be applied to independence in MS patients; an increase in the quality of life with regular exercise will aid overall fitness and outlook, which may reinforce leading an active life style.Support or Funding InformationThis project was supported by the National Multiple Sclerosis Society RG 4702A1/2. Data presented: Mean ± SD. Stretchers (N= 21) Exercise (N=23) Pre‐Intervention Post‐Intervention Pre‐Intervention Post‐Intervention MSIS* 58.2±18.3 59.4±19.3 66.7±25.2 54.7±24.1 MSIS Physical Comp 37.6+3.2 37.5+2.9 42.9+2.9 37.8+2.7 MSIS Mental Coup* 20.6±1.9 21.9±1.8 22.9±1.7 19.0±1.6 HADS Anxiety 14.3±3.9 13.5±2.7 13.2±3.2 13.7±2.9 HADS Depression 5.3±3.8 6.9±2.7 6.7±3.1 7.7±32 VO2peak* (ml/kg/min) 22.58+4.79 21.94+4.86 19.40+4.33 20.95+5.25 Peak Power (Watts) 116±7.1 114.2±7.2 112.3±6.7 116±6.7 (p<0.05), Interaction‐‐‐‐‐‐‐‐‐‐‐‐‐_(Time*Group)