Feasibility of remotely delivered and supported aerobic walking exercise training for cognitive processing speed impairment in fully-ambulatory persons with multiple sclerosis
•Aerobic exercise is a promising approach for treating impaired cognition in MS.•Supervised exercise presents travel barriers for cognitively-impaired MS patients.•This trial involved home-based aerobic walking for impaired cognition in MS.•The trial was safe, acceptable, and feasible in cognitively...
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Veröffentlicht in: | Multiple sclerosis and related disorders 2023-06, Vol.74, p.104709-104709, Article 104709 |
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Zusammenfassung: | •Aerobic exercise is a promising approach for treating impaired cognition in MS.•Supervised exercise presents travel barriers for cognitively-impaired MS patients.•This trial involved home-based aerobic walking for impaired cognition in MS.•The trial was safe, acceptable, and feasible in cognitively-impaired patients.•Exercise was associated with improved cognition relative to control.
The current pilot, single-blind, randomized controlled trial (RCT) examined the feasibility of remotely-delivered and supported aerobic walking exercise training compared with an active control condition on cognitive processing speed (CPS) in 19 fully-ambulatory persons with multiple sclerosis (pwMS) who were pre-screened for impaired CPS.
Feasibility was assessed in the domains of process (e.g., recruitment), resource (e.g., monetary costs), management (e.g., time requirements), and scientific outcomes (i.e., treatment effect). Fully-ambulatory, but CPS-impaired pwMS were randomly assigned into either 16-weeks of home-based aerobic walking exercise or home-based stretching and range-of-motion activities. Both conditions involved delivery of informational newsletters and one-on-one, online video chats with a behavior coach. Participants across both conditions tracked their activity using highly accurate wearable motion sensors. Treatment-blinded assessors administered the Symbol Digit Modalities Test (SDMT) remotely before and after the 16-week study period.
The study was cost-effective, accessible, and acceptable. The intervention further was safe. Adherence and compliance rates across both conditions exceeded 80%. There was an overall moderate effect for change in SDMT score between the conditions (d = 0.42). The intervention was associated with a 4.8-point improvement in SDMT scores (d = 0.70; 10% increase) compared with a 1-point improvement for the control condition (d = 0.09; 2% increase).
This remotely-delivered and supported aerobic walking exercise training intervention was safe and feasible for fully-ambulatory, CPS-impaired pwMS. The pattern of results, including the promising effects on CPS, support the design and implementation of an appropriately-powered RCT on this approach for managing CPS impairment in a large MS sample. |
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ISSN: | 2211-0348 2211-0356 |
DOI: | 10.1016/j.msard.2023.104709 |