Table e-1 – Rehabilitation and Exercise Studies in MS Intervention target Intervention Outcome Study Design Balance Aerobic training1 Improving symptoms and QoL Randomized, controlled study Balance Balance rehabilitation for motor and sensory strategies2 Reduced fall rate and improved balance Randomized, controlled trial Balance Balance exercise program3 Reduced falls and improved balance Multicenter, single-group, pretest-posttest trial Balance, cognition, fatigue, depression, walking, QoL Exercise Training4 Exercise can yield improvements in walking, balance, cognition, fatigue, depression, QoL Literature review and meta-analyses Fatigue and balance Vestibular rehabilitation5 Clinically relevant changes in fatigue and balance Randomized, controlled trial Fatigue and mobility Treadmill training6 Walking speed and endurance increased. No significant change in fatigue. Prospective, randomized, controlled trial Fatigue Fatigue management plus physical activity intervention7 Novel, multidisciplinary effort to combine fatigue management and physical activity promotion Randomized, controlled trial Fatigue Endurance exercise8 Maximal walking distance improved. Randomized, controlled trial Fatigue Aerobic training9 Maximum exercise tolerance and walking capacity improved. Randomized, crossover controlled study Intervention target Intervention Outcome Design Fatigue, mood Aerobic training10 Improved upper- and lower-extremity strength, reduced depression and anger scores, improved fitness and QoL. Randomized, controlled Fatigue, function and participation Multidisciplinary rehabilitation and Rehabilitation improves function and participation Systematic review
fatigue management courses11 Fatigue Review of 38 studies of variety of exercise and behavioral change interventions12 Exercise and behavior change interventions are effective in managing MS fatigue Literature review Fatigue, impairment, disability and QoL Resistance-, endurance-, and combined training13 Beneficial effects and improved QoL Literature review Impairment, disability and QoL Varied exercise protocols14 Helpful in managing symptoms, preventing complications and comorbidities, and may have neuroprotective effects. Literature review Impairment, disability and QoL Inpatient physical rehabilitation15 Improved functional independence, disability and QoL Randomized, controlled trial Disability and QoL Robot-assisted and conventional treadmill training (BWSTT)16 Both types of BWSTT may improve QoL and decrease overall disability. Randomized, controlled trial Cognitive dysfunction Cognitive rehabilitation intervention17 Promising for improving cognitive function Randomized, controlled trial Intervention target Intervention Outcome Study Design Cognitive dysfunction Treadmill walking, cycle ergometer, guided yoga18 Treadmill walking has a beneficial effect on executive function Randomized, controlled trial Cognitive dysfunction Cognitive retraining treatment strategies19 Improves day-to-day performance Review article Cognitive dysfunction Exercise intervention programs. Includes review of 12 controlled clinical trials20 Significant improvements in cognition were found in 9 of 12 studies. Systematic review and meta-analysis Depression Cognitive behavioral therapy (CBT)21 Face-to-face CBT is feasible for use in decreasing depressive symptoms Single-group pilot feasibility study
Mood Treadmill walking22 Moderate-intensity walking may help with mood management Randomized, and counter-balanced Mood Walking exercise, yoga23 Walking and yoga show improvement in mood symptoms Randomized, controlled trial Muscular and cardiorespiratory fitness Exercise training24 Exercise training is associated with improvements in muscular and cardiorespiratory fitness changes Meta-analysis of randomized controlled trials Benefits and safety of exercise Prescription of exercise25 Summary of benefits and safety Literature reviews and meta-analyses Safety of exercise Exercise training26 Exercise training was not associated with increased risk of relapse or increased risk of adverse events Systematic review of relapse and other adverse events in randomized controlled trials Intervention target Intervention Outcome Study Design Outcome measures Outcome measures used by physical therapist in studies of patients with MS27 The Multiple Sclerosis Task Force of the APTA offers a summary of standardized measures used in MS. Systematic literature review Fall risk Home-based exercise program, education program, and combined program28 Fall risk scores were lower in the exercise group. Randomized, controlled trial Fall risk and mobility impairments Rehabilitation and fall prevention29 9 of 10 investigations report reduction in falls after rehab intervention. Improved balance also noted. Literature review Walking ability Exercise training30 Exercise improves walking speed and endurance Meta-analysis of randomized, controlled trials trial.