Exercise for Multiple Sclerosis

Overseen By Cameron Mang, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Regina

Disqualifiers: High physical activity, Seizure history, Other neurological conditions, Relapse, Psychiatric diagnosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 36

Duration: 12 weeks

69 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different types of exercise can benefit people with multiple sclerosis (MS) by examining physical and brain function. Participants will join groups focusing on mobility and balance, physical fitness, or flexibility and muscle tone. The study aims to determine which exercise type best manages MS symptoms. Individuals with a progressive form of MS, who have received medical clearance to exercise and face moderate motor challenges, might be suitable for this trial. As an unphased study, this trial provides a unique opportunity to contribute to understanding how exercise can enhance life with MS.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these exercise protocols are safe for people with multiple sclerosis?

Research shows that exercise is generally safe for people with multiple sclerosis (MS). Studies have found that exercising does not lead to more relapses or serious side effects compared to not exercising. Most people with MS can safely include exercise in their routine. However, exercise should not be too intense. Regular, moderate exercise can help manage MS symptoms and improve overall health. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these exercise treatments for multiple sclerosis (MS) because they offer a non-pharmaceutical approach to managing the condition. Traditional treatments for MS often involve medications like interferons or monoclonal antibodies, which can come with significant side effects. In contrast, these exercise interventions focus on different aspects such as mobility, balance, physical fitness, and flexibility. This holistic approach could enhance overall quality of life for MS patients by improving physical capabilities without the need for medication. By targeting these specific areas, researchers hope to discover effective ways to manage MS symptoms naturally.

What evidence suggests that this trial's exercise protocols could be effective for managing multiple sclerosis?

Research has shown that exercise can greatly benefit people with multiple sclerosis (MS). Studies have found that exercise improves balance, walking, and stamina in those with MS. It also helps reduce fatigue and depression, making daily tasks easier and enhancing overall quality of life. Exercise is associated with better physical and mental functions, which MS often affects. This trial will compare different exercise interventions: one focusing on mobility and balance, another on physical fitness, and a third on flexibility, range of motion, and muscle tone. While different exercises may have varying effects, the overall evidence strongly supports exercise as an effective way to manage MS symptoms. ^{3 4 6 7 8}

Who Is on the Research Team?

Cameron Mang, PhD

Principal Investigator

University of Regina

Are You a Good Fit for This Trial?

This trial is for people with progressive multiple sclerosis (MS) who have moderate motor disability and can safely exercise. They should not be highly active already, haven't had an MS relapse in the last three months, and don't have other neurological conditions, psychiatric diagnoses or substance abuse issues.

Inclusion Criteria

My condition is progressive MS, diagnosed by a neurologist.

Physician clearance for exercise

I have moderate difficulty moving around due to my condition.

Exclusion Criteria

Baseline score >24 on the Godin-Shephard Leisure Time Physical Activity Questionnaire (i.e., high physical activity levels)

I have never had a seizure or other reasons I can't have TMS.

Substance abuse

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in one of three distinct exercise programs focusing on mobility, fitness, or flexibility, delivered three times per week in 60-minute group sessions

12 weeks

36 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments conducted immediately before, after, and six weeks following completion of the exercise programs

6 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Exercise

Trial Overview

The study is testing how different types of exercises affect physical function, fitness, and central nervous system changes in individuals with MS. Participants will be assigned to one of three distinct exercise protocols to see which has the most beneficial effects.

How Is the Trial Designed?

Group I: Exercise Group 1 Experimental Treatment 1 Intervention

The intervention will focus on mobility and balance.

Group II: Exercise Group 2 Active Control 1 Intervention

This intervention will focus on physical fitness.

Group III: Exercise Group 3 Placebo Group 1 Intervention

This intervention will focus on flexibility, range of motion, and muscle tone.

Who Is Running the Clinical Trial?

University of Regina

Lead Sponsor

Trials

59

Recruited

9,100+

First Steps Wellness Centre

Collaborator

Trials

1

Recruited

70+

Saskatchewan Health Research Foundation

Collaborator

Trials

33

Recruited

5,100+

University of Saskatchewan

Collaborator

Trials

261

Recruited

156,000+

Published Research Related to This Trial

Exercise and physical activity have been shown to provide various benefits for individuals with multiple sclerosis (MS), including improvements in immune function, brain health, walking ability, cognitive performance, fatigue, depression, pain, and overall quality of life.

Despite the positive effects, there is significant variability in the outcomes of exercise interventions for MS, highlighting the need for better-designed studies and a focus on challenges in implementing effective exercise programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lessons learned from clinical trials of exercise and physical activity in people with MS - guidance for improving the quality of future research. Motl, RW., Fernhall, B., McCully, KK., et al.[2022]

A 10-week exercise program combined with Social Cognitive Theory (SCT) education showed improvements in anxiety, depression, cognition, and the physical impact of multiple sclerosis (MS) for participants in the SCT group, while no significant differences were found between the SCT and attention control groups overall.

Both groups experienced significant improvements in fatigue, strength, and physical activity, which were maintained for 3 to 6 months after the program, indicating that following exercise guidelines can have lasting benefits for individuals with MS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of exercising at minimum recommendations of the multiple sclerosis exercise guideline combined with structured education or attention control education - secondary results of the step it up randomised controlled trial. Coote, S., Uszynski, M., Herring, MP., et al.[2018]

Exercise is a safe and well-tolerated intervention that can effectively improve modifiable impairments in individuals with multiple sclerosis (MS).

Properly prescribed exercise programs, following general guidelines, can enhance the management of MS, particularly for those with more severe symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise in multiple sclerosis. Sandoval, AE.[2022]

High-intensity resistance training significantly reduced levels of the pro-inflammatory cytokine tumor necrosis factor in patients with relapsing-remitting multiple sclerosis, suggesting a positive impact on immune function.

Participants experienced clinically meaningful improvements in fatigue, health-related quality of life, mood, muscle strength, walking speed, and cognition after 12 weeks of training, indicating that this exercise regimen is both effective and well-tolerated.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-intensity resistance training in multiple sclerosis - An exploratory study of effects on immune markers in blood and cerebrospinal fluid, and on mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Kierkegaard, M., Lundberg, IE., Olsson, T., et al.[2022]

Recent studies indicate that physical exercise programs are safe and effective for improving various physiological functions in patients with multiple sclerosis (MS).

Implementing exercise in rehabilitation strategies can lead to functional improvements that positively impact the daily lives of MS patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Exercise and MS Recommendations. Dalgas, U., Ingemann-Hansen, T., Stenager, E.[2022]

Physical activity has been shown to counteract depression and fatigue in patients with multiple sclerosis (MS), potentially improving their overall quality of life.

Exercise may have an immunomodulatory effect in MS, as it influences the immune system and promotes the release of neurotrophic factors, which could help reduce functional impairment in these patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Multiple sclerosis and exercise : effects of physical activity on the immune system]. Waschbisch, A., Tallner, A., Pfeifer, K., et al.[2021]

Exercise therapy is a safe and effective nonpharmacological treatment for people with multiple sclerosis (MS), showing improvements in physical function without increasing the risk of relapses.

In addition to enhancing physical capabilities, exercise therapy positively impacts brain health, leading to improvements in brain volume and cognitive function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise therapy in multiple sclerosis and its effects on function and the brain. Dalgas, U.[2018]

A six-week resistance training program using bodyweight exercises significantly improved physical fitness in 36 patients with multiple sclerosis, suggesting that strength training can be beneficial for MS sufferers.

This study highlights the importance of incorporating muscular strength development into rehabilitation programs for MS, which have traditionally focused more on aerobic exercises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a resistance training program in multiple sclerosis Spanish patients: a pilot study. Ayán Pérez, C., Martín Sánchez, V., De Souza Teixeira, F., et al.[2019]

A systematic review of 26 randomized controlled trials involving 1295 participants found that exercise training in individuals with multiple sclerosis (MS) did not increase the risk of relapse, with a relapse rate of 4.6% for exercise compared to 6.3% for control.

The study also reported that the rate of adverse events (AEs) was similar between exercise (2.0%) and control (1.2%) groups, indicating that exercise training is generally safe and does not pose a higher risk of AEs compared to healthy populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The safety of exercise training in multiple sclerosis: a systematic review. Pilutti, LA., Platta, ME., Motl, RW., et al.[2022]

A systematic review of 40 randomized controlled trials involving 1780 participants found that exercise training does not increase the risk of clinical relapse or adverse events in individuals with multiple sclerosis, suggesting it is a safe intervention.

The analysis showed no significant differences in the rates of relapse, adverse events, or serious adverse events between exercise training and non-exercise groups, supporting the promotion of exercise as a beneficial activity for people with MS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety of exercise training in multiple sclerosis: An updated systematic review and meta-analysis. Learmonth, YC., P Herring, M., Russell, DI., et al.[2023]

Exercise has been shown to provide significant benefits for individuals with multiple sclerosis (MS), improving both physical function and quality of life, as supported by recent meta-analyses and literature reviews.

The chapter emphasizes that exercise is safe for people with MS, and it provides guidelines for how to effectively prescribe exercise to maximize these benefits while ensuring safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise and Multiple Sclerosis. Motl, RW.[2020]

A systematic review of 20 randomized controlled trials involving exercise training in individuals with multiple sclerosis showed that exercise significantly improves muscular fitness (small effect size of 0.27) and cardiorespiratory fitness (moderate effect size of 0.47).

The results indicate that while exercise training leads to beneficial changes in fitness levels for people with MS, the improvements in muscular fitness are smaller compared to those in cardiorespiratory fitness, highlighting the importance of exercise in rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Exercise Training on Fitness in Multiple Sclerosis: A Meta-Analysis. Platta, ME., Ensari, I., Motl, RW., et al.[2022]

Exercise training is now widely recommended for managing multiple sclerosis (MS), reflecting over 25 years of research supporting its benefits for individuals with the condition.

The paper highlights eight emerging research areas, such as behavior change interventions and telerehabilitation, that could enhance the effectiveness and implementation of exercise in clinical practice for MS patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Current perspectives on exercise training in the management of multiple sclerosis. Motl, RW., Sandroff, BM.[2021]

Citations

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Safety of exercise training in multiple sclerosis - PubMed Central

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Exercise and multiple sclerosis

People with MS can exercise, with benefits outweighing challenges. At least 30 minutes of activity 5 days a week is recommended, but avoid aggressive exercise. ...