Remote Exercise Training for Multiple Sclerosis

(FERLAMS Trial)

Overseen By Robert Motl, Ph.D

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Illinois at Chicago

Disqualifiers: Age, MS diagnosis, Physical activity, others

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

Compensation: Varies

Number of Visits: Unknown

50 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial investigates a home-based exercise program for Hispanics/Latinos with multiple sclerosis (MS). The program includes flexibility, aerobic, and resistance exercises guided by experienced coaches. It aims to improve physical function, manage symptoms, and enhance quality of life for this underserved group. The study also examines how factors like income and access to healthcare affect the program's success.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on exercise training for people with multiple sclerosis.

What data supports the effectiveness of the treatment Remote Exercise Training for Multiple Sclerosis?

Research shows that exercise training is beneficial for people with multiple sclerosis (MS), improving various physical functions and enhancing daily life. Although most studies focus on those with mild-to-moderate disability, exercise is generally considered safe and effective for managing MS symptoms. ^{1 2 3 4 5}

Is exercise training safe for people with multiple sclerosis?

Exercise training is generally safe for people with multiple sclerosis, with a slightly higher rate of minor adverse events compared to those not exercising, but it does not increase the risk of relapse. ^{1 3 6 7 8}

How is the Remote Exercise Training for Multiple Sclerosis treatment different from other treatments for this condition?

This treatment is unique because it offers a home-based, internet-supported exercise program that combines aerobic and resistance training, making it accessible for people with mobility issues or transportation challenges. It provides a flexible and individualized approach to increase physical activity and improve muscle strength and lung function, which is not always feasible with traditional in-person therapies. ^{1 5 9 10 11}

Research Team

Robert Motl, Ph.D

Principal Investigator

University of Illinois Chicago

Eligibility Criteria

This trial is for Hispanic/Latino individuals aged 18-65 living in Chicago with MS, who are not currently very active. They must be relapse-free for at least a month, able to walk (with or without help), have internet access, and be safe to exercise.

Inclusion Criteria

I am between 18 and 65 years old.

Insufficient physical activity (i.e., not meeting current physical activity guidelines of 150 minutes of moderate to vigorous physical activity per week)

I have been diagnosed with multiple sclerosis (MS).

Exclusion Criteria

Unable to speak, read, and understand English

Too much physical activity (i.e. 150 minutes or more of moderate to vigorous physical activity per week)

I am unwilling to complete all required tests and questionnaires.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-3 months

Baseline Measures

Baseline measures are taken before the intervention begins

1 week

Exercise Intervention

Participants engage in a 4-month remotely-delivered exercise training intervention including aerobic and resistance exercises

16 weeks

Remote sessions with one-on-one coaching

Control Condition

Participants in the control group engage in flexibility exercises through telerehabilitation

16 weeks

Remote sessions

Follow-up

Participants are monitored for safety and effectiveness after the intervention

4 weeks

Treatment Details

Interventions

• Exercise Training Program
• Flexibility Program

Trial Overview The study tests if a remote 4-month exercise program can improve physical function and quality of life in Hispanics/Latinos with MS. It includes flexibility and aerobic/resistance training guided by coaches compared to a control group.

Participant Groups

Group I: Exercise Training Program Experimental Treatment 1 Intervention

Participants will receive a theory-based, remotely-delivered exercise training program that includes aerobic and resistance exercise training.

Group II: Flexibility Program Active Control 1 Intervention

Participants will receive a remotely-delivered flexibility program, focusing on improving flexibility and range of motion.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

National Institute on Minority Health and Health Disparities (NIMHD)

Collaborator

Trials

473

Recruited

1,374,000+

Findings from Research

Home-based exercise training (HBET) is beneficial, feasible, and safe for people with multiple sclerosis (MS), as shown in a systematic review of 24 studies.

The review highlighted that while HBET can improve physical fitness and quality of life, challenges such as adherence to exercise programs and the need to assess disability-related outcomes remain important areas for future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-Based Exercise Training in Multiple Sclerosis: A Systematic Review with Implications for Future Research. Ghahfarrokhi, MM., Banitalebi, E., Negaresh, R., et al.[2021]

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]

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]

The BASE-MS study is a 4-month randomized controlled trial involving 72 participants with mild to moderate multiple sclerosis, designed to evaluate the effectiveness of a remotely supervised exercise program based on established guidelines.

This research aims to assess not only the safety and feasibility of remote exercise delivery for MS patients but also to gather data on exercise participation and its impact on symptoms and behavior change, which could inform future interventions for neurological conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changing Behaviour towards Aerobic and Strength Exercise (BASE): Design of a randomised, phase I study determining the safety, feasibility and consumer-evaluation of a remotely-delivered exercise programme in persons with multiple sclerosis. Learmonth, YC., Kaur, I., Baynton, SL., et al.[2021]

A systematic review of 19 studies found that exercise training, particularly adapted modalities like body-weight support treadmill training and electrical stimulation cycling, can lead to significant improvements in mobility, physical fitness, and quality of life for individuals with severe mobility impairment due to multiple sclerosis (MS).

While conventional exercise training showed some benefits, the majority of positive outcomes were associated with adapted exercise approaches, highlighting the need for accessible exercise interventions for people with MS who have high levels of disability.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions. Edwards, T., Pilutti, LA.[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]

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]

Progressive resistance training (PRT) is shown to significantly improve muscle strength in individuals with multiple sclerosis (MS), based on a systematic review of 16 studies.

While PRT shows positive trends in improving functional capacity, balance, and self-reported measures like fatigue and quality of life, the evidence is less robust, indicating a need for more focused research on these outcomes and the underlying mechanisms involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multiple sclerosis and progressive resistance training: a systematic review. Kjølhede, T., Vissing, K., Dalgas, U.[2022]

Web-based interventions have a short-term positive effect on increasing self-reported physical activity in ambulant individuals with multiple sclerosis, with a standardized mean difference of 0.67 based on meta-analysis of 4 studies.

While there is evidence of increased physical activity from self-reports, the current research lacks long-term data and does not include interventions for individuals with more severe mobility limitations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of and User Experience With Web-Based Interventions in Increasing Physical Activity Levels in People With Multiple Sclerosis: A Systematic Review. Dennett, R., Gunn, H., Freeman, JA.[2019]

A randomized controlled trial with 126 participants showed that internet-based exercise training (e-training) significantly improved muscle strength and lung function in persons with multiple sclerosis after three months, but did not affect health-related quality of life.

The e-training program, which included home-based aerobic and strength training, is considered a feasible method for providing individualized exercise support to pwMS, highlighting its potential for large-scale implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet-Supported Physical Exercise Training for Persons with Multiple Sclerosis-A Randomised, Controlled Study. Tallner, A., Streber, R., Hentschke, C., et al.[2022]

A study involving 30 participants with Multiple Sclerosis showed that a telerehabilitation (TR) program is a feasible alternative to conventional physical therapy, lasting 8 weeks and conducted via real-time telecommunication.

The TR program demonstrated comparable efficacy to in-person physical therapy, as both methods led to improvements in gait and balance without significant differences in patient-reported outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telerehabilitation in Multiple Sclerosis: Results of a Randomized Feasibility and Efficacy Pilot Study. Fjeldstad-Pardo, C., Thiessen, A., Pardo, G.[2020]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Home-Based Exercise Training in Multiple Sclerosis: A Systematic Review with Implications for Future Research. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Current perspectives on exercise training in the management of multiple sclerosis. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Physical Exercise and MS Recommendations. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Changing Behaviour towards Aerobic and Strength Exercise (BASE): Design of a randomised, phase I study determining the safety, feasibility and consumer-evaluation of a remotely-delivered exercise programme in persons with multiple sclerosis. [2021]

5. Netherlands pubmed.ncbi.nlm.nih.gov

The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Safety of exercise training in multiple sclerosis: An updated systematic review and meta-analysis. [2023]

7. Netherlands pubmed.ncbi.nlm.nih.gov

The safety of exercise training in multiple sclerosis: a systematic review. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Multiple sclerosis and progressive resistance training: a systematic review. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of and User Experience With Web-Based Interventions in Increasing Physical Activity Levels in People With Multiple Sclerosis: A Systematic Review. [2019]

10. Switzerland pubmed.ncbi.nlm.nih.gov

Internet-Supported Physical Exercise Training for Persons with Multiple Sclerosis-A Randomised, Controlled Study. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Telerehabilitation in Multiple Sclerosis: Results of a Randomized Feasibility and Efficacy Pilot Study. [2020]