Exercise in the community for people with multiple sclerosis - A follow-up of people with minimal gait impairment

Background: Although there are many studies evaluating exercise interventions, few studies have evaluated the effect at follow-up. Objectives: This paper presents follow-up data for participants who completed the exercise interventions in a large randomised controlled trial. Methods: One hundred twenty-one people with multiple sclerosis (MS) with minimal gait impairment who completed 10 weeks of community-based exercise interventions were evaluated by a blinded assessor 12 weeks after the intervention. The primary outcome measure was the Multiple Sclerosis Impact Scale-29 version 2 (MSIS-29,v2) physical component. Other outcomes were the MSIS-29 psychological component, the Modified Fatigue Impact Scale (MFIS) and the 6-minute walk test (6MWT) distance. Results: The positive effect on the physical impact of MS was not maintained from baseline to follow-up (-1.6, 95% CI -0.8, 4.0, p=0.189). The psychological impact and the impact of fatigue remained significantly improved (-3.5, 95% CI -6.1, -1.0, p = 0.006 and -4.68, 95% CI -6.9, -2.5, p < 0.001, respectively). There was no time effect for the 6MWT (f = 1.76, p = 0.179) although the trend suggests reversal of the benefits gained from the physiotherapist (PT)- and fitness instructor (FI)-led intervention. Conclusion: The maintained benefit on the psychological impact of MS and fatigue may have important personal and socioeconomic consequences; however, it is important to find ways to maintain the physical benefits of exercise over the long term.