Highlights
- •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.
Abstract
Purpose
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.
Methods
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.
Results
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).
Conclusions
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.
Keywords
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Article info
Publication history
Published online: April 07, 2023
Accepted:
April 6,
2023
Received in revised form:
March 26,
2023
Received:
December 23,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
