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.
Is the Exercise Training Program a promising treatment for Multiple Sclerosis?Yes, the Exercise Training Program is promising for people with Multiple Sclerosis. It can be done at home, making it easier for those who have trouble traveling. It helps improve muscle strength, lung function, and physical activity levels. It can be done online, which is just as effective as in-person sessions. This makes it a good option for many people with MS.456710
What data supports the idea that Remote Exercise Training for Multiple Sclerosis is an effective treatment?The available research shows that Remote Exercise Training is an effective treatment for Multiple Sclerosis (MS). Studies have found that exercise programs can improve various physical functions, which can positively impact daily life for people with MS. Home-based exercise training is highlighted as a promising option, especially for those who face transportation challenges. This approach allows people with MS to engage in physical activity from home, making it more accessible. Overall, the evidence supports the benefits of exercise training, including remote options, for managing MS.158910
Do I need to stop my current medications for this trial?The trial protocol does not specify whether you need to stop taking your current medications. It seems focused on exercise, so you may not need to stop, but it's best to ask the trial coordinators for confirmation.
What safety data exists for exercise training in multiple sclerosis?Exercise training in multiple sclerosis (MS) has been shown to be generally safe. A systematic review found that the rate of relapse was lower in exercise groups (4.6%) compared to control groups (6.3%), and the rate of adverse events (AEs) was slightly higher in exercise groups (2.0%) compared to control groups (1.2%). The relative risk of relapse for exercise training was 0.73, indicating no increased risk of relapse, and the risk of AEs was not higher than in healthy populations. This evidence suggests that exercise training is safe for individuals with MS.1231011
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.Treatment Details
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.
2Treatment groups
Experimental Treatment
Active Control
Group I: Exercise Training ProgramExperimental Treatment1 Intervention
Participants will receive a theory-based, remotely-delivered exercise training program that includes aerobic and resistance exercise training.
Group II: Flexibility ProgramActive Control1 Intervention
Participants will receive a remotely-delivered flexibility program, focusing on improving flexibility and range of motion.
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Research locations nearbySelect from list below to view details:
University of Illinois at ChicagoChicago, IL
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Who is running the clinical trial?
University of Illinois at ChicagoLead Sponsor
References
Physical Exercise and MS Recommendations. [2022]The use of physical exercise programmes in the rehabilitation of patients with multiple sclerosis (MS) has been a controversial issue for many years. During the last decade, however, evidence from a number of studies has suggested that exercise is a safe and efficient way to induce improvements in a number of physiological functions, which ultimately can lead to functional improvements that have a positive effect on a patients daily life. The purpose of this review is, based on the existing research, to provide clinicians with some easily administrable recommendations for the application of exercise in the rehabilitation strategy of MS.
Multiple sclerosis and progressive resistance training: a systematic review. [2022]Recently progressive resistance training (PRT) has been recognised as an effective tool in the rehabilitation of persons with multiple sclerosis (MS). The objective of this study was to systematically review the literature of PRT studies for persons with MS. A comprehensive literature search (PubMed, SveMed+, Embase, Cochrane, PEDro, SPORTDiscus and Bibliotek.dk) was conducted. Identified papers were rated according to the PEDro-scale. Sixteen studies were included and scored between 3 and 8 of 11 total points on the PEDro-scale, showing a general lack of blinding. Strong evidence regarding the beneficial effect of PRT on muscle strength was observed. Regarding functional capacity, balance and self-reported measures (fatigue, quality of life and mood) evidence is less strong, but the tendency is overall positive. Indications of an effect on underlying mechanisms such as muscle morphological changes, neural adaptations and cytokines also exist, but the studies investigating these aspects are few and inconclusive. PRT has a positive effect on muscle strength for persons with MS. Heterogeneous results exist regarding the effect on functional capacity and self-reported measures probably because of differences in training protocols, samples sizes, type and severity of MS. The area of underlying mechanisms deserves more attention in future research.
The safety of exercise training in multiple sclerosis: a systematic review. [2022]There are many reviews documenting the benefits of exercise training among persons with multiple sclerosis (MS). To date, we are unaware of a review that summarizes the risks of relapse and other adverse events (AEs) associated with exercise training, yet this is critical for informing decisions and recommendations regarding the safety of this behavior. We conducted a systematic review of relapse and other AEs reported in randomized controlled trials (RCTs) of exercise training in MS. We searched electronic databases for RCTs of exercise training in MS. We calculated the rate of relapse and AEs, and the relative risk of relapse and AEs for exercise training versus control. Twenty-six studies were reviewed that included 1295 participants. We determined that the rate of relapse was 6.3% and 4.6% for control and exercise, respectively. The rate of AEs was 1.2% and 2.0% for control and exercise, respectively. The relative risk of relapse for exercise training was 0.73, whereas the relative risk of AE for exercise training was 1.67. Exercise training was not associated with an increased risk of relapse, and risk of AEs was not higher than in healthy populations. This evidence should alleviate uncertainty regarding the safety of exercise training in MS.
Internet-Supported Physical Exercise Training for Persons with Multiple Sclerosis-A Randomised, Controlled Study. [2022]Physical exercise is effective in improving functional outcomes in persons with multiple sclerosis (pwMS). We evaluated the feasibility and effectiveness of internet-based exercise training (e-training) for pwMS on health-related quality of life (HrQoL). Secondary outcomes were muscle strength, aerobic capacity, lung function, physical activity, and fatigue. This is a randomised, controlled trial with a wait-list control group. Data were collected at baseline, after three and six months, and analysed using a hybrid linear model. One-hundred twenty-six pwMS participated in the home-based aerobic (1×/week) and strength training (2×/week) intervention that was supervised and documented via an internet-platform. The intervention group received e-training for six months, and the control group received e-training after a three months waiting period. Significant differences between the groups were only observed for muscle strength (knee flexion (effect size ES = 0.3, p = 0.003), knee extension (ES = 0.24, p = 0.015)), peak expiratory flow (ES = 0.2, p = 0.039), and sports activity (ES = 0.33, p = 0.001) after three months. E-training had no effect on HrQoL but did on muscle strength, lung function, and physical activity. It is a promising and feasible approach to facilitate large-scale, yet individual, training support.
The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions. [2022]There is evidence for the benefits of exercise training in persons with multiple sclerosis (MS). However, these benefits have primarily been established in individuals with mild-to-moderate disability (i.e., Expanded Disability Status Scale [EDSS] scores 1.0-5.5), rather than among those with significant mobility impairment. Further, the approaches to exercise training that have been effective in persons with mild-to-moderate MS disability may not be physically accessible for individuals with mobility limitations. Therefore, there is a demand for an evidence-base on the benefits of physically accessible exercise training approaches for managing disability in people with MS with mobility impairment.
Effectiveness of and User Experience With Web-Based Interventions in Increasing Physical Activity Levels in People With Multiple Sclerosis: A Systematic Review. [2019]Supporting people with multiple sclerosis (MS) to achieve and maintain recommended levels of physical activity is important but challenging. Web-based interventions are increasingly being used to deliver targeted exercise programs and promote physical activity.
Telerehabilitation in Multiple Sclerosis: Results of a Randomized Feasibility and Efficacy Pilot Study. [2020]A prospective, randomized, three-arm, evaluator blinded study to demonstrate the feasibility of a telerehabilitation (TR) program in individuals with ambulatory deficits secondary to Multiple Sclerosis (MS) and evaluate its efficacy when compared to conventional on-site physical therapy (PT) was completed. Thirty participants were evaluated at baseline and randomized to one of three groups with intervention lasting 8 weeks: Group 1 (control)- customized unsupervised home-based exercise program (HEP) 5 days a week; Group 2 (TR)- remote PT supervised via audio/visual real-time telecommunication twice weekly; Group 3 (PT)- in-person PT at the medical facility twice weekly. Outcomes included patient reported outcomes (PROs) obtained through questionnaires, and measurements of gait and balance performed with bedside tests and a computerized system. Functional gait assessment improved from baseline in all three groups. There were no significant differences between the TR and the conventional PT groups for a variety of outcome measures. TR is a feasible method to perform PT in persons with MS and has comparable efficacy to conventional in-person PT as measured by patient reported outcomes and objective outcomes of gait and balance.
Current perspectives on exercise training in the management of multiple sclerosis. [2021]The science supporting the application of exercise training and physical activity in persons with multiple sclerosis (MS) has expanded considerably in strength and scope over the past 25+ years. Exercise training is now a strategy that is commonly recommended for management of MS in clinical practice. Yet, there are still many opportunities for expanding the breadth and strength of research on exercise training in MS.
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]Multiple sclerosis is a chronic progressive neurological disease. Evidence attests to the benefits of exercise, guidelines for exercise in multiple sclerosis are available. Remote-delivery of exercise adherence programmes based on the exercise guidelines require urgent testing.
Home-Based Exercise Training in Multiple Sclerosis: A Systematic Review with Implications for Future Research. [2021]Substantial evidence supports the benefits of supervised exercise training (ET) in people with multiple sclerosis (MS). However, there are limitations such as transportation problems preventing physical activity for some people with MS. One opportunity for increasing physical activity participant in people with MS is home-based exercise training (HBET), yet we are unaware of a systematic review of HBET in people with MS. We undertook a systematic review for enhancing the knowledge about HBET in people with MS.
Safety of exercise training in multiple sclerosis: An updated systematic review and meta-analysis. [2023]A review of the safety profile of exercise training in multiple sclerosis (MS) has not been conducted since 2013.