Exercise Cycling

INTRODUCTION: Different therapies can improve clinical and motor symptoms of multiple sclerosis (MS) similarly but studies comparing the effects of different exercise therapies on clinical and motor outcomes are scant. We compared the effects of exergaming (EXE), balance (BAL), cycling (CYC), proprioceptive neuromuscular facilitation (PNF), and a standard care wait-listed control group (CON) on clinical and motor symptoms and quality of life (QoL) in people with MS (PwMS).

METHODS: PwMS (n=68, 90% females; age: 47.0y, Expanded Disability Status Scale: 5 to 6) were randomized to 5 groups. Before and after the interventions (5x/week for 5 weeks) PwMS were tested for: MS-related clinical and motor symptoms (Multiple Sclerosis Impact Scale-29; MSIS-29, primary outcome), QoL (EQ-5D), symptoms of depression, gait and balance ability (Tinetti Assessment Tool, TAT), static and dynamic balance and fall risk (Berg Balance Scale (BBS), walking capacity (six-minute walk test, 6MWT), and standing posturography on a force platform.

RESULTS: EXE, BAL, and CYC improved MSIS-29 scores similarly. EXE and CYC improved QoL and walking capacity similarly but more than BAL. Only EXE improved gait and balance scores (TAT). EXE and BAL improved fall risk and standing balance similarly but more than CYC. PNF and CON revealed no changes. EQ-5D moderated the exercise effects on MSIS-29 scores only in EXE. Changes in QoL and changes in MSIS-29 scores correlated R=0.73 only in EXE.

CONCLUSION: In conclusion, BAL and CYC but EXE in particular, but not PNF, can improve clinical and motor symptoms and QoL in PwMS (EDSS: 5 to 6), expanding the evidence-based exercise options to reduce mobility limitations in PwMS.