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Exercise in the community for people with multiple sclerosis -- a follow-up of people with minimal gait impairment |
Garrett M, Hogan N, Larkin A, Saunders J, Jakeman P, Coote S |
Multiple Sclerosis Journal 2013 May;19(6):790-798 |
clinical trial |
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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 to 4.0, p = 0.189). The psychological impact and the impact of fatigue remained significantly improved (-3.5, 95% CI -6.1 to -1.0, p = 0.006 and -4.68, 95% CI -6.9 to -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.
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