Home-Based Resistance Training for Older Adults with Severe Multiple Sclerosis
Objectives: To examine the safety and efficacy of a 6-month home-based PRT intervention among older adults with severe MS.
Methods: 25 older adults (age=50-75) with severe MS (Expanded Disability Status Scale [EDSS]=6.5-8.0) were randomized to either a home-based PRT program (n=13) or a wait-list control (n=12) condition for 6 months. The PRT intervention consisted of 2 weekly home-based training sessions and 5 in-person visits over 6 months. Primary outcomes were safety and efficacy, determined as the ability of the intervention to improve muscle strength and lean mass. Secondary outcomes included functional, symptomatic, and participatory measures. Outcomes were assessed at baseline and 6-months.
Results: 13 individuals completed the intervention (PRT n=6; control n=7). Three adverse events (1 shoulder injury, 1 fall, 1 relapse) were reported by participants in the home-based PRT group. There was a moderate-to-large positive effect of PRT on muscle strength including the knee flexors (ηρ2 =.22), shoulder flexors (ηρ2 =.07), and dorsiflexors (ηρ2 =.22) compared to control. There was a moderate positive effect of PRT on whole-body lean soft tissue mass (ηρ2 =.06), cognitive processing speed (ηρ2 =.06), and overall impact of fatigue (ηρ2 =.10) compared to control. The intervention did not improve functional outcomes, other MS symptoms, or health-related quality of life (HRQOL).
Conclusions: We provide preliminary evidence that a home-based PRT intervention is safe for older adults with severe MS and can improve muscle strength and lean mass. There are potential benefits of this intervention for cognition and fatigue, although other exercise modalities or combined strategies might be more effective for managing MS symptoms and HRQOL. The effectiveness might be improved by strategies for promoting retention.