The Effects of a Six Week Wellness Exercise Class on Perceived Walking Ability, Fatigue, Quality of Life, and Sustainability of Exercising Independently in Persons with Multiple Sclerosis.

Background: Leading a physically active lifestyle for those with Multiple Sclerosis (MS) may help to manage symptoms and prevent further disability. Continued individualized PT is not always feasible due to cost/insurance coverage throughout a lifetime, and a wellness exercise class (WEC) that focuses on exercise and overall well-being may increase confidence, mobility, enhance quality of life (QOL), and lessen the perceived impact of disease for those with MS. It may also serve as a bridge for patients to be able to exercise independently confidently and safely. 

Objectives: In persons with MS, we wanted to determine the impact of a six-week physical therapist supervised wellness exercise class (WEC) on the perceived QOL, self-reported walking ability, overall impact of disease, and sustainability of independent (IND) exercise four weeks later. We expected improvements in walking, and disease-specific QOL after intervention, and the outcomes maintained with IND exercise.

Methods: Eight persons with MS participated in the WEC led by a Senior Neurological Clinical Specialist Physical Therapist. The WEC was one time per week, 60 minutes/session for six weeks with focus on aerobic and resistance training, stretching, and safe completion and progression. Participants were ambulatory, recruited from an MS Comprehensive Center, and cleared by their doctor for participation. All patients had recently been discharged from outpatient physical therapy (PT). Before and after the WEC, and at follow up 4 weeks later, participants completed disease-specific self-reported measures of physical and psychological impact of MS, including the Multiple Sclerosis Impact Scale 29 (MSIS-29), the 12 item Multiple Sclerosis Walking Scale (MSWS-12) and the Multiple Sclerosis Quality of Life-54 (MSQOL-54). None of the participants were exercising independently prior to the WEC. After six weeks we found that MSIS-29 scores improved from 69.5 to 52.9, MSWS-12 scores improved from 71.2 to 50.4, and MSQOL-54 scores improved from scores improved from 52.4 to 68.8. After four weeks, seven of the participants reported being active in an IND gym program outside of rehabilitation. 

Results: After discharge from outpatient PT, WEC focused on progressive resistance and aerobic exercises had a positive impact on the perceived QOL and ability to ambulate in persons with MS. After the supervised WEC, nearly all participants continued IND exercise in the community. 

Conclusions: This report illustrates that improvements can occur in self-reported outcomes after a WEC for those with MS. Providers should work with physical therapists to assure that after rehabilitation, affordable opportunities such as group WEC exist to help those with MS have the opportunity to independently engage in an exercise program. This bridge between therapy and discharge could safely enhance adherence to exercise post rehabilitation, and potentially, decrease the need for a future prolonged course of PT.