Deterioration of walking capacity is a common symptom in persons with multiple sclerosis (pwMS), furthermore having a negative influence on well-being. Studies have nevertheless shown that walking exercise therapy can improve walking capacity in pwMS. This may be particularly potent if occurring outdoors due to the varying stimuli it can provide (different surfaces and terrain etc.), and if the intensity and duration is adequate. Furthermore, outdoor walking is (1) suitable as a group intervention facilitating interaction between pwMS and (2) advantageous due to the health benefits offered through the interaction with nature itself. Both these aspects are also relevant for well-being. Few studies have nevertheless examined the effects of outdoor walking exercise therapy in pwMS. The purpose of the present study is therefore to examine the effects of 7 weeks of moderate-to-high intensity outdoor walking exercise therapy on walking capacity (primary outcome: 6-minute walk test) and well-being in pwMS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Moderate-to-high intensity walking exercise therapy (7 weeks, 14 session) with progression in duration and intensity.
Aarhus University, Health, Exercise Biology
Aarhus, Jutland, Denmark
6-minutes walk test (6MWT)
Maximal distance covered in 6 minutes using a 30 meter walkway. Assesses walking endurance.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
6-minutes walk test (6MWT)
Maximal distance covered in 6 minutes using a 30 meter walkway. Assesses walking endurance.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
Timed 25-foot walk test (T25FWT)
Time used to complete a 25-foot (= 7.62 meters) walk test. Two trials are given. Assesses horizontal walking propulsion/acceleration (i.e. walking speed).
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
Timed 25-foot walk test (T25FWT)
Time used to complete a 25-foot (= 7.62 meters) walk test. Two trials are given. Assesses horizontal walking propulsion/acceleration (i.e. walking speed).
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
Six spot step test (SSST)
Time used to complete the SSST (5 wooden blocks must be pushed/kicked outside their initial position). Four trials are given, two with each foot being used to push/kick the wooden blocks. Assesses horizontal coordination and dynamic balance during walking.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
Six spot step test (SSST)
Time used to complete the SSST (5 wooden blocks must be pushed/kicked outside their initial position). Four trials are given, two with each foot being used to push/kick the wooden blocks. Assesses horizontal coordination and dynamic balance during walking.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
12-item multiple sclerosis walking scale (MSWS-12)
Questionnaire (patient-reported outcome) assessing patient-reported impact of multiple sclerosis on walking ability. Total score range 12-60 (0-100%); lower is better.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
12-item multiple sclerosis walking scale (MSWS-12)
Questionnaire (patient-reported outcome) assessing patient-reported impact of multiple sclerosis on walking ability. 12 questions. Total score range 12-60 (0-100%); lower is better.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
Modified fatigue impact scale (MFIS)
Questionnaire (patient-reported outcome) assessing patient-reported perceived fatigue impact. 21 questions. Total score range 0-84; lower is better. Physical subscale score range (9 questions) 0-36; lower is better. Cognitive subscale score range (10 questions) 0-40; lower is better. Psychosocial subscale score range (2 questions) 0-8; lower is better.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
Modified fatigue impact scale (MFIS)
Questionnaire (patient-reported outcome) assessing patient-reported perceived fatigue impact. 21 questions. Total score range 0-84; lower is better. Physical subscale score range (9 questions) 0-36; lower is better. Cognitive subscale score range (10 questions) 0-40; lower is better. Psychosocial subscale score range (2 questions) 0-8; lower is better.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
Falls-efficacy scale (FES-I)
Questionnaire (patient-reported outcome) assessing concerns of falling along with history of falls. 7 questions. Total score range 0-28; lower is better. History of falls: one year recall.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
Falls-efficacy scale (FES-I)
Questionnaire (patient-reported outcome) assessing concerns of falling along with history of falls. 7 questions. Total score range 0-28; lower is better. History of falls: one year recall.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
WHO five well-being index (WHO5)
Questionnaire (patient-reported outcome) assessing patient-reported well-being. 5 questions. Score range 0-25 (0-100%); higher is better.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
WHO five well-being index (WHO5)
Questionnaire (patient-reported outcome) assessing patient-reported well-being. 5 questions. Score range 0-25 (0-100%); higher is better.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
EuroQoL 5 dimensions 3 levels (EQ5D)
Questionnaire (patient-reported outcome) assessing patient-reported quality of life. VAS scale score range 0-100%; higher is better. 5 domains, scored separately, score range 1-3; lower is better.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
EuroQoL 5 dimensions 3 levels (EQ5D)
Questionnaire (patient-reported outcome) assessing patient-reported quality of life. VAS scale score range 0-100%; higher is better. 5 domains, scored separately, score range 1-3; lower is better.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
Baecke physical activity questionnaire
Questionnaire (patient-reported outcome) assessing patient-reported participation in physical activities. 4 questions. Score range is continuous (0-xx). Higher is better.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
Baecke physical activity questionnaire
Questionnaire (patient-reported outcome) assessing patient-reported participation in physical activities. 4 questions. Score range is continuous (0-xx). Higher is better.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
Patient-determined disease steps (PDDS)
Questionnaire (patient-reported outcome) assessing patient-reported disability in multiple sclerosis (MS). 9 questions/categories. Each category represents disability level; lower is better.
Time frame: Change from baseline (Pre) to after 7 weeks intervention (Post)
Patient-determined disease steps (PDDS)
Questionnaire (patient-reported outcome) assessing patient-reported disability in multiple sclerosis (MS). 9 questions/categories. Each category represents disability level; lower is better.
Time frame: Change from baseline (Pre) to 24 weeks follow-up (Follow-up)
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