New research shows that exercise is good for people with multiple sclerosis (MS) and may decrease symptoms and improve health and mobility. However, people with MS often face barriers to exercise, such as transportation issues, knowing how to exercise safely, and lack of motivation and confidence to overcome barriers. An exercise program that incorporates ways to overcome these barriers may help improve mobility as well as decrease fatigue.
Supervised versus Telerehab Exercise Program for People with MS (STEP for MS) will compare the outcomes of a 16-week exercise program conducted at home (“telerehab”) to a program conducted in a gym (“facility-based”). The exercise protocol in both programs is identical. The only difference is where people will exercise.
STEP for MS involves exercising two days per week for one hour each day for a total of 16 weeks. Each exercise session involves 30 minutes of walking and 30 minutes of resistance training. Participants will be able to choose from three levels of exercise difficulty that best meets their abilities. Participants will be provided with all the equipment they need, including a pedometer.
A trained “coach” will teach participants how to exercise and provide encouragement throughout the program. Telerehab participants will meet with their coach “virtually” via Skype, or phone. Facility-based participants will meet with their coach at the gym facility. The coaching sessions are based on Bandura’s Social Cognitive Theory, and offer motivational tips and strategies to increase the likelihood of behavior change.
Participants will take assessments before starting the program, two months into the program, at the end of the 16-week program, and 12 months after starting the program. The study will measure many variables, but the main outcome of interest is walking. In particular, we will assess the extent to which participants improve walking outcomes by the end of the exercise program. We will also assess whether there is a difference in outcomes between telerehab and facility-based participants.
We are also assessing the impact of participant’s preference, or choice, on outcomes. Once enrolled, participants will be randomly placed in either a “choice” group or a “random” group. Those in choice will be able to choose whether they want to be in the telerehab or facility-based group. Those in the random group will be randomly assigned to either telerehab or facility-based.
The study began in early 2018 and will take four years to complete. There are seven locations throughout the country where people can participate in the study: University of Alabama, Birmingham; University of Colorado, Denver; the Shepherd Center, GA; University of Georgia, GA; University of North Carolina, Chapel Hill; the Cleveland Clinic, OH; Marquette University, WI.
This work is supported through a Patient-Centered Outcomes Research Institute (PCORI) Project Program Award (MS-1610-36999).
All statements about this study presented on this website, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.
We hope that the findings will make exercise and its benefits more available to people with MS who have problems walking.