Outdoor walking exercise therapy improves walking capacity and well-being in persons with multiple sclerosis: A randomized controlled trial

IF 4.6 3区医学 Q1 REHABILITATION

Annals of Physical and Rehabilitation Medicine Pub Date : 2025-04-18 DOI:10.1016/j.rehab.2025.101985

Lars G. Hvid , Josephine L. Steenberg , Freja Roy , Lasse Skovgaard

{"title":"Outdoor walking exercise therapy improves walking capacity and well-being in persons with multiple sclerosis: A randomized controlled trial","authors":"Lars G. Hvid , Josephine L. Steenberg , Freja Roy , Lasse Skovgaard","doi":"10.1016/j.rehab.2025.101985","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>While outdoor walking exercise therapy could likely elicit multiple beneficial effects in persons with multiple sclerosis (pwMS), little evidence exists.</div></div><div><h3>Objective</h3><div>To evaluate the effects of a 7-week group-based outdoor walking exercise therapy intervention on walking capacity and mental well-being as well as additional outcomes in pwMS.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, <em>n</em> = 62 ambulatory pwMS (49/62, 79% females; 51 years [range, 27–68 years]), patient-determined disease steps 1.7 (range, 0–4) were assigned to either a WALK group (a ‘personalized’ program suited to the starting level of each participant, including one continuous and one intermittent supervised walking session per week at moderate-to-high intensity) or a CONTROL group (continuation of habitual lifestyle). Tests were carried out at baseline (Pre) and after the intervention (Post). Walking capacity included 6-minute walk test (6MWT; primary outcome), timed 25-foot walk test (T25FWT), and six spot step test (SSST). Walking fatigability indexes were calculated from 6MWT data. Patient-reported outcomes included 12-item MS Walking Scale (MSWS), modified fatigue impact scale (MFIS), 7-item falls efficacy scale-international (FES-I), World Health Organization five well-being index (WHO5; main secondary outcome), and 0–100 visual analogue scale health-related quality of life (HR-QoL).</div></div><div><h3>Results</h3><div>Across the 7-week intervention period, <em>n</em> = 17 (5/17, 27%) pwMS dropped out. No adverse events were reported. Across all WALK sessions, 78% of the time was spent on forest/gravel trails. Substantial between-group changes were observed (beneficial changes in WALK vs no changes in CONTROL) in 6MWT (<em>mean change [95% CI];</em> +41 m [22;60]; deemed clinically relevant), T25FWT (+0.27 [0.15;0.39] m/s), SSST (-0.80 [-1.33;-0.27] s), WHO5 (+7.3 [0.1;14.5] points), MSWS (-5.1 [-9.2;-1.0] points), MFIS (-6.7 [-11.7;-1.7] points), FES-I (<em>trend</em>; -0.8 [-1.7;0.1] points), and HR-QoL (<em>trend</em>; +5.3 [-2.3;12.9] points). In contrast, walking fatigability indexes remained unaffected.</div></div><div><h3>Conclusions</h3><div>Outdoor walking exercise therapy elicited multiple beneficial effects in pwMS, especially evidenced by improvements in walking capacity and mental well-being.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier NCT05415956.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101985"},"PeriodicalIF":4.6000,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Physical and Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1877065725000508","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Background

While outdoor walking exercise therapy could likely elicit multiple beneficial effects in persons with multiple sclerosis (pwMS), little evidence exists.

Objective

To evaluate the effects of a 7-week group-based outdoor walking exercise therapy intervention on walking capacity and mental well-being as well as additional outcomes in pwMS.

Methods

In this randomized controlled trial, n = 62 ambulatory pwMS (49/62, 79% females; 51 years [range, 27–68 years]), patient-determined disease steps 1.7 (range, 0–4) were assigned to either a WALK group (a ‘personalized’ program suited to the starting level of each participant, including one continuous and one intermittent supervised walking session per week at moderate-to-high intensity) or a CONTROL group (continuation of habitual lifestyle). Tests were carried out at baseline (Pre) and after the intervention (Post). Walking capacity included 6-minute walk test (6MWT; primary outcome), timed 25-foot walk test (T25FWT), and six spot step test (SSST). Walking fatigability indexes were calculated from 6MWT data. Patient-reported outcomes included 12-item MS Walking Scale (MSWS), modified fatigue impact scale (MFIS), 7-item falls efficacy scale-international (FES-I), World Health Organization five well-being index (WHO5; main secondary outcome), and 0–100 visual analogue scale health-related quality of life (HR-QoL).

Results

Across the 7-week intervention period, n = 17 (5/17, 27%) pwMS dropped out. No adverse events were reported. Across all WALK sessions, 78% of the time was spent on forest/gravel trails. Substantial between-group changes were observed (beneficial changes in WALK vs no changes in CONTROL) in 6MWT (mean change [95% CI]; +41 m [22;60]; deemed clinically relevant), T25FWT (+0.27 [0.15;0.39] m/s), SSST (-0.80 [-1.33;-0.27] s), WHO5 (+7.3 [0.1;14.5] points), MSWS (-5.1 [-9.2;-1.0] points), MFIS (-6.7 [-11.7;-1.7] points), FES-I (trend; -0.8 [-1.7;0.1] points), and HR-QoL (trend; +5.3 [-2.3;12.9] points). In contrast, walking fatigability indexes remained unaffected.

Conclusions

Outdoor walking exercise therapy elicited multiple beneficial effects in pwMS, especially evidenced by improvements in walking capacity and mental well-being.

Trial registration

ClinicalTrials.gov identifier NCT05415956.

查看原文本刊更多论文

户外步行运动疗法改善多发性硬化症患者的行走能力和幸福感：一项随机对照试验

虽然户外步行运动疗法可能会对多发性硬化症（pwMS）患者产生多种有益影响，但证据很少。目的评价为期7周的户外步行运动治疗干预对pwMS患者行走能力、心理健康状况及其他预后的影响。方法在本随机对照试验中，n = 62例动态pwMS患者(49/62，女性79%；51岁[范围，27-68岁])，患者确定的疾病步骤1.7（范围，0-4）被分配到WALK组（适合每个参与者起始水平的“个性化”计划，包括每周一次中至高强度的连续和间歇步行）或对照组（继续习惯生活方式）。在基线（前）和干预后（后）进行测试。步行能力包括6分钟步行测试(6MWT；主要结果)、定时25英尺步行测试（T25FWT）和6点步测试（SSST）。步行疲劳指数根据6MWT数据计算。患者报告的结局包括12项MS步行量表（MSWS）、改良疲劳影响量表（MFIS）、7项国际跌倒功效量表（FES-I）、世界卫生组织五项幸福指数(WHO5；主要次要结局)和0-100视觉模拟量表健康相关生活质量（HR-QoL）。结果在7周的干预期内，n = 17 (5/17, 27%) pwMS退出。无不良事件报告。在所有的WALK项目中，78%的时间花在森林/砾石小径上。在6MWT中观察到实质性的组间变化（WALK组有益变化vs对照组无变化）(平均变化[95% CI]；+41 m [22;60]；认为临床相关),T25FWT (+ 0.27 [0.15, 0.39] m / s), SSST(-0.80[-1.33, -0.27]年代),WHO5(+ 7.3(0.1, 14.5)点),”(-5.1[-9.2,-1.0]点),小额信贷机构(-6.7[-11.7,-1.7]点),FES-I(趋势;-0.8[-1.7；0.1]分),HR-QoL(趋势；+5.3[-2.3；12.9]分)。相比之下，步行疲劳指数没有受到影响。结论户外步行运动治疗对pwMS患者有多种有益作用，尤其是对行走能力和心理健康的改善。临床试验注册clinicaltrials .gov识别码NCT05415956。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of Physical and Rehabilitation Medicine Medicine-Rehabilitation

CiteScore

7.80

自引率

4.30%

发文量

136

审稿时长

34 days

期刊介绍： Annals of Physical and Rehabilitation Medicine covers all areas of Rehabilitation and Physical Medicine; such as: methods of evaluation of motor, sensory, cognitive and visceral impairments; acute and chronic musculoskeletal disorders and pain; disabilities in adult and children ; processes of rehabilitation in orthopaedic, rhumatological, neurological, cardiovascular, pulmonary and urological diseases.