Outdoor walking exercise therapy improves walking capacity and well-being in persons with multiple sclerosis: A randomized controlled trial - 02/10/25
, Josephine L. Steenberg c, Freja Roy c, Lasse Skovgaard cHighlights |
• | Outdoor walking exercise therapy benefits persons with multiple sclerosis. |
• | Improvements observed in walking capacity, particularly 6MWT. |
• | Improvements observed in patient-reported outcomes, particularly mental well-being. |
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.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Multiple sclerosis, Physical rehabilitation, Walking, Nature, Fatigue, Fatigability, Concerns of falling
Abbreviations : 6mwt, ATOM, be thoughtful, BMI, CI, CNS, CONSORT, covid19, FES-I, FITT-VP, HR, HRmax, HR-QoL, MFIS, MS, MSWS, PDDS, pwMS, QoL, RCT
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Vol 68 - N° 6
Articolo 101985- settembre 2025 Ritorno al numero
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