Response heterogeneity in fitness, mobility and cognition with exercise-training in MS

Abstract

BACKGROUND: Exercise-training is a beneficial approach for improving function in persons with multiple sclerosis (MS). However, it is unlikely that every participant who engages in an exercise-training intervention will demonstrate similar benefits. Identifying factors that may influence the accrual of specific exercise-training benefits can aid in the development of optimized rehabilitation interventions for improving specific outcomes in MS. OBJECTIVE: This study described possible response heterogeneity in physical fitness, mobility and cognitive outcomes with exercise-training and identified baseline performance, compliance and demographic/clinical outcomes as possible predictors of exercise-related changes in those outcomes. METHODS: Thirty-two persons with MS-related mobility disability completed 6-months of multimodal exercise-training. Physical fitness, mobility and cognitive processing speed (CPS) were measured before and after the 6 months. RESULTS: There was response heterogeneity in fitness, mobility and cognitive outcomes with multimodal exercise-training. Low baseline aerobic fitness, slow walking speed and slow CPS were associated with greater exercise-related improvements in those respective outcomes. CONCLUSIONS: Those with MS-related mobility disability who have the lowest aerobic fitness, walking speed and CPS might benefit the most from multimodal exercise-training. This provides critical evidence for informing the development of a precision medicine framework for improving targeted outcomes with exercise-training in MS.