A COMPREHENSIVE, TWO-MONTH CIRCUIT TRAINING IN PEOPLE WITH MULTIPLE SCLEROSIS - ADHERENCE AND SATISFACTION WITH THE STUDY INTERVENTION

Background: Exercise therapy in people with multiple sclerosis (MS) can improve strength, aerobic capacity, fatigue, balance and manual dexterity. Circuit training has been shown to be an effective exercise intervention in several neurological diseases, though it has been poorly investigated in people with MS. So far, a few small trials reported promising results, but exercise adherence and patient satisfaction have not yet been investigated. Purpose: As part of a larger randomized controlled trial this study aimed to investigate the adherence of people with MS to a structured, two-month ambulatory circuit training (MS-Fit) and to determine their overall satisfaction with the program. Methods: People with MS-related disability affecting activities of daily living (ADL) and/or quality of life (QoL) were included. The participants attended the circuit training for 2x2 hours weekly over 2 months. The circuit training was conducted in two rehabilitation centres in Switzerland and supervised by experienced physiotherapists. The program consisted of six workstations, where endurance, strength, flexibility, balance, dexterity and reaction were exercised individually. Physiotherapists evaluated and adapted quality and intensity according to the participants' performance. A training group consisted of two to six participants. Program satisfaction and adherence were evaluated using a face-validated questionnaire and attendance rate. Results: From totally 51 people with MS eligible, 37 (10 men, 27 women, mean age 52.7±10.3, median Expanded Disability Status Scale (EDSS) 3.5 (min 2.0, max 6.5) participated in the MS-fit program. Main reasons not to participate were lack of time, or family issues. All 37 participants achieved >80% (mean 90.5%±8.2) of attendance rate and sent the evaluation questionnaire back. Participants rated the program quality as good with an overall median score of 39/50 (min 26, max 50). Overall program satisfaction was median 8 (min4, max10) on a Likert scale from 0-10. 95% of participants would recommend the program to others. Moreover, participants highlighted the positive impact on social participation, peer learning opportunities and reported an increase in exercise management competences. Expectations concerning further program availability was high. Conclusion(s): The MS-Fit training program seems to be a highly appreciated form of exercise therapy with a high rate of attendance. The two-month program intensity and duration was practicable and acceptable. Furthermore, the program positively affected social participation and stimulated participants' exercise competences and learning aspects. Further research is needed to evaluate the functional, mental and physical effects of the program. Implications: The MS-Fit training program might motivate people with MS that are usually involved in one-to-one therapy settings. After analysis of the effectiveness of the circuit training program, implementation and national dispersion might be proposed to offer MS-fit access to people with MS close to their domicile