1. A Controlled Trial Investigating the Effects of Fitness Training in Multiple Sclerosis O’CONNELL R, MURPHY RM, COOKE G, FITZGERALD T. Kindly Funded by Biogen Pharmaceutical Company

2. Introduction  Sedentary Lifestyle (Ng & Kent-Braun 1997, Stuifbergen 1997)  Age of Onset  Social Outlet (Compston 1993)  Fatigue (Thompson, 1993) Sutherland & Anderson, 2001, Neilson & Norgaard, 2002 Sutherland & Anderson, 2001, Neilson & Norgaard, 2002  Positive effects on QOL, fitness, fatigue and strength (Petajan et al 1996)

3. Aim To investigate the effects of a twelve week aerobic programme on the physical and psychosocial aspects of MS patients with mild disability

4. Methods Subjects  Diagnosed, independently mobile, unchanged status for 3 months  Random allocation of 24 patients: exercise group n=12 / control group n=12 Intervention  12 weeks: twice weekly in gym, once at home  Circuit style training  Heart Rate and RPE monitored

5. Methods Assessment: baseline, three months and F/U :  Aerobic Fitness: Modified Graded Exercise Test - HR and RPE  50 Metre Walk Test  Questionnaires: Quality Of Life - FAMS (232) - MSIS-29 (145) - MSIS-29 (145) Fatigue – MFIS (84) Fatigue – MFIS (84) Analysis: Medians, upper and lower quartiles Kruskal-Wallis rank sum test Kruskal-Wallis rank sum test

6. Within-Group Changes from Baseline Baseline P50 [P25, P75] Changes at 3 months P50 [P25, P75] Changes at 6 months P50 [P25, P75] NexExNexExP valueNexExP value HR 152 [132.5, 168] 157.5 [130, 163] 0.5 [-4, 5.5] -14 [-18.5, - 2.5] 0.009* 1.5 [-0.5, 5] 0.5 [-10.5, 10.5] 0.88 RPE 17 [15.5, 18] 18 [17, 20] 1 [-0.5, 2] -3 [-5, -0.5] 0.003* 1 [-1, 1.5] -1.5 [-2.5, 1] 0.08 FAMS 191 [170.5, 208] 168.5 [149.5, 99.5] -3.5 [-16, 5] 23 [9.5, 42.5] 0.006* -4.5 [-25, 8] 19 [14, 31] 0.002* MFIS 26.5 [21.5, 33.5] 26 [17, 40.5] 1 [-4, 4.5] -13 [-20.5, -3] 0.02* 0.5 [-2.5, 6.5] -8.5 [-19.5, -1] 0.02* MSIS- 29 44.5 [38.5, 57] 43 [40, 61] [-4.5, 4.5] -6.5 [-10, 1] 0.13 0 [-1, 1] -6 [-9, 0.5] 0.10 50MW 33.5 [29.5, 5.5] 34 [32, 37.5] -0.5 [-2.5, 0] -3.5 [-6, -2] 0.02* [-2.5, 0] -3.5 [-6, -1] 0.09 STEP 68 [60.5, 73] 69.5 [64.5, 77] -2 [-7, 0] -5 [-11, -3.5] 0.09 0.5 [-4.5, 2.5] -4.5 [-10, -2] 0.06

7. Changes from Baseline: Heart Rate

8. Changes from Baseline: Rate of Perceived Exertion

9. Changes from Baseline: Quality of Life

10. Changes from Baseline: Fatigue

11. Conclusion