Center‐Based Group and Home‐Based Individual Exercise Programs Have Similar Impacts on Gait and Balance in People With Multiple Sclerosis: A Randomized Trial

BACKGROUND: Group and home-based exercises to improve function in people with multiple sclerosis (MS) are common but have little underpinning evidence. OBJECTIVE: To determine the comparative effectiveness of a center-based group versus home-based individual 8-week exercise program to improve gait and balance in people with MS. DESIGN: Prospective, randomized controlled trial. SETTING: Community center-based and home-based exercise program. PARTICIPANTS: Fifty people with MS were randomized and completed allocated intervention (n = 26 center, n = 24 home), 47 completed post-assessment and 44 follow-up assessment. METHODS: The center- and home-based groups completed an 8-week progressive functional and balance training exercise program. The center-based groups of four to six were supervised by a physiotherapist. The home-based group was provided with telephone support. MAIN OUTCOME MEASUREMENTS: The primary outcome was gait speed (10-meter walk test). Secondary outcomes were gait endurance (6-minute walk test) and balance (Berg Balance Scale). Outcome assessments were conducted at baseline, immediately postintervention and at 8-week follow-up. RESULTS: There was no statistically significant difference between groups in gait speed post training, with a mean difference of 0.01 m/s, 95% CI -0.36 to 0.37. There were no group effects, time effects, or interactions for gait speed, endurance, or balance. In both groups, gait speed improved to a level that met minimal clinically important differences. CONCLUSIONS: Gait speed, endurance, and balance did not statistically improve in either group; however, gait speed changes met minimally important differences.