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Zanotto T, Kumar DP, Tabatabaei A, Lynch SG, He J, Herda TJ, Devos H, Thiyagarajan R, Chaves L, Seldeen K, Troen BR, Sosnoff JJ. Multimodal exercise training to reduce frailty in people with multiple sclerosis: study protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2024; 10:65. [PMID: 38650042 PMCID: PMC11034042 DOI: 10.1186/s40814-024-01496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/14/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Frailty, a syndrome characterized by decreased reserve and resistance to stressors across multiple physiologic systems, is highly prevalent in people living with multiple sclerosis (pwMS), independent of age or disability level. Frailty in MS is strongly associated with adverse clinical outcomes, such as falls, and may aggravate MS-related symptoms. Consequently, there is a pressing necessity to explore and evaluate strategies to reduce frailty levels in pwMS. The purpose of this pilot randomized controlled trial (RCT) will be to examine the feasibility and preliminary efficacy of a multimodal exercise training program to reduce frailty in pwMS. METHODS A total of 24 participants will be randomly assigned to 6 weeks of multimodal exercise or to a waitlist control group with a 1:1 allocation. PwMS aged 40-65 years and living with frailty will be eligible. The multimodal exercise program will consist of cognitive-motor rehabilitation (i.e., virtual reality treadmill training) combined with progressive, evidence-based resistance training. At baseline and post-intervention, participants will complete the Evaluative Frailty Index for Physical Activity (EFIP), measures of fall risk, and quality of life. Frailty-related biomarkers will also be assessed. In addition, the feasibility of the multimodal exercise program will be systematically and multidimensionally evaluated. DISCUSSION To date, no RCT has yet been conducted to evaluate whether targeted exercise interventions can minimize frailty in MS. The current study will provide novel data on the feasibility and preliminary efficacy of multimodal exercise training as a strategy for counteracting frailty in pwMS. TRIAL REGISTRATION ClinicalTrials.gov, NCT06042244 (registered in September 2023).
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Affiliation(s)
- Tobia Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA.
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Danya Pradeep Kumar
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Abbas Tabatabaei
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sharon G Lynch
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jianghua He
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Trent J Herda
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS, USA
| | - Hannes Devos
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ramkumar Thiyagarajan
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lee Chaves
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Research Service, Kansas City Veterans Affairs Healthcare System, Kansas City, MO, USA
| | - Kenneth Seldeen
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Research Service, Kansas City Veterans Affairs Healthcare System, Kansas City, MO, USA
| | - Bruce R Troen
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Research Service, Kansas City Veterans Affairs Healthcare System, Kansas City, MO, USA
| | - Jacob J Sosnoff
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
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