KANSAS CITY, KS — Frailty not only is a prevalent and debilitating condition in multiple sclerosis (MS) patients; it also is linked to poorer health outcomes.
Noting that targeted interventions remain limited, University of Kansas Medical Center-led researchers examined the feasibility of a multimodal exercise training (MET) program to reduce frailty in MS patients. The Kansas City, MO, VA Healthcare System participated in the study.
Included in the pilot randomized controlled trial were 16 frail people with MS with a median age of 55 and 81.3% female and median Fried frailty scores of 3 or greater. They were randomly assigned to a 6-week MET program consisting of virtual reality treadmill training plus resistance training or to a waitlist control group. The feasibility outcomes included recruitment, retention and adherence rates as well as safety and user engagement throughout the study (Study Participant Feedback Questionnaire-SPFQ).
The researchers collected exploratory outcomes at baseline and 6 weeks and included the Evaluative Frailty Index for Physical Activity (EFIP), the 54-item MS Quality of Life questionnaire (MSQoL-54), the Modified Fatigue Impact Scale (MFIS) and the Physiological Profile Assessment (PPA).
The study was completed by 14 participants, eight in the intervention group and six in the control group. The authors noted that the recruitment rate was 0.33 participants/week, retention was 87.5%, and adherence was high, with participants completing 97.2% of planned training sessions. No adverse events or training-related pain were recorded, they said.
Participants agreed or strongly agreed with 95.7% of applicable SPFQ items, indicating high levels of engagement and satisfaction with the trial. The results, published in PLoS One, indicated that between-group differences in baseline to 6-week change were: EFIP -0.07 (95% CI: -0.14, -0.00); MSQoL-54 mental health +21.24 (95% CI: 7.32, 35.16); MSQoL-54 physical health +19.26 (95% CI: 5.61, 32.91); MFIS -11.46 (95% CI: -18.34, -5.13); and PPA -0.09 (95% CI: -1.19, 1.01).1
“The MET program was safe, feasible, and well-received by frail people with MS. These findings support the viability of MET for future larger-scale trials targeting frailty reduction in this population,” the study team concluded.
- Zanotto T, Tabatabaei A, Lynch SG, He J, Lysaught M, Ahmadnezhad P, Ibude J, Devos H, Chaves LD, Troen BR, Sosnoff JJ. Reducing frailty in frail people with multiple sclerosis: Feasibility of a 6-week multimodal exercise training program. PLoS One. 2026 Apr 15;21(4):e0347063. doi: 10.1371/journal.pone.0347063. PMID: 41984883; PMCID: PMC13082602.