Exercise in the treatment of multiple sclerosis

Exercise has been shown to be effective in improving health outcomes of people with multiple sclerosis (MS). However, systematic reviews and meta-analysis into the benefits of exercise for people with MS have highlighted a need for robustly designed research trials.This chapter discusses the development, implementation, and findings of a pragmatically designed exercise trial in people with MS, the ExIMS (Exercise Interventions in Multiple Sclerosis) trial. The pragmatic approach adopted in the ExIMS trial involved a tailored exercise program guided by the individual and cognitive behavioral techniques to promote long-term adherence. The results from the ExIMS trial increased self-reported exercise behavior, improved fatigue, and led to a sustained enhancement of health-related quality of life in people with MS.The results provide evidence that a pragmatic approach to exercise can have important long-term health benefits that improve self-management in people with MS. The ExIMS should offer encouragement to health professionals to motivate individuals with MS to exercise.