Feasibility, Safety, and Intensity of Frame Running for people with Multiple Sclerosis with Moderate-to-Severe Walking Impairments

Abstract

Purpose: Physical activity is a key symptom management strategy for people with Multiple Sclerosis (pwMS). Yet, pwMS with advanced disability remain less active than the general population, possibly reflecting the dearth of adapted exercise opportunities for this population. This study therefore aimed to evaluate the feasibility of Frame Running, an adapted physical activity, for pwMS with moderate-to-severe walking impairments, its physiological demands, and the feasibility of conducting a definitive trial. Methods: A single-arm, pre-post design was employed, with physical function and self-reported outcomes assessed before and after a 12-week Frame Running programme. Feasibility outcomes included consent and retention rates, adherence, and safety. A one-year follow-up evaluated continued community-based Frame Running participation. Heart rate (HR), steps, cadence, and distance covered during training were recorded. Results: Twenty individuals registered interest, of whom 10 (all with progressive MS; Patient Determined Disease Steps score: 4–6) consented. Consent, retention, and adherence rates were 50.0%, 70.0%, and 86.9%, respectively. Six participants continued attending weekly training sessions one year later. Three participants reported eleven non-serious adverse events. Sessions elicited mean and peak HRs of 64.7±6.7% HRmax and 84.6±9.6% HRmax, respectively. Participants covered 1801±941 m per session, accumulating more steps at cadences ≥100 steps/min on training than non-training days (1756 vs. 767 steps). Conclusion: Frame Running appeared, for those who chose to participate, to present a feasible and safe community-based exercise option for pwMS with substantial mobility impairments, enabling participation in moderate-to-vigorous intensity exercise. Larger controlled trials are warranted to evaluate efficacy and address participation barriers.