Proximal Resistance Training for People With Multiple Sclerosis (PT-MS)

April 15, 2025 updated by: University of Colorado, Denver

Proximal Resistance Training to Improve Walking Capacity and Physical Activity in People With Multiple Sclerosis: A Feasibility Study

The objective of this study is to pilot a 10-week resistance and functional movement intervention targeting proximal muscles in 40 people with MS. The investigators will assess implementation feasibility (recruitment, fidelity, retention, satisfaction), collect pilot data for key walking function outcomes, and examine movement-pattern and activity behavior mechanisms. Walking function will be measured by walking capacity (6-Minute Walk Test - 6MWT) and PA quantity (average steps/ day over 10 days). Movement-pattern mechanisms will be measured using 3D motion capture analysis (pelvis and trunk kinematics). Activity behavior mechanisms will be measured by patient-reported outcome questionnaires (perception of walking ability, self-efficacy, and readiness to change).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The proposed study will be a prospective cohort in 40 people with MS with one baseline and one follow-up assessment after a 10-week functional resistance training intervention. The screening and outcome assessments will take place in the CU Interdisciplinary Movement Science Lab and intervention will occur in the CU Physical Therapy Program gym. Both facilities have the necessary space and equipment for outcomes assessment and intervention, respectively. The PI will perform the initial screening and deliver the intervention. In order to limit testing bias, all functional tests, patient-reported outcomes, and motion capture data collection will be performed by an experienced research assistant.

Participants will receive 14 one-on-one supervised intervention visits over 10 weeks. Intervention frequency will mimic clinical practice, starting at 2x/ week in clinic (2x/ week independently) for four weeks and tapering to 1x/ week in clinic (3x/ week independently) for the final six weeks. Participants will be prescribed 5 categories of resistance exercises, and each category will have a series of exercises to select from. Two will target hip abduction (lying down and standing), two will target trunk muscles (sidelying/ forward planks, resisted trunk rotation), and one will target functional resistance training for the hip and trunk during walking-related tasks such as multi-directional resisted walking. Dosing will be based on guidelines for MS. Strengthening exercises will begin with 3 sets of 12-15 reps at 15 rep-max load (RM) and progress to 3 sets of 8-10 reps at 10-12 RM. Endurance exercises requiring a static hold will progress from 3 sets of 15-20 second holds to 30-second holds. Functional resistance will be dosed to improve muscular endurance: 3 sets of 15-20 reps based on form fatigue. Progression will be achieved by modifying body position, and/or adding cuff weights or resistance bands. Exercises will take 30-45 minutes to complete. Upper extremity use to maintain balance will be allowed as needed.

Study Type

Interventional

Enrollment (Actual)

34

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Colorado
      • Aurora, Colorado, United States, 80045
        • University of Colorado

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria.

  • 18-64 years old
  • Neurologist-confirmed diagnosis of MS
  • Able to walk at least 100 meters without an assistive device
  • Expanded Disability Status Scale - EDSS < 6
  • Have their own tablet/phone/computer capable of video calls/Zoom meetings.

Exclusion Criteria.

  • Other conditions limiting their ability to exercise or walk
  • Unsafe to exercise as determined by a neurologist or physical therapist
  • Currently undergoing physical therapy
  • Unable to provide consent or follow simple directions
  • Have an MS-related exacerbation or changes to their disease-modifying drug therapy in the month prior to enrollment
  • A 25 foot walk test time of > 4.5 seconds

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Proximal Resistance Training
Participants will receive 6 one-on-one supervised intervention visits and 8 telerehabilitation visits over 10 weeks. For the first 4 weeks intervention frequency will start with 1x/ week in clinic and 1x/ week via telerehabilitation, and the participant will be asked to perform exercises 2x/ week independently. For the final 6 weeks there will be 1x week supervised visits (weeks 6 and 8 in person, and weeks 5,7, 9, and 10 via telerehabilitation) and the participant will be asked to perform exercises 3x/ week independently.
Participants will be prescribed 5 categories of resistance exercises, and each category will have a series of exercises to select from. Two will target hip abduction, two will target trunk muscles, and one will target functional resistance training for the hip and trunk during walking-related tasks such as multi-directional resisted walking. Dosing will be based on guidelines for MS. Strengthening exercises will begin with 3 sets of 12-15 reps at 15 rep-max load (RM) and progress to 3 sets of 8-10 reps at 10-12 RM. Endurance exercises requiring a static hold will progress from 3 sets of 15-20 second holds to 30-second holds. Functional resistance will be dosed to improve muscular endurance: 3 sets of 15-20 reps based on form fatigue.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in 6-minute walk test
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
The 6MWT assesses walking endurance via the maximal distance an individual is able to walk in 6 minutes, reported in meters
Baseline, end of 10 week intervention period, 22 week follow-up.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in average daily step count
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
Step count will be measured by waist-mounted ActiGraph accelerometer-based activity monitors
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in movement patterns
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
Mechanisms of movement patterns will be measured by 3-dimensional motion capture analysis during self-selected walking speed and during a 30 second chair raise test.
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in Multiple Sclerosis Walking Scale-12
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
A 12 questions assessment of self-reported walking mobility in people with multiple sclerosis. Scores range from 0 to 100 with higher scores indicating better mobility.
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in Multiple Sclerosis Self-Efficacy Score
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
An 18 item assessment of measures of self-efficacy in multiple sclerosis including a function component and a control component. Total score is reported on a 10-100 point scale with higher scores indicating greater certainty in ones ability to manage multiple sclerosis symptoms.
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in Exercise Self-Efficacy Scale
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
A 9 item questionnaire that assesses perceptions about ability to participate in at least 20 minutes of moderate physical activity 3x per week. Scores range from 0 to 90 points with higher scores indicating more confidence to exercise in different circumstances.
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in Exercise Stages of Change category
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
A 4 item measure to assess readiness to participate in exercise and activity. Depending on the answers to the yes/no questions, results are categorized as "pre-contemplation", "contemplation", "preparation", "action", and "maintenance".
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in Modified Fatigue Impact Scale
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
The standard measure of patient-reported limitations due to fatigue in people with MS. Scores range from 0 to 84 with higher scores indicating higher impact of fatigue on daily activities.
Baseline, end of 10 week intervention period, 22 week follow-up.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Patient-Specific Functional Scale
Time Frame: Baseline and end of 10 week intervention period.
Participant identifies 3 activities that the participant is unable to do, or is difficult for the participant to do and rates them on a 10-point scale, with higher scores indicating greater ability to perform activity.
Baseline and end of 10 week intervention period.
Change in hip abduction strength
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
Hip abduction strength will be measured in kg using hand-held dynamometry.
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in lateral trunk flexion strength
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
Lateral trunk flexion strength will be measured in kg using hand-held dynamometry.
Baseline, end of 10 week intervention period, 22 week follow-up.
Change in lateral trunk flexion endurance
Time Frame: Baseline, end of 10 week intervention period, 22 week follow-up.
Trunk flexion endurance as measured by a clinical trunk curl-up test which counts the number of trunk curls a participant can perform in 1 minute.
Baseline, end of 10 week intervention period, 22 week follow-up.
Expanding Disability Status Scale
Time Frame: Baseline
Neurological exam used to assess disability in people with multiple sclerosis. Scores range from 0 to 6 with higher scores indicating more disability.
Baseline
25 Foot Walk Test
Time Frame: Baseline and after the 10 week intervention period.
Amount of time in seconds it takes for participant to walk 25 feet as quickly and safely as possible.
Baseline and after the 10 week intervention period.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Mark M. Manago, DPT, PhD, University of Colorado, Denver

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 12, 2020

Primary Completion (Actual)

October 31, 2022

Study Completion (Actual)

October 31, 2022

Study Registration Dates

First Submitted

September 8, 2020

First Submitted That Met QC Criteria

September 8, 2020

First Posted (Actual)

September 14, 2020

Study Record Updates

Last Update Posted (Actual)

April 18, 2025

Last Update Submitted That Met QC Criteria

April 15, 2025

Last Verified

April 1, 2025

More Information

Terms related to this study

Other Study ID Numbers

  • 20-1527
  • K12HD055931 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

We will publish the trial results data on the ClinicalTrials.gov website, on which the clinical trial will be registered. Sharing of data will include the potential of sharing raw data generated from all clinical assessments under a data-sharing agreement.

IPD Sharing Time Frame

We will publish the trial results within one year of testing the final participant.

IPD Sharing Access Criteria

User registration will be required to access/download any data and will require agreement to conditions of use in accordance with NIH Data Sharing Policy Guidelines.

IPD Sharing Supporting Information Type

  • ICF
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Multiple Sclerosis

Clinical Trials on Proximal Resistance Training

Search Similar Trials