Patient-Centered Outcomes Research Institute Awards $5.7 Million in Research Funding for Study of Exercise Delivery and Effects in People with Multiple Sclerosis

Researchers studying methods of exercise delivery and their effects on people living with multiple sclerosis have been awarded $5.7 million in funding by the Patient-Centered Outcomes Research Institute (PCORI). Collaborating on the research are Deborah Backus, PT, Ph.D., director of multiple sclerosis (MS) research at Shepherd Center, and Robert Motl, Ph.D., a professor at the University of Alabama at Birmingham and associate director of research for the UAB/Lakeshore Research Collaborative.

The study, “Comparative Effectiveness of an Exercise Intervention Delivered via Telerehabilitation and Conventional Mode of Delivery,” will evaluate the effectiveness of different types of exercise programs for people with multiple sclerosis (MS). The project will compare exercise programs provided at gyms or rehabilitation facilities with a telerehabilitation program available to patients at home. The goal is to increase the accessibility and sustainability of exercise options for people with MS.

“People with MS often have decreased mobility that can lead to more disability and less physical activity and participation in daily life activities,” said Dr. Backus, whose research focuses on improving the health and function of people with MS.. “Though exercise has been shown to decrease symptoms of MS and improve mobility, many people with MS face obstacles to exercise such as inaccessibility, affordability, lack of knowledge and training, as well as symptoms of MS that can make exercising difficult.”

In addition to being co-principal investigator of the study, Dr. Motl, also developed the exercise program being evaluated in the study.

“This is an exciting partnership to evaluate whether telerehab delivery is as effective as facility-based delivery,” Dr. Motl said. “If it is, it has the potential to break down barriers to exercise for people in remote areas who do not have access to MS experts.”

At multiple sites, the project will enroll people with MS who are able to walk slowly. They will be assigned to one of two exercise groups – a facility-based exercise training (FET) or a telerehab exercise training (TET) group. In both cases, participants will receive evidence-based exercise guidelines and support. A group of participants will be in a gym or rehabilitation center (FET), and some will participate in the telerehab exercise training at their homes. Researchers will measure participants’ ability to walk, their perception of their mobility and symptoms and quality of life, as well as participants’ confidence level with exercising or participating in physical activities on their own.

“With the findings of this study, our goal is to develop tools to help educate people with MS, as well as caregivers, community providers, insurers and policymakers about different modes of exercise interventions to help them make educated choices about which one might be most beneficial for any given person with MS,” Dr. Backus explained. “That we are also evaluating the impact of choice on participant outcomes is a novel aspect of the study.”

Shepherd Center is the lead site for the study. Other collaborators include Kevin McCully, Ph.D., at the University of Georgia; Gary Cutter, Ph.D., at the University of Alabama at Birmingham; Jeffrey R. Hebert, PT, Ph.D., MSCS, at the University of Colorado; Francois Bethoux, M.D., at the Cleveland Clinic Mellen Foundation; Eduard Gappmaier, PT, Ph.D., at the University of Utah; Alexander Ng, Ph.D., at Marquette University; and, Robert McBurney, Ph.D., of the Accelerated Cure Project.

This innovative study was selected for funding through a PCORI funding announcement specifically focused on comparing the effectiveness of treatment options for people with MS. While there are a variety of therapies available to people with MS, input from a variety of stakeholders helped PCORI identify this as an important topic for research based on the lack of evidence available to help patients and other stakeholders choose among the available care options.

“This project was selected for PCORI funding for its potential to fill an important gap in our understanding of MS treatment,” said PCORI Executive Director Joe Selby, M.D., MPH. “It will provide useful information to help patients and their caregivers weigh the effectiveness of their care options. We look forward to following the study’s progress and working with Shepherd Center and its collaborators to share the results.”

Dr. Backus’ award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.