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Healing and Building Strength Through Exercise

Shepherd Center leading multi-center study to evaluate at-home exercise routine for people with multiple sclerosis.

If you or someone you know lives with multiple sclerosis (MS), you know that mobility – and even the most basic of activities – can be challenging.

With MS, the body’s immune system attacks the protective covering of the nerves, so messages between the brain and the body don’t always get relayed appropriately. Muscles weaken, and many people struggle with balance and coordination.

“It can quickly become a vicious cycle in which people with MS try to avoid being active, fearing that it will make their symptoms worse, but then they lose ground in terms of their mobility,” says Deborah Backus, PT, Ph.D., director of multiple sclerosis research at the Eula C. and Andrew C. Carlos Multiple Sclerosis Rehabilitation and Wellness Program at Shepherd Center. “We know that exercise can reduce MS symptoms, and that it carries a host of other health benefits. It’s a powerful tool to help manage the physical and emotional side of MS.”

Still, many people with MS face hurdles when it comes to being physically active. Flare-ups of their symptoms, con-cerns over how to safely exercise and lack of easy access to a gym or suitable exercise equipment can all be issues.

Recently, Backus along with Robert Motl, Ph.D. at the University of Alabama and collaborators at six other research sites were awarded a grant from the Patient Centered Outcomes Research Institute to study MS and exercise. They hope to make exercise more accessible to people with MS and gain a deeper understanding into how exercise programs should be designed to best meet their unique needs. They are also currently seeking participants to join the study.

The researchers are comparing a four-month home-based exercise program against one that takes place at a gym or other facility. Both exercise programs include a mix of aerobic and resistance training twice weekly, tailored to each participant. The goal is to find out if the home-based is as effective as facility-based program for improving walking ability, quality of life and overall self-confidence to stay active.

The study will also give important insight into whether a person’s ability to choose how and where they train affects their participation and any gains they make. Half will choose where they prefer to exercise – at the gym with trained staff or at home using a DVD and with access to a virtual coach. The other half will be randomly assigned to one of the two groups. Researchers will follow participants for one year.

With 56 people already enrolled, researchers are aiming to recruit a total of 500 adults with MS (ages 18-65 years). To be considered for the study, people must be able to walk at least 25 feet, but with some effort.

“If people are still walking, but have trouble with walking and don’t know how to safely exercise, it’s the perfect study for them,” says Backus. “Participants who’ve completed the study so far are really enthusiastic and have been able to continue with their exercise regimen even when their MS symptoms have challenged them.”

The research team is also collecting information about what helps people stick with exercise.

“We want people to change their behavior over the long-term, not just for the time they are in the study, so it’s important to know what helps,” says Backus. “This program is unique in that it is teaching people a safe way to exercise and progress in a way that is sustainable and allows them to be active through the highs and lows of MS – even on days when they feel very tired or when their symptoms are flaring up.”

Shepherd Center and the University of Alabama are the lead sites for this study. Collaborating sites include: 

» Accelerated Cure Project for Multiple Sclerosis

» Cleveland Clinic Mellen Foundation

» Marquette University

» University of Colorado, Denver

» University of Georgia

» University of North Carolina at Chapel Hill

For more information about the study, “Comparative Effectiveness of an Exercise Intervention Delivered via Telerehabilitation and Conventional Mode of Delivery,” or to enroll at Shepherd Center, please contact Erica Sutton at 404-367-1305 or To find a site near you, visit

Written by Amanda Crowe, MA, MPH

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.