Exercise, Behavioral Therapy Improves Outcomes in Multiple Sclerosis Patients

A combination of physical, occupational, hand, speech, cognitive, and behavioral therapy improves outcomes.

INDIANAPOLIS — A continuous disease management program of prescribed exercise for patients with multiple sclerosis (MS) successfully reversed disease-related decline in the majority of patients, according to data presented at the Consortium of Multiple Sclerosis Centers 2015 Annual Meeting.

“MS patients are told this is a progressive disease and it is, but, clinically speaking, we’ve seen patients improve over long periods of time and continue to improve,” study presenter John Marmarou, DPT, MSCS, of Total Rehab & Fitness in Cherry Hill, NJ, told Neurology Advisor. “Patients were falling less, walking further and faster, and improving in cognition and hand function.”

Total Rehab & Fitness, a freestanding multidisciplinary practice, offers evidence-based rehabilitation services for patients with MS. The disease management program features a continuous model that addresses disabilities and impairments, while striving to improve and maintain lost function, enhance quality of life, and lower health care costs. It includes physical, occupational, hand, speech, cognitive, and behavioral therapy.

Marmarou and colleagues examined the efficacy of this program in 50 randomized patients (72% women), who were included if they were in the program for at least 12 months (mean, 18 months) and had at least a 68% attendance rate.

According to results, 92% of patients demonstrated an improvement in MS functional composite score, with an average improvement of 15%. In addition, researchers reported the following data:

  • 72% improved in 25-foot walk test time
  • 96% improved in 9-Hole Peg Test (HPT) time in the dominant hand
  • 90% improved in 9-HPT time in the non-dominant hand
  • 90% improved in Paced Auditory Serial Addition Test score
  • 82% improved in the 6 minute walk test distance
  • 86% improved in fall frequency

“Early intervention is key with [MS] patients,” Marmarou said. “More people are being diagnosed with MS everyday. We need to be thinking of … out-of-the-box ways to deliver care and not let third-party payers dictate care, which ultimately affects patients’ quality of life. If there is a way to get patients the care they need regardless of their ability to pay, it improves their quality of life and saves community and federal government resources, as well as third-party payers.”

Going forward, Marmarou said he would like to see a larger, highly controlled study performed on the disease management program in hopes that this form of treatment can become the new standard of care. However, for now, “interpret the findings with caution,” he said.


  1. Marmarou J et al. Long-Term Effects of Prescribed Exercise for Persons with MS. Presented at: Consortium of Multiple Sclerosis Centers Annual Meeting 2015; May 27-30, 2015; Indianapolis, Indiana.