# Feasibility and Pre–Post Changes Associated with a 12-Week Treadmill Walking Training Programme on Walking Performance, Physical Function, Fatigue, and Quality of Life in People with Multiple Sclerosis: A Single-Arm Pilot Study

## TL;DR

A 12-week treadmill walking program for people with multiple sclerosis was found to be safe and effective in improving walking, physical function, and reducing fatigue.

## Contribution

This study demonstrates the feasibility and positive outcomes of treadmill walking training in a single-arm pilot study for people with MS.

## Key findings

- Participants showed significant improvements in walking performance and physical function.
- Fatigue levels decreased significantly after the 12-week program.
- Quality of life improvements were limited to specific domains like vitality and general health.

## Abstract

What are the main findings?
A 12-week supervised treadmill walking training programme was feasible and safe for people with multiple sclerosis, with high adherence and no adverse events.The intervention was associated with improvements in walking performance, functional mobility, physical function, and fatigue, while overall quality of life showed domain-specific changes only.

A 12-week supervised treadmill walking training programme was feasible and safe for people with multiple sclerosis, with high adherence and no adverse events.

The intervention was associated with improvements in walking performance, functional mobility, physical function, and fatigue, while overall quality of life showed domain-specific changes only.

What are the implications of the main findings?
These findings suggest that supervised treadmill walking training can be integrated into routine neurorehabilitation settings and was associated with clinically meaningful pre–post changes in mobility and fatigue in people with multiple sclerosis.The domain-specific pre–post changes observed in vitality and general health suggest that treadmill-based exercise may preferentially be associated with changes in perceived energy levels and health status, rather than global quality of life, in people with multiple sclerosis.

These findings suggest that supervised treadmill walking training can be integrated into routine neurorehabilitation settings and was associated with clinically meaningful pre–post changes in mobility and fatigue in people with multiple sclerosis.

The domain-specific pre–post changes observed in vitality and general health suggest that treadmill-based exercise may preferentially be associated with changes in perceived energy levels and health status, rather than global quality of life, in people with multiple sclerosis.

Background/Objectives: Walking impairment and fatigue are common in multiple sclerosis (MS) and contribute to reduced physical function and quality of life (QoL). This study evaluated the feasibility, safety, and pre–post changes associated with a 12-week treadmill walking training (TWT) programme on walking performance, physical function, fatigue, and QoL in people with MS. Methods: Single-arm pilot study with pre–post assessments (T1–T2). Eleven adults with MS (Expanded Disability Status Scale [EDSS] ≤ 6) completed supervised TWT for 12 weeks (two 25 min sessions/week) at the Complejo Asistencial Universitario de Soria (Spain). Outcomes included SF-36, Timed Up and Go (TUG), 4 m gait speed, Short Physical Performance Battery (SPPB), and Modified Fatigue Impact Scale (MFIS). Within-participant changes were analysed using paired t-tests or Wilcoxon signed-rank tests as appropriate; effect sizes were reported as appropriate for the statistical test. Results: SF-36 total score did not change significantly (p = 0.160), while general health (p = 0.039) and vitality (p = 0.043) improved. Walking performance improved (TUG, p = 0.007; 4 m gait speed, p < 0.001), and physical function increased (SPPB, p = 0.003). Fatigue impact decreased (MFIS total, p = 0.015; physical, p = 0.007; psychosocial, p = 0.026), whereas the cognitive subscale did not change significantly (p = 0.094). Adherence was 91.7%, and no adverse events were reported. Conclusions: In this pilot sample, a 12-week TWT programme was feasible and safe and was associated with improvements in walking performance, physical function, and fatigue, with QoL changes limited to specific SF-36 domains. These findings support proceeding to a randomised controlled trial to establish efficacy. These findings should be interpreted as preliminary and exploratory, given the single-arm pre–post study design.