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A Controlled Clinical Trial on the Effects of Exercise on Cognition and Mobility in Adults With Multiple Sclerosis

Felippe, Lilian Assunção, MSc; Salgado, Pedro Rippel, Spec; de Souza Silvestre, Diego, PT; Smaili, Suhaila Mahmoud, PhD; Christofoletti, Gustavo, PhD

American Journal of Physical Medicine & Rehabilitation: February 2019 - Volume 98 - Issue 2 - p 97–102
doi: 10.1097/PHM.0000000000000987
Original Research Articles: CME Article . 2019 Series . Number 2

Objective The aim of the study was to investigate the effects of a 6-mo exercise program on cognition and mobility in participants with multiple sclerosis.

Design This is a prospective, single-blind, controlled clinical trial.

Setting A community rehabilitation program within a large metropolitan health service.

Participants Twenty-eight patients with multiple sclerosis were referred for outpatient rehabilitation.

Interventions Participants were allocated to one of two groups and undertook a cognitive-motor exercise program or monitoring (control group).

Main Outcome Measures Cognition and mobility were the main outcome measures. Cognition was evaluated using the Mini-Mental State Examination and the Frontal Assessment Battery. Mobility was assessed with the Timed Get Up and Go test, applied with and without dual task distractors.

Results The findings showed benefits provided by exercise on cognition and mobility. Differently, participants of the control group did not have significant changes in cognition scores after 6 mos of follow-up and had a worse performance in mobility tests.

Conclusion Six months of exercise provided benefits to cognition and mobility in adults with multiple sclerosis. This trial was registered prospectively with the Brazilian Clinical Trials Register, ID: RBR-9gh4km (

To Claim CME Credits Complete the self-assessment activity and evaluation online at

CME Objectives Upon completion of this article, the reader should be able to: (1) Recognize the physical and cognitive decline in multiple sclerosis; (2) Identify the importance of exercise on cognition and mobility in patients with multiple sclerosis; and (3) Appreciate the potential benefit of dual tasking in the rehabilitation of individuals with multiple sclerosis.

Level: Advanced

Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

From the Faculty of Medicine, Universidade Federal University de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil (LAF, GC); Multiple Sclerosis Outpatient Clinic, Hospital Complex, Campo Grande, Brazil (PRS); Institute of Health, Universidade Federal University de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil (DSS, GC); and Department of Physiotherapy at the Universidade Estadual de Londrina, Londrina, Brazil (SMS).

All correspondence should be addressed to: Gustavo Christofoletti, PhD, Institute of Health, Universidade Federal de Mato Grosso do Sul, Av. Universitária, s/n, Caixa Postal 549, Campo Grande, MS, Brazil.

Clinical Trial Identifier: RBR-9gh4km (

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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