Objectives Objective 1: To determine the effects of a 16-week remotely delivered Pilates intervention on walking endurance, walking speed, balance, fatigue, and pain compared to a waitlist control group in individuals with MS.
Objective 2: To examine the impact of a 16-week remotely delivered Pilates intervention on depression \& anxiety, cognitive function, and QOL compared to a waitlist control group in individuals with MS.
Aim Aim 1: To assess whether the 16-week remotely delivered Pilates intervention significantly improves walking endurance, walking speed, balance, fatigue, and pain compared to a waitlist control group in individuals with MS Aim 2: To investigate whether the 16-week remotely delivered Pilates intervention significantly improves depression \& anxiety, cognitive function, and QOL compared to a waitlist control group in individuals with MS.
Hypothesis Hypothesis 1: The 16-week remotely delivered Pilates intervention will significantly improve walking endurance, walking speed, balance, fatigue, and pain compared to a waitlist control group in individuals with MS.
Hypothesis 2: Participants receiving the 16-week remotely delivered Pilates intervention will demonstrate significantly greater improvements in depression \& anxiety, cognitive function, and QOL compared to a waitlist control group in individuals with MS.
Age 18 years or older
Self-reported diagnosis of multiple sclerosis by a neurologist
Relapse-free for the past 30 days before screening
Able to speak and read English as the primary language
Pregnant
Elevated risk for strenuous or maximal exercise, defined as more than one "Yes" response on the Physical Activity Readiness Questionnaire (PAR-Q) during screening
Parallel
Pilates
BehavioralREMOTLY PILATES EXERCISE
Change from baseline in walking endurance (Six-Minute Walk Test distance)
Distance walked during the Six-Minute Walk Test (6MWT) will be measured in meters. The outcome is the change from baseline to 16 weeks in 6MWT distance.
Change from baseline in walking speed (Timed 25-Foot Walk)
Walking speed will be assessed using the Timed 25-Foot Walk (T25FW). The outcome is the change from baseline to 16 weeks in time to walk 25 feet, measured in seconds.
Change from baseline in balance (Berg Balance Scale)
Balance will be assessed using the Berg Balance Scale (BBS), a 14-item performance-based measure of static and dynamic balance. Each item is scored from 0 to 4, and the outcome will be the change from baseline to 16 weeks in the BBS total score (range 0-56), with higher scores indicating better balance and lower risk of falls.
Change from baseline in fatigue (Fatigue Severity Scale)
Fatigue will be measured using the Fatigue Severity Scale (FSS), a 9-item questionnaire assessing the impact of fatigue on daily functioning. Each item is rated from 1 to 7, and the outcome will be the change from baseline to 16 weeks in the FSS mean score (range 1-7), with higher scores indicating more severe fatigue.
Change from baseline in cognitive processing speed (Symbol Digit Modalities Test)
Cognitive processing speed will be assessed using the Symbol Digit Modalities Test (SDMT). The outcome is the change from baseline to 16 weeks in SDMT total score, with higher scores indicating better processing speed. SDMT scores typically range from 0 to about 110 correct responses.
Change from baseline in verbal learning and memory (California Verbal Learning Test-II)
Verbal learning and memory will be assessed using the California Verbal Learning Test-II (CVLT-II). The outcome is the change from baseline to 16 weeks in CVLT-II total recall score, with higher scores indicating better verbal learning and memory. CVLT-II total recall scores typically range from 0 to about 80.
Change from baseline in visuospatial learning and memory (Brief Visuospatial Memory Test-Revised)
Visuospatial learning and memory will be assessed using the Brief Visuospatial Memory Test-Revised (BVMT-R). The outcome is the change from baseline to 16 weeks in BVMT-R total recall score, with higher scores indicating better visuospatial memory. BVMT-R total recall scores typically range from 0 to 36.
Change from baseline in depression symptoms
Depression will be measured using a validated questionnaire (e.g., the Hospital Anxiety and Depression Scale-Depression subscale or a similar instrument). The outcome is the change from baseline to 16 weeks in depression total score, with higher scores indicating greater depressive symptoms. Typical depression scales have ranges such as 0-21 (HADS-D) ; enter the exact range that matches the scale you are using.
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