title: Predictors of the physical impact of Multiple Sclerosis following community-based, exercise trial.
abstract: BACKGROUND
  Studies evaluating exercise interventions in people with multiple sclerosis (PwMS) demonstrate small to medium positive effects and large variability on a number of outcome measures. No study to date has tried to explain this variability.
  
  
  OBJECTIVE
  This paper presents a novel exploration of data examining the predictors of outcome for PwMS with minimal gait impairment following a randomised, controlled trial evaluating community-based exercise interventions (N = 242).
  
  
  METHODS
  The primary variable was the physical component of the Multiple Sclerosis Impact Scale-29, version 2 (MSIS-29, v2) after a 10-week, controlled intervention period. Predictors were identified a priori and were measured at baseline. Multiple linear regression was conducted.
  
  
  RESULTS
  Four models are presented lower MSIS-29, v2 scores after the intervention period were best predicted by a lower baseline MSIS-29,v2, a lower baseline Modified Fatigue Impact Score (physical subscale), randomisation to an exercise intervention, a longer baseline walking distance measured by the Six Minute Walk Test and female gender. This model explained 57.4% of the variance (F (5, 211) = 59.24, p < 0.01).
  
  
  CONCLUSIONS
  These results suggest that fatigue and walking distance at baseline contribute significantly to predicting MSIS-29, v29 (physical component) after intervention, and thus should be the focus of intervention and assessment. Exercise is an important contributor to minimising the physical impact of MS, and gender-specific interventions may be warranted.
authors.affiliation: University of Limerick, Limerick, Ireland Maria.Kehoe@hse.ie.
authors.forename: M
authors.initials: M
authors.lastname: Kehoe
authors.affiliation: Statistical Consulting Unit / CSTAR @ UL, University of Limerick, Limerick, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Saunders
authors.affiliation: Department of Physical Education and Sports Science, University of Limerick, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Jakeman
authors.affiliation: University of Limerick, Limerick, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: Coote
mesh_terms: D000328:Adult; D003153:Community Health Services; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D012727:Sex Characteristics; D016896:Treatment Outcome; D016138:Walking
keywords: Multiple sclerosis; exercise; fatigue; predict or; quality of life; rehabiliation