The benefits of exercising in a group vs at home independently for ambulatory people with multiple sclerosis

There is one intervention arm, Group circuit training. Group circuit training consists of; - twice weekly balance training strategy exercise class (60 minutes, 8 weeks) aimed at improving gait speed, endurance, balance and reported fatigue. The training intervention providers were registered Physiotherapists with experience working with people with Multiple Sclerosis. Each training intervention Physiotherapist was provided with a list of exercises per station with progression strategies and modifications to be provided as suitable to progress the participant and manage any safety concerns. All classes were undertaken at local community halls. Exercises were performed for 5 minutes per station at intensity selected by the participant - best effort - but no more than borg rating of 6/10. A total of 10 stations were included, each lasting for 5 minutes (total of 50 minutes, with 2 stations dedicated to warm up (5 minutes) and cool down (5 minutes). There transition from station to station was 1 minute (total of 9 minutes). Each participant completed 59 minutes of activity, the final minutes used to answer any participant concerns. Rests were provided as required for each participant with no formal time period designated, however each participant was encouraged to pace themselves and to limit their rests to no more than 30 seconds at a time if taken. Examples of exercises performed Sit to stand from variable height chair - progressions: speed, base of support, preferential loading, height of chair. Marching on the spot - progressions, lifting legs higher, starting from toe off - into claw, reducing hand support, speed. walking forward and backward - progressions longer steps, faster, narrower base of support Balance standing dynamic - progression with reduced / altered base of support, increase dynamic trunk and arm movement, distance reached, holding distance reached, changing direction of distances reached, adding unstable surfaces each interventions is personalised and adapted individually for the group program by the treating physiotherapists monitoring the participants skill of execution and encouraging variances to the task. At 4 weeks all participants were encouraged to increase intensity and beat personal goals of repetitions, speed, distances covered. The treating physiotherapists provided ongoing feedback and monitoring of participant adherence and needs. If a participant failed to attend without prior notification, phone contact was made to ascertain concerns / problems and encourage return.