Background: Exercise is safe and beneficial for managing symptoms, preventing progression, and enhancing the physical and mental well-being of people with multiple sclerosis (MS). Such evidence has supported prescriptive guidelines delivered alongside behavioral interventions to promote and sustain exercise behavior. Evidence-based exercise training interventions now exist for people with MS, such as Project GEMS, a home-based program grounded in MS-specific exercise training guidelines and supported by principles of behavior change based on social–cognitive theory. The field is now ready for the process of translating evidence-based programs from research settings into clinical or community contexts for greater reach and accessibility, but dissemination and implementation remain significant challenges. Objectives: The current paper presents a conceptual roadmap for implementing a validated home-based exercise training intervention for people with MS, originally tested in controlled research environments, within the broader community context. This is guided by the PRACTIS framework for scaling up physical activity/exercise interventions. Roadmap: Our paper presents a conceptual example along with details regarding strategic adaptations for tailoring the remote GEMS program for a diverse and wide MS population, integrating input from community stakeholders and ensuring long-term sustainability through collaborative researcher–stakeholder partnerships. Such an initiative may bridge the gap between research and practice in the domains of exercise training and behavioral interventions for people with MS and further serve as a scalable model for promoting exercise behavior in other neurological conditions by expanding accessibility for effective digital resources. Conclusion: The design of the exercise intervention discussed in this paper offers one example and conceptual pathway for expanding access for evidence-based exercise programs at the wider level.

To evaluate the feasibility and validity of the remotely administered 30-second Sit-to-Stand (30s STS) test as a measure of lower-extremity function in a convenience sample of people with multiple sclerosis (MS). Cross-sectional observational study. Remote, videoconference-based assessments conducted via Zoom. Convenience sample of adults with MS (n = 541) and healthy controls (n = 74). NA. Number of 30s STS repetitions, completion rate, and correlations of 30s STS performance with cognitive and PROM measures. The remote 30s STS test was completed by 498 participants with MS (92%) and all 74 healthy controls (100%) with no adverse events. 30s STS performance was significantly lower in the MS than in healthy controls (10.4 vs 14.0 repetitions; p<0.001; d=-0.75), and this group difference remained significant after adjusting for group differences in age, sex, and marital status. 30s STS repetitions were strongly associated with mobility disability (PDDS: r=-0.56) and walking limitations (MSWS-12: r=-0.57); moderately associated with physical health (SF-12 PCS: r=0.41) and processing speed (SDMT; r=0.34); and weakly associated with symptoms, mental status, verbal learning and memory (CVLT-II), and physical activity in MS. The remotely administered 30s STS appears to be a feasible and valid measure of lower-extremity physical function in stable, relapse-free individuals with MS and may be a useful outcome for telerehabilitation research in this population.

Background: Research demonstrates that exercise training is both safe and beneficial for individuals with multiple sclerosis (MS). There is a timely opportunity for updating the guidelines for exercise training in MS, as the number of RCTs examining the effects of exercise training on a range of functional and biomedical outcomes among adults with MS has increased substantially in the past decade. The evidence for updating the guidelines should be gathered through rigorous methodology, thereby ensuring a comprehensive analysis. This systematic review of the literature will evaluate the type and dose of exercise training necessary to improve fitness, biomarkers of health and disease, physical and cognitive functions, symptoms of MS, quality of life, and/or participation in activities of daily life among adults with MS presenting with mild, moderate, or severe disability. Methods: This protocol for a systematic review follows the PRISMA-P guidelines and was registered on Prospero. We will undertake a systematic and comprehensive search will be conducted across 8 electronic bibliographic databases. Retrieved references will be screened by two authors based on pre-established inclusion and exclusion criteria. Relevant data will be extracted into piloted tables and synthesized qualitatively. Methodological quality of the included studies will be determined using the Tool for the Assessment of Study quality and Reporting in Exercise (TESTEX). Risk of bias will be assessed through the revised Cochrane risk-of-bias tool for RCTs (RoB 2). Finally, the certainty of evidence provided for the outcomes of interest will be evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. Discussion: The evidence gathered and analyzed through this review will be crucial for our next step of updating the exercise guidelines for MS. These updated guidelines will provide people with MS, their families and/or their caregivers, as well as health care professionals and MS services organization or advocates, with clear information to promote exercise training among patients with MS. This will subsequently facilitate implementation of exercise training programs into MS-care. Registration details: PROSPERO registration number CRD42025628825

Research demonstrates that exercise training is both safe and beneficial for individuals with multiple sclerosis (MS). This is a timely opportunity to upda