{"doi":"10.1016/j.apmr.2024.09.010","title":"Effects of a 6-Week Treadmill Training With and Without Virtual Reality on Frailty in People With Multiple Sclerosis","abstract":"Objective To examine the effects of a cognitive-motor rehabilitation program consisting of treadmill training (TT) augmented by virtual reality (TT+VR) on frailty in people with multiple sclerosis (pwMS). Design Secondary analysis from a multicenter randomized controlled trial investigating the effects of TT+VR, compared with TT only, on measures of mobility and cognitive function in pwMS. Setting Four university research laboratories in 3 countries. Participants A total of 124 pwMS were randomized into the parent trial. Here, we studied a subset of n=83 participants (mean age, 49.4±9.3y; 73.5% female; expanded disability status scale range, 2.0-6.0), who completed the intervention and had complete preintervention and postintervention frailty data. Interventions Participants were randomly allocated to TT+VR (n=44) or TT (n=39). Both groups trained 3 times a week for 6 weeks. Main Outcome Measures Frailty was assessed using a 40-item frailty index (FI) through standard validated procedures and represented the primary study outcome. Two exploratory frailty indices were also computed by isolating health-related deficits involving the cognitive (FI-physical) or physical (FI-cognitive) domains from the main FI. The assessments were performed at baseline and after 6 weeks, upon intervention completion. Results The mean FI of study participants at baseline was 0.33±0.13, indicating a moderate average level of frailty. FI scores improved in both TT+VR and TT groups participants (pooled mean ΔFI, 0.024; 95% CI, 0.010-0.038; F=10.49; P= .002; η p 2 =0.115), without any group-by-time interaction (F=0.82; P= .367; η p 2 =0.010 ) . However, a significant group-by-time interaction was found for pretraining and posttraining changes in FI-cognitive (F=5.74; P= .019; η p 2 =0.066), suggesting a greater improvement for TT+VR group participants than for TT group participants. Conclusions TT with or without virtual reality can reduce frailty levels in pwMS. While both TT and TT+VR had a positive effect on overall frailty, only TT+VR improved cognitive aspects of frailty and may represent an appropriate strategy for counteracting frailty in pwMS.","journal":"Archives of Physical Medicine and Rehabilitation","year":2024,"id":429408,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9452,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1231493,"name":"Irina Galperin","orcid":"0000-0002-8373-6915","position":1,"is_corresponding":false},{"id":1231494,"name":"Danya Pradeep Kumar","orcid":"0000-0002-6913-5902","position":2,"is_corresponding":false},{"id":233013,"name":"Anat Mirelman","orcid":"0000-0002-1520-2292","position":3,"is_corresponding":false},{"id":1232063,"name":"Shahar Yehezkyahu","orcid":null,"position":4,"is_corresponding":false},{"id":1232064,"name":"Keren Regev","orcid":null,"position":5,"is_corresponding":false},{"id":1231495,"name":"Arnon Karni","orcid":"0000-0002-5625-7900","position":6,"is_corresponding":false},{"id":918646,"name":"Tanja Schmitz‐Hübsch","orcid":"0000-0003-4833-5937","position":7,"is_corresponding":false},{"id":18655,"name":"Friedemann Paul","orcid":"0000-0002-6378-0070","position":8,"is_corresponding":false},{"id":349480,"name":"Sharon Lynch","orcid":null,"position":9,"is_corresponding":false},{"id":529901,"name":"Abiodun Akinwuntan","orcid":"0000-0002-0167-685X","position":10,"is_corresponding":false},{"id":366797,"name":"Jianghua He","orcid":"0000-0002-9718-1009","position":11,"is_corresponding":false},{"id":484463,"name":"Bruce R. Troen","orcid":"0000-0002-3699-0021","position":12,"is_corresponding":false},{"id":1231496,"name":"Hannes Devos","orcid":"0000-0003-3695-6445","position":13,"is_corresponding":false},{"id":233010,"name":"Jeffrey M. Hausdorff","orcid":"0000-0002-1608-0776","position":14,"is_corresponding":false},{"id":689370,"name":"Jacob J. Sosnoff","orcid":"0000-0002-0286-9207","position":15,"is_corresponding":false},{"id":1076038,"name":"Tobia Zanotto","orcid":"0000-0002-6571-4763","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-19T01:59:06.668462Z","pmid":"39341443","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}