The approach could allow patients to get more benefit from exercise and physical therapy, researchers say.

Fatigue is a common symptom of MS and frequently limits a patient's ability to exercise. Herb Karpatkin, DSc, MPT, a physical therapist, MS specialist, and professor at the Hunter College Program in Physical Therapy in Brooklyn, New York, and colleagues set out to determine if patients reported different levels of fatigue when they engaged in intermittent instead of continuous exercise. They enrolled 30 ambulatory patients in a study with a repeated-measures, crossover, within-subject design. Participants had Expanded Disability Status Scale scores between 2.0 and 6.5. They were asked to perform 6 minutes of continuous or intermittent walking.

A visual analog scale of fatigue was used to measure fatigue. When patients walked for 6 minutes continuously, self-rating of fatigue went from a mean of 43.53 points to 68.73 points — an increase of 25.20 points. During intermittent walking, the mean fatigue score went from 48.03 to 57.20 — an increase of 9.17 points. Disease severity, duration, and the mood of the participant had no effect on the change in score.

The intermittent approach was suggested by his patients, Dr. Karpatkin told Medscape Neurology & Neurosurgery.

Intermittent exercise seems to have the same physical benefit as continuous exercise. A comparison hasn't been done in MS patients, but comparison studies of intermittent and continuous exercise have shown the 2 forms of exercise to be equivalent in chronic fatigue syndrome, diabetes, obesity, chronic obstructive pulmonary disease, and fibromyalgia, Dr. Karpatkin said.

Exercise does take longer, but success is generally its own reward, he noted. "There was 1 patient who couldn't walk more than 3 or 4 minutes on a treadmill; after a few sessions, she could do 20 or 25 minutes. That's a very powerful thing for her," Dr. Karpatkin said.

"It bodes well for us in how we prescribe exercise programs," Susan Bennett, PT, EdD, NCS, physical therapist and clinical associate professor at the University of Buffalo, New York, who attended the session, told MedscapeNeurology & Neurosurgery. Still, the results are preliminary. "More research is needed," Dr. Bennett added.

Consortium of Multiple Sclerosis Centers (CMSC) 24th Annual Conference and the Third Joint Meeting of Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS): Abstract P19. Presented June 4, 2010.