Physical Activity in Multiple Sclerosis: Meeting the Guidelines at the Time of the COVID-19 Pandemic

Ludovico Pedullà, Carme Santoyo-Medina, Klara Novotna, Lousin Moumdjian, Tori Smedal, Ellen Christin Arntzen, Marietta L. Van Der Linden, Yvonne Learmonth, Alon Kalron, Feray Güngör, Una Nedeljkovic, Daphne Kos, Johanna Jonsdottir, Susan Coote, Andrea Tacchino*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background and Purpose: Regular physical activity (PA) helps to reduce the severity of physical and mental symptoms and improves quality of life in people with multiple sclerosis (PwMS). Based on current evidence and expert opinion, the recent multiple sclerosis guidelines recommend at least 150 minutes/week of PA. This study presents the results of a survey analyzing whether and how PwMS met the guidelines before and during the pandemic. Methods: We developed and disseminated an international online survey between December 2020 and July 2021, investigating changes in self-reported PA type, duration, frequency, and intensity due to the COVID-19 outbreak in PwMS with differing disability levels. Results: Among respondents (n = 3810), 3725 were eligible. The proportion of those who conducted at least one activity decreased with increasing disability level at both time points (pre and during). Overall 60% of respondents met the guidelines before the pandemic (mild: 64.43%; moderate: 51.53%; severe: 39.34%; χ2(2)= 109.13, P < 0.01); a reduction of approximately 10% occurred during the pandemic in all disability groups (mild: 54.76%; moderate: 42.47%; severe: 29.48%; χ2(2)= 109.67, P < 0.01). Respondents with higher disability participated more in physical therapy and less in walking, cycling, and running at both time points. Most respondents reported practicing PA at a moderate intensity at both time points; frequency and duration of sessions decreased as disability level increased. Discussion and Conclusions: The percentage of those meeting the guidelines reduced with increasing disability level and during the pandemic. PA type and intensity varied widely across the disability categories. Interventions accounting for disability level are required to enable more PwMS to reap the benefits of PA. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1,

Original languageEnglish
Pages (from-to)112-121
Number of pages10
JournalJournal of Neurologic Physical Therapy
Issue number2
StatePublished - 1 Apr 2023
Externally publishedYes


  • COVID-19
  • multiple sclerosis
  • online survey
  • physical activity
  • recommendation


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