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Updated: Apr 30, 2026

Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

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Published on: January 29, 2016

Implementation of a Program to Enhance Cognitive Reserve in Patients With Multiple Sclerosis (EM Reserva Program).

Miriam Ben-Yelun Insenser¹, Rocío Lopez Ruiz¹, Mónica Borges Guerra¹

¹Multiple Sclerosis Unit, Hospital Virgen Macarena, 41009 Sevilla, Spain.

Revista De Neurologia

|April 29, 2026

Summary

The EM Reserva program improved processing speed and reduced fatigue in multiple sclerosis patients short-term, but cognitive benefits did not last 12 months. Long-term strategies are needed for sustained cognitive reserve enhancement.

Keywords:

cognitive rehabilitation cognitive reserve multiple sclerosis

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Area of Science:

Neuroscience
Rehabilitation Medicine
Clinical Psychology

Background:

Cognitive reserve (CR) may protect against cognitive decline in people with multiple sclerosis (PwMS).
Few interventions target CR enhancement, especially in individuals without baseline cognitive impairment.
The EM Reserva program is a multimodal intervention (cognitive activities, aerobic exercise, social engagement) to strengthen CR in relapsing-remitting MS (RRMS).

Purpose of the Study:

To evaluate the effectiveness of the EM Reserva program in enhancing cognitive reserve in PwMS without cognitive impairment.
To assess the impact of the intervention on cognitive function, fatigue, and quality of life.

Main Methods:

A pragmatic, single-center, observer-blinded randomized controlled trial.
Included PwMS (18-55 years) with RRMS and no cognitive impairment, randomized 1:1 to EM Reserva or usual care.
Primary endpoint: change in Symbol Digit Modalities Test (SDMT) at 6 months; secondary outcomes included other neuropsychological tests, fatigue, and quality of life measures.

Main Results:

At 6 months, the EM Reserva group showed significant improvements in SDMT and verbal fluency (COWAT) compared to controls.
Cognitive gains were not sustained at 12 months.
Fatigue improved in both groups at 6 months, but remained significantly lower only in the EM Reserva group at 12 months. No differences in perceived deficits or quality of life.

Conclusions:

The EM Reserva program offers short-term cognitive benefits (processing speed, verbal fluency) and sustained fatigue reduction in cognitively preserved PwMS.
Cognitive benefits were not maintained long-term, and subjective cognitive functioning was unchanged.
Multimodal CR interventions may provide temporary advantages, highlighting the need for long-term maintenance strategies.