Exploring an integrated group psychotherapy-exercise program for multiple sclerosis: a non-randomized pilot study

This pilot study evaluated "Your Health Belongs to You," a six-week group intervention combining psychotherapy and exercise to improve quality of life, emotional health, and symptom management in individuals with Multiple Sclerosis (MS), emphasizing mental health as a key component of comprehensive MS care.

Using a single-blind, non-randomized, prospective pragmatic design, participants were assigned to either the intervention group (n = 55) or a small, unbalanced waiting-list control group (n = 13). The intervention consisted of six weekly 90-minute sessions addressing Symptoms, Emotions, and Fatigue. Assessments included the Hospital Anxiety and Depression Scale (HADS), Outcome Rating Scale (ORS), Group Session Rating Scale (GSRS), and Fatigue Severity Scale (FSS). Evaluations occurred at baseline and Week 6, with weekly measurements in the intervention group. Primary analysis focused on first visits only.

Significant large-effect improvements were observed on the ORS (d=0.784), with smaller reductions in depression (HADS-D, d=0.397) and anxiety (HADS-A, d=0.361). No significant effect emerged for FSS. Compared to the control group, only a trend toward improvement was noted for the ORS. Participants reported high engagement, strong therapeutic alliance (GSRS mean = 36.8 ± 3.8), and low drop-out (9.1%).

This pilot study suggests that integrating psychotherapy and exercise may improve well-being and functioning in individuals with MS. However, due to non-randomized allocation, a small and unbalanced control group, and a focus on first visits only, findings should be interpreted cautiously. The results reinforce the importance of addressing mental health in MS management. Future randomized trials with balanced groups and extended follow-up are warranted.