Culturally adapted exercise training intervention for Hispanics/Latinos with multiple sclerosis: Study protocol for a hybrid type 1 implementation randomized controlled trial

Hispanics with multiple sclerosis (MS) have worse walking mobility and health-related quality of life (QOL) than non-Hispanic white counterparts. Hispanics further receive less specialty care and have low physical activity rates. Exercise training can improve MS symptoms, including mobility and QOL, but there are few RCTs of exercise training programs in Hispanics with MS.

The moVement for Advancing Mobility and Strength in MS (VAMOS-MS) study is a hybrid type 1 implementation randomized control trial that culturally adapts the Guidelines for Exercise in MS (GEMS) intervention for Hispanics with MS. The primary outcome is walking dysfunction, measured using the MSWS-12; the secondary outcome is Health-Related QOL (HRQOL), measured by the MSIS-29. Implementation outcomes include measures of Acceptability, Appropriateness, Feasibility, Adoption, and Sustainability. Exercise behavior will be measured using the Godin Leisure Time Exercise Questionnaire (GLTEQ). Following the baseline assessment, participants will be randomized to the 16-week GEMS exercise training condition or the 16-week waitlist control. Participants will receive materials, equipment, and coaching calls with a trained Community Health worker (CHW). Outcomes will be measured at baseline, 16 weeks, and 32 weeks. The data analysis will be conducted using the intent-to-treat principle, with linear mixed models including an interaction term between condition and time. Implementation outcomes will be analyzed using descriptive and qualitative methods.

VAMOS-MS is a culturally adapted, home-based exercise training program for Hispanics with MS. It incorporates community feedback to inform the adaptation and implementation of an evidence-based exercise training program for scalability among Hispanics with MS.