The Effect of Remotely Delivered Pilates on Physical , and Psychological Outcomes in Individuals With Multiple Sclerosis

Distance walked during the Six-Minute Walk Test (6MWT) will be measured in meters. The outcome is the change from baseline to 16 weeks in 6MWT distance.

Walking speed will be assessed using the Timed 25-Foot Walk (T25FW). The outcome is the change from baseline to 16 weeks in time to walk 25 feet, measured in seconds.

Balance will be assessed using the Berg Balance Scale (BBS), a 14-item performance-based measure of static and dynamic balance. Each item is scored from 0 to 4, and the outcome will be the change from baseline to 16 weeks in the BBS total score (range 0-56), with higher scores indicating better balance and lower risk of falls.

Fatigue will be measured using the Fatigue Severity Scale (FSS), a 9-item questionnaire assessing the impact of fatigue on daily functioning. Each item is rated from 1 to 7, and the outcome will be the change from baseline to 16 weeks in the FSS mean score (range 1-7), with higher scores indicating more severe fatigue.

Pain will be measured using the Short-form McGill Pain Questionnaire (SF-MPQ). The outcome is the change from baseline to 16 weeks in SF-MPQ total score.

Cognitive processing speed will be assessed using the Symbol Digit Modalities Test (SDMT). The outcome is the change from baseline to 16 weeks in SDMT total score, with higher scores indicating better processing speed. SDMT scores typically range from 0 to about 110 correct responses.

Verbal learning and memory will be assessed using the California Verbal Learning Test-II (CVLT-II). The outcome is the change from baseline to 16 weeks in CVLT-II total recall score, with higher scores indicating better verbal learning and memory. CVLT-II total recall scores typically range from 0 to about 80.

Visuospatial learning and memory will be assessed using the Brief Visuospatial Memory Test-Revised (BVMT-R). The outcome is the change from baseline to 16 weeks in BVMT-R total recall score, with higher scores indicating better visuospatial memory. BVMT-R total recall scores typically range from 0 to 36.

Depression will be measured using a validated questionnaire (e.g., the Hospital Anxiety and Depression Scale-Depression subscale or a similar instrument). The outcome is the change from baseline to 16 weeks in depression total score, with higher scores indicating greater depressive symptoms. Typical depression scales have ranges such as 0-21 (HADS-D) ; enter the exact range that matches the scale you are using.

Anxiety will be measured using a validated questionnaire (e.g., the Hospital Anxiety and Depression Scale-Anxiety subscale or a similar instrument). The outcome is the change from baseline to 16 weeks in anxiety total score, with higher scores indicating greater anxiety. Typical anxiety scales have ranges such as 0-21 (HADS-A) or 0-63 (BAI); enter the exact range that matches the scale you are using.

Health-related quality of life will be assessed using a validated questionnaire (e.g., the MSQoL-54 or a comparable instrument). The outcome is the change from baseline to 16 weeks in the quality-of-life total score or composite score. For instruments scored 0-100, higher scores typically indicate better quality of life; specify the exact scoring range and direction according to your chosen measure.