1 This dramatic change in the demographic landscape presents sign

1 This dramatic change in the demographic landscape presents significant medical, societal and economic challenges,2 particularly as older age is generally accompanied by reductions in physical function and increased levels of disability.3–5 These seemingly inherent consequences selleck chemical of aging can often be further exacerbated by the onset and/or progression of chronic disabling diseases, such as multiple sclerosis (MS). The prevalence of MS, a progressive neurodegenerative disease that affects the central nervous system,6 is estimated to be 2.3 million people worldwide, with more than 400 000 cases in the USA alone,7 and 45% are aged 55 years

and older.8 Even with variations in the pathological manifestations of MS, some of the most common symptoms and impairments mirror those that are characteristically associated with aging, such as reduced strength, difficulties with balance, mobility, and coordination, frequent fatigue, cognitive

dysfunction, and compromised quality of life (QOL).9–11 Unfortunately, there is a dearth of research examining these outcomes in older adults with MS.12 13 Physical inactivity among individuals with MS14 may exacerbate problems associated with this chronic condition. Physical activity participation, by comparison, can confer a protective and potential restorative effect on functional limitations and disability in older adults with MS15–17 and may also have a protective effect on the rate of disease progression.18 Thus, it is imperative to establish methods to increase levels of physical activity engagement in the MS population. Although a number of exercise interventions have been safely and successfully implemented for more general or younger segments of the MS population,19–21 to the best of our knowledge, there have been no interventions designed for and specifically targeting older adults with MS. Additionally, the majority of MS-specific exercise interventions tend to be supervised, centre-based (eg, fitness centres, university laboratories, medical settings,

etc) programmes, which can provide challenges to participation, in terms of accessibility and ultimately resulting in limited generalisability.22 Additionally, centre-based programmes have limited reach, can be difficult to implement, and are often resource intensive (eg, costs, time, staff, etc). There is a need to identify innovative, low-cost and broad-reaching strategies specifically aimed at improving physical function and, as a result, delaying (or at the very least Carfilzomib minimising) the progression of functional limitations and disability in older adults with MS. Targeted exercise training via DVD may be one contemporary approach in achieving this goal. Commercial revenue for exercise DVDs exceeded $260 million in the past 5 years and demand remains high, especially among older adults.23 The efficacy of delivering such programmes via DVD to improve physical function in older adults living with chronic disease remains to be determined.

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