Background. Mobility limitations are a key feature of MS and 25% will require the use of a walking aid 15 years after diagnosis. Few studies have specifically evaluated the effectiveness of physiotherapy and exercise interventions delivered in the community for those with significant disability. Methods. An assessor blind, block randomised, and controlled study recruited participants who required bilateral assistance for gait and who occasionally used wheelchairs for longer distances. They were randomised to 10 weeks of group physiotherapy (balance and strengthening exercises), individual physiotherapy, yoga group, or a control group. Results. Repeated measures ANOVA found significant time effects for physical component of MSIS-29v2 ( , ) and MFIS ( , ). The group × time interaction was significant for the BBS ( , ). Post hoc analysis revealed no difference between group and individual physiotherapy for BBS. There was no significant difference between groups but the 6MWT improved for individual physiotherapy ( ) and MSIS-29v2 psychological score for group physiotherapy ( ). Discussion. This study found that balance and strengthening exercises, delivered in the community to those with significant mobility limitations, improve balance. The effect on walking endurance and patient-reported outcomes are unclear and warrants further investigation with a larger control group with similar baseline characteristics to the intervention groups. 1. Introduction Multiple sclerosis is a chronic progressive disease that results in a number of symptoms including weakness, spasticity, tremor, ataxia, sensory disturbance, and balance disruption [1]. It is suggested that within 15–25 years of diagnosis approximately 50% of people with MS (PwMS) will require the use of a walking aid [2, 3]. Mobility loss is significantly associated with loss of employment and with increasing assistance with activities of daily living (ADLS) [4] and PwMS identify the continued loss of mobility as one of their greatest concerns for their future [5]. Loss of mobility and its resultant impact on every day activities are reflected by the increasing cost of care with greater disability [6]. There is an ever-expanding body of the literature to suggest the positive effect of exercise and physiotherapy interventions. Those who use walking aids have been included in several studies of physiotherapy interventions [7–10], progressive resistance training (PRT) [11, 12], aerobic exercise [13–15], and a combination of the above [16], and generally the studies have had positive outcomes. However, as the
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