Impact of Exercise Training on Serum Neurofilament Light Chain (NfL), Brain Volumetry, and Functional Outcomes in Multiple Sclerosis

Treatment tested

• Exercise

Other measures (5)

Inclusion Criteria: * Clinically confirmed relapsing-remitting multiple sclerosis (RRMS) diagnosis according to revised McDonald criteria (2017) * Mild-to-moderate disability (EDSS score 1.0-5.5) * No corticosteroid treatment within the previous 3 months Exclusion Criteria: * Acute MS relapse within 90 days prior to enrollment * Regular participation in structured exercise programs (>3 hours/week) * Comorbid conditions that may limit exercise participation, including; significant orthopedic impairments, unstable cardiopulmonary conditions and other systemic disorders affecting physical activity * Standard MRI contraindications (metallic implants, claustrophobia, etc.) * Concurrent neurological disorders (other than MS) * Initiation or modification of disease-modifying therapy within 6 months * Severe spasticity (Modified Ashworth Scale ≥3 in any major muscle group)

This single-blind, randomized controlled trial will employ a two-arm parallel design (exercise group vs. control group) with a 12-week intervention period. Randomization will be implemented using SPSS 25.0 (IBM Corporation, Armonk, NY, USA) to ensure balanced group allocation. All outcome measures will be assessed at baseline and post-intervention.