A 49 Year-Old Woman Who Has Relapsing Remitting Multiple Sclerosis

A 49 year-old woman who has relapsing remitting multiple sclerosis (MS) is being evaluated by a physical therapist in an outpatient setting.The therapist suspects significant disuse atrophy in the trunk and lower extremities that is adversely affecting functional skills,with patient report of a recent decline in transfer and walking skills.The therapist is designing a home exercise program with therapeutic goals of improving strength,endurance and function,but is concerned about not over fatiguing this patient.Which of the following home exercise program (HEP) options would be most appropriate to address these goals for this patient?

A) Treadmill training at moderate intensity for 45 minutes,4× week.
B) Aquatic exercise program with functional strengthening activities,for 30 minutes,3× week in a cool pool.
C) Lower extremity PRE program using cuff weights performed on floor or bed level,repetitions to fatigue,1 set,4× week.
D) Lower extremity bicycle ergometer training program for 30 minutes with 1 minute high-intensity (speed) intervals every 5 minutes,3× week.