Exploring the impact of exercise and essential amino acid plus cholecalciferol supplementation on physical fitness and body composition in multiple sclerosis: A case study

KEY CLINICAL MESSAGE: In MS patients, especially those frail or malnourished, combining home‐based exercise twice weekly with essential amino acids and vitamin D may improve body composition, strength, and physical performance, enabling long‐term functional improvements. ABSTRACT: Multiple sclerosis (MS) is associated with reduced bone and muscle strength and function. We aimed to investigate the effectiveness of a 24‐week intervention in a 57‐year‐old frail female with MS. The participant completed a 2×/week exercise intervention and ingested 2×/day a supplement containing 7.5 g essential amino acids and 500 IU cholecalciferol. Body composition, 6‐m gait speed (GS), handgrip strength (HGS), 30‐sec arm‐curl test (30ACT), 6‐min walking test (6MWT), 30‐sec chair‐stand test (30CST), and plasma concentrations of 25‐hydroxyvitamin D(3) [25(OH)D(3)], insulin‐like growth factor 1 (IGF‐1), and amino acids were assessed at baseline, and at Weeks 12 and 24. Plasma 25(OH)D(3) increased from 23.2 to 41.3 ng/mL and IGF‐1 from 131.6 to 140.7 ng/mL from baseline to post‐intervention. BMI, total lean tissue mass (LTM), fat mass, bone mineral content, and the sum of 17 amino acids increased by 3.8, 1.0, 3.5, 0.2, and 19%, respectively, at Week 24. There were clinically significant increases in regional LTM (6.9% arms and 6.3% legs) and large increases in GS (67.3%), dominant HGS (31.5%), non‐dominant HGS (11.8%), dominant 30ACT (100%), non‐dominant 30ACT (116.7%), 6MWT (125.6%), and 30CST (44.4%). The current intervention was effective in improving components of physical fitness and body composition in a female with MS.