Feasibility and Pre–Post Changes Associated with a 12-Week Treadmill Walking Training Programme on Walking Performance, Physical Function, Fatigue, and Quality of Life in People with Multiple Sclerosis: A Single-Arm Pilot Study

<b>Background/Objectives</b>: Walking impairment and fatigue are common in multiple sclerosis (MS) and contribute to reduced physical function and quality of life (QoL). This study evaluated the feasibility, safety, and pre-post changes associated with a 12-week treadmill walking training (TWT) programme on walking performance, physical function, fatigue, and QoL in people with MS. <b>Methods</b>: Single-arm pilot study with pre-post assessments (T1-T2). Eleven adults with MS (Expanded Disability Status Scale [EDSS] ≤ 6) completed supervised TWT for 12 weeks (two 25 min sessions/week) at the Complejo Asistencial Universitario de Soria (Spain). Outcomes included SF-36, Timed Up and Go (TUG), 4 m gait speed, Short Physical Performance Battery (SPPB), and Modified Fatigue Impact Scale (MFIS). Within-participant changes were analysed using paired <i>t</i>-tests or Wilcoxon signed-rank tests as appropriate; effect sizes were reported as appropriate for the statistical test. <b>Results</b>: SF-36 total score did not change significantly (<i>p</i> = 0.160), while general health (<i>p</i> = 0.039) and vitality (<i>p</i> = 0.043) improved. Walking performance improved (TUG, <i>p</i> = 0.007; 4 m gait speed, <i>p</i> < 0.001), and physical function increased (SPPB, <i>p</i> = 0.003). Fatigue impact decreased (MFIS total, <i>p</i> = 0.015; physical, <i>p</i> = 0.007; psychosocial, <i>p</i> = 0.026), whereas the cognitive subscale did not change significantly (<i>p</i> = 0.094). Adherence was 91.7%, and no adverse events were reported. <b>Conclusions</b>: In this pilot sample, a 12-week TWT programme was feasible and safe and was associated with improvements in walking performance, physical function, and fatigue, with QoL changes limited to specific SF-36 domains. These findings support proceeding to a randomised controlled trial to establish efficacy. These findings should be interpreted as preliminary and exploratory, given the single-arm pre-post study design.