scholarly journals Randomized controlled trial of an e-learning designed behavioral intervention for increasing physical activity behavior in multiple sclerosis

2017 ◽  
Vol 3 (4) ◽  
pp. 205521731773488 ◽  
Author(s):  
Robert W Motl ◽  
Elizabeth A Hubbard ◽  
Rachel E Bollaert ◽  
Brynn C Adamson ◽  
Dominique Kinnett-Hopkins ◽  
...  

Background Internet-delivered, behavioral interventions represent a cost-effective, broadly disseminable approach for teaching persons with multiple sclerosis (MS) the theory-based skills, techniques, and strategies for changing physical activity. Objectives This pilot, randomized controlled trial examined the efficacy of a newly developed Internet website based on e-learning approaches that delivered a theory-based behavior intervention for increasing physical activity and improving symptoms, walking impairment, and neurological disability. Methods Participants with MS ( N = 47) were randomly assigned into behavioral intervention ( n = 23) or waitlist control ( n = 24) conditions delivered over a six-month period. Outcomes were administered before and after the six-month period using blinded assessors, and data were analyzed using analysis of covariance in SPSS. Results There was a significant, positive intervention effect on self-reported physical activity ( P = 0.05, [Formula: see text] = 0.10), and non-significant improvement in objectively measured physical activity ( P = 0.24, [Formula: see text] = 0.04). There were significant, positive effects of the intervention on overall ( P = 0.018, [Formula: see text] = 0.13) and physical impact of fatigue ( P = 0.003, [Formula: see text] = 0.20), self-reported walking impairment ( P = 0.047, [Formula: see text] = 0.10), and disability status ( P = 0.033, [Formula: see text] = 0.11). There were non-significant improvements in fatigue severity ( P = 0.10, [Formula: see text] = 0.06), depression ( P = 0.10, [Formula: see text] = 0.07) and anxiety ( P = 0.06, [Formula: see text] = 0.09) symptoms, and self-reported disability ( P = 0.10, [Formula: see text] = 0.07). Conclusions We provide evidence for the efficacy of an Internet-based behavioral intervention with content delivered through interactive video courses grounded in e-learning principles for increasing physical activity and possibly improving secondary outcomes of fatigue, depression, anxiety, and walking impairment/disability in persons with MS.

2013 ◽  
Vol 20 (5) ◽  
pp. 594-601 ◽  
Author(s):  
LA Pilutti ◽  
D Dlugonski ◽  
BM Sandroff ◽  
R Klaren ◽  
RW Motl

Background: Exercise training is beneficial, but most persons with multiple sclerosis (MS) are sedentary and physically inactive. This has prompted a new focus on the promotion of lifestyle physical activity in MS. We previously designed, tested, and refined a behavioral intervention delivered through the Internet that successfully increased lifestyle physical activity in MS, but have not evaluated the effects on secondary symptomatic and health-related quality of life (HRQOL) outcomes. Objective: We conducted a 6-month randomized controlled trial (RCT) that examined the efficacy of an Internet-delivered, behavioral intervention for improving outcomes of fatigue, depression, anxiety, pain, sleep quality, and HRQOL in 82 ambulatory persons with MS. The secondary aim was to replicate previous results regarding change in free-living physical activity. Results: There was a significant and positive effect of the intervention on fatigue severity ( p=.001, ηρ2=.15) and its physical impact ( p=.008, ηρ2=.09), depression ( p=.006, ηρ2=.10), and anxiety ( p=.006, ηρ2=.10). There were non-significant improvements in pain ( p=.08, ηρ2=.04), sleep quality ( p=.06, ηρ2=.05), and physical HRQOL ( p=.06, ηρ2=.05). We replicated our previous results by demonstrating an increase in self-reported physical activity ( p=.001, ηρ2=.13). Conclusions: Our results support behavioral interventions targeting lifestyle physical activity as an alternative approach for managing symptoms in MS.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A209-A209
Author(s):  
Katie Cederberg ◽  
Robert Motl

Abstract Introduction Restless legs syndrome (RLS) occurs in approximately 26% of persons with multiple sclerosis (MS) and can worsen other symptoms of MS, including sleep quality. Physical activity represents a promising approach for managing RLS and its secondary effects in MS. This pilot randomized controlled trial examined the feasibility and efficacy of a physical activity intervention for improving RLS severity and secondary sleep outcomes among a sample of adults with MS. Methods Participants with MS (N=15) were randomly assigned into intervention (n=8) or waitlist control (n=7) conditions. The physical activity behavioral intervention was delivered over a 16-week period and outcomes were assessed at baseline and immediately following the 16-week period in both conditions. Results There was a significant, positive effect of the intervention on overall RLS severity (p=.01;ηρ2=.43), RLS severity during the night (p=.03,ηρ2=.35), RLS severity during the day while resting (p=.01,ηρ2=.44), and RLS severity during the day while active (p<.01,ηρ2=.61), and non-significant improvements in RLS severity while falling asleep (p=.33,ηρ2=.09). There were significant positive effects on sleep satisfaction (p<.01,ηρ2=.49) and non-significant improvements in self-reported global sleep quality (p=.35,ηρ2=.08). There was a significant intervention effect on self-reported time in bed (p=.03,ηρ2=.37) and total sleep time (p=.03,ηρ2=.36), and non-significant improvements in self-reported sleep latency (p=.08,ηρ2=.25), sleep efficiency (p=.27,ηρ2=.11), and daytime sleepiness (p=.52,ηρ2=.04; p=.35,ηρ2=.08; p=.51,ηρ2=.04). There was no significant effect of the intervention on device-measured sleep quality. Conclusion This study provides initial evidence for the feasibility and efficacy of a physical activity intervention for reducing RLS severity and possibly self-reported sleep quality outcomes in persons with MS. These preliminary results should inform a future, fully-powered randomized controlled trial that further establishes the efficacy of physical activity for reducing symptoms of RLS and secondary outcomes in a larger sample of adults with MS and RLS. Support (if any) This work was supported, in part, by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development of the National Institutes of Health [F31HD097903]. ClinicalTrials.gov Identification Number: NCT0406168.


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