eHealth-Based Behavioral Intervention for Increasing Physical Activity in Persons With Multiple Sclerosis: Fidelity Protocol for a Randomized Controlled Trial

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.

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Phase-III, randomized controlled trial of the behavioral intervention for increasing physical activity in multiple sclerosis: Project BIPAMS

Contemporary Clinical Trials ◽

10.1016/j.cct.2018.06.017 ◽

2018 ◽

Vol 71 ◽

pp. 154-161 ◽

Cited By ~ 6

Author(s):

Robert W. Motl ◽

Brian M. Sandroff ◽

Brooks C. Wingo ◽

Justin McCroskey ◽

Lara A. Pilutti ◽

...

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Randomized Controlled Trial ◽

Behavioral Intervention ◽

Controlled Trial ◽

Phase Iii ◽

Randomized Controlled

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Randomized controlled trial of a behavioral intervention targeting symptoms and physical activity in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458513503391 ◽

2013 ◽

Vol 20 (5) ◽

pp. 594-601 ◽

Cited By ~ 102

Author(s):

LA Pilutti ◽

D Dlugonski ◽

BM Sandroff ◽

R Klaren ◽

RW Motl

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Randomized Controlled Trial ◽

Sleep Quality ◽

Behavioral Intervention ◽

Behavioral Interventions ◽

Controlled Trial ◽

Randomized Controlled ◽

Related Quality ◽

Lifestyle Physical Activity

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.

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