Internet-delivered behavioral intervention to increase physical activity in persons with multiple sclerosis: Sustainability and secondary outcomes

Abstract

Physical activity is associated with many benefits, but persons with multiple sclerosis (MS) are less physically active than the general population. There is a critical need for research on methods of increasing and sustaining the physical activity levels of this population. This randomized controlled trial examined the efficacy of an Internet-delivered and theory-based behavioral intervention that was supplemented with video coaching for increasing and sustaining physical activity over time in persons with MS. Physically inactive, ambulatory persons with MS (N = 45) were randomly assigned to intervention (n = 22) or control (n = 23) conditions and completed a battery of questionnaires before, after, and three months after a 12-week intervention period. Data analyses were conducted in PASW 18.0. Partial eta squared ([Formula: see text]) effect size indicated that there was a large, statistically significant condition-by-time interaction on physical activity ([Formula: see text]). Cohen's d effect sizes indicated that the intervention group had a large increase in physical activity after the 12-week trial (d = .98) that was sustained over a three-month follow-up (d = .79). The current study supports the efficacy of a behavioral intervention for increasing and sustaining physical activity in a sample of persons with MS.

Does the Effect of a Physical Activity Behavioral Intervention Vary by Characteristics of People with Multiple Sclerosis?

“…We noted interindividual variability in the efficacy of behavioral interventions for increasing physical activity behavior in people with MS. [6][7][8] This motivated a behavior change across therapeutic regimens. We did not collect data regarding physical therapy or other types of rehabilitation that might have moderated the effect of the behavioral intervention.…”

“…This effect size is consistent with the magnitude of change averaged across measures in a previous study of the behavioral intervention delivered across a 3-month period in people with MS (d = 0.51). 19 We note that some studies of the behavioral intervention have reported larger changes in physical activity (d = 0.98) (eg, Dlugonski et al 6 ), but those studies included exploratory ANCOVA (ie, sex) and exploratory bivariate correlation analyses in the intervention and control groups separately (ie, age and MS disease duration).…”

“…1,2 However, people with this immune-mediated disease of the central nervous system are often physically inactive compared with the general population. 3 Researchers have identified variables from social-cognitive theory (SCT) 4 as correlates of physical activity 5 that have informed the design of behavioral interventions delivered through the Internet for successfully increasing this health behavior in people with MS. [6][7][8] Inspection of the data from such behavioral interventions reveals the presence of interindividual variability in the pattern and amount of change in physical activity. 7 This suggests that some people are benefiting from the behavioral intervention more than others, and this variability might be explained by the characteristics of the participants.…”

Ehealth Solutions in Multiple Sclerosis: Use of Digital and Remote Communication Technologies

“…Internet-delivered behavioral interventions have also demonstrated an increase in activity among patients with MS. A 3-month randomized controlled study evaluating an Internet-delivered and theory-based behavioral intervention that was supplemented with video coaching in 45 patients with MS showed a large increase in physical activity after 12 weeks that was sustained over 3 months [67].…”

“…Home-based technologies have also been used for online physiotherapy exercises [63,64], physical telerehabilitation [65], and physical-activity-targeted behavioral interventions [66,67]. Web Based Physio, developed by the University of Glasgow, Glasgow, UK, provides online physiotherapy exercise programs personalized for individual patients with long-term conditions including MS, with the aim of allowing patients to self-manage their condition [63].…”