The effectiveness of interventions targeting physical activity and/or sedentary behaviour in people with Multiple Sclerosis: a systematic review

Coulter, Elaine; Bond, Sarah; Dalgas, Ulrik; Paul, Lorna

doi:10.1080/09638288.2018.1503737

Cited by 31 publications

(27 citation statements)

References 72 publications

(482 reference statements)

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“…We speculate that PA assessed with other tools such as accelerometers and pedometers might demonstrate different relationships with BMI compared with leisure-time PA in the MS population. Additionally, there seems to be a discrepancy between objectively vs. subjectively assessed PA in PwMS [24]. Moreover, in a recent validation study of the GLTEQ, it was found that the GLTEQ scores primarily reflect moderate-to-vigorous PA rather than light PA and sedentary behavior in PwMS [25].…”

Section: Discussionmentioning

confidence: 99%

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Kalron

2020

IJERPH

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(1) Purpose: Conflicting information exists regarding the relationship between obesity, leisure-time physical activity (PA), and disability in people with multiple sclerosis (PwMS). We aimed to investigate the association between leisure-time PA and weight status in a relatively large cohort of PwMS. Furthermore, we examined this relationship according to the level of neurological disability. (2) Methods: The study included 238 PwMS (138 women) with a mean Expanded Disability Status Scale (EDSS) score of 2.5 (standard deviation [SD] = 1.7), mean disease duration of 6.4 (SD = 8.2) years, and mean age of 40.5 (SD = 12.9) years. Obesity was defined using two different metrics, each based on body mass index (BMI). Leisure-time PA was determined by the Godin–Shephard leisure-time PA questionnaire. Statistical analyses included multivariate logistic regression, the chi-square test, and Pearson coefficient correlations. (3) Results: The unadjusted odds ratio (OR) between leisure-time PA and BMI based on the World Health Organization’s (WHO) definition was 1.070 (p = 0.844) for overweight and 1.648 (p = 0.254) for obesity. The adjusted OR was 1.126 (p = 0.763) for overweight and 1.093 (p = 0.847) for obesity after adjustment for age, gender, and disability status. Chi-square analysis revealed no significant correlation between leisure-time PA and obesity (p = 0.564) according to the BMI threshold for PwMS. The unadjusted OR (95% confidence interval [CI]) between disability level and BMI based on the WHO definition was 1.674 (p = 0.220) for overweight and 0.618 (p = 0.460) for obesity. The adjusted OR was 1.130 (p = 0.787) for overweight and 0.447 (p = 0.234) for obesity after adjustment for age, gender, and leisure-time PA. Similarly, chi-square analysis revealed no significant correlation between disability level and obesity (p = 0.701) per the BMI threshold for PwMS. (4) Conclusions: No association was found between leisure-time PA and BMI in PwMS. An additional finding was the absence of any association between obesity and neurological disability level in the multiple sclerosis cohort.

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Section: Discussionmentioning

confidence: 99%

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Kalron

2020

IJERPH

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“…Focal review of interventions delivering the exercise guidelines has not been undertaken; this is fundamental to the clinical promotion of these guidelines. We will compare previous literature on exercise training safety in MS [35][36][37], and with our planned review of retention rates, intervention adherence rates, and intervention compliance rates, we will confirm recent meta-analyses [40]. Our protocol provides a systematic and robust approach to determining the safety of exercise training in a clinical population and has high utility for repetition in other clinical populations such as stroke, Parkinson's disease, and other populations where exercise prescription is a management strategy.…”

Section: Discussionmentioning

confidence: 79%

“…Relapse risk, adverse events (AE), and serious adverse events (SAE) [33,34] indicate the construct of safety in MS clinical study, and we describe these terms in Table 1. To date, only three reviews have considered the safety of exercise training for MS [35][36][37]. The most comprehensive included 26 RCTs published up until November 2013 [35].…”

Section: Introductionmentioning

confidence: 99%

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Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis

et al. 2021

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Background There has been an exponential growth in the number of clinical research studies regarding exercise training in multiple sclerosis, and literature reviews and meta-analyses have documented the many benefits of exercise training. This research further requires careful review for documenting the safety of exercise training in multiple sclerosis, as clarity on safety represents a major hurdle in the clinical prescription of exercise behaviour. Objectives To enhance understanding of the feasibility of exercise in multiple sclerosis, we (1) provide a protocol of a systematic review and meta-analysis that summarises rates and risks of clinical relapse, adverse events (i.e., an unfavourable outcome that occurs during the intervention delivery time period), and serious adverse events (i.e., an untoward occurrence that results in death or is life threatening, requires hospitalisation, or results in disability during the intervention delivery time period), as well as retention, adherence, and compliance, from randomised controlled trials of exercise training in persons with multiple sclerosis; and (2) identify moderators of relapse, adverse events, and serious adverse event rates. Methods Eight field-relevant databases will be searched electronically. Studies that involve a randomised controlled trial of exercise training (with non-exercise, non-pharmacological, comparator), report on safety outcomes, and include adults with multiple sclerosis will be included. Rates and relative risks of the three primary outcomes (relapse, adverse event, and serious adverse event) will be calculated and reported each with standard error and 95% confidence interval. Random-effects meta-analysis will estimate mean population relative risk for outcomes. Potential sources of variability, including participant characteristics, features of the exercise stimulus, and comparison condition, will be examined with random-effects meta-regression with maximum likelihood estimation. Discussion The results from this systematic review and meta-analysis will inform and guide healthcare practitioners, researchers, and policymakers on the safety of exercise training in persons with multiple sclerosis. Where possible, we will identify the impact of exercise type, exercise delivery style, participant disability level, and the prescription of exercise guidelines, on the safety of exercise training. The result will identify critical information on the safety of exercise in persons with multiple sclerosis, while also identifying gaps in research and setting priorities for future enquiries. Systematic review registration PROSPERO 2020 CRD42020190544

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“…To date, there are very few interventions targeting sedentary behaviour in MS, and a recent review reported that there was no evidence that physical activity interventions changed sedentary behaviour in MS 13. This is not surprising as the interventions were not specifically designed to change sedentary behaviour.…”

Section: Introductionmentioning

confidence: 99%

Management of multiple sclerosis symptoms through reductions in sedentary behaviour: protocol for a feasibility study

et al. 2019

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IntroductionPeople with multiple sclerosis (MS) are less physically active, and more sedentary than their peers despite evidence that activity helps to manage MS-related symptoms. Traditional approaches to increasing physical activity, such as exercise programmes, can be challenging for people with MS, especially those with walking disability. Focusing on decreasing prolonged sitting, and increasing light-intensity activities may be more feasible and result in more sustainable behaviour change in persons with MS. This paper describes the rationale and development of a sedentary behaviour intervention targeting persons with MS.Methods and analysisThe feasibility and preliminary efficacy of a sedentary behaviour intervention will be tested using a prepost intervention design in 40 adults with MS. The 22-week programme includes a 15-week intervention and a 7-week follow-up. The intervention itself is divided into two stages: Sit-Less and Move-More. The Sit-Less stage is designed to encourage participants to break up prolonged sitting bouts, while the Move-More stage promotes increasing steps per day, in addition to interrupting sitting. The intervention is delivered through individual coaching sessions between an interventionist and a participant, and an accompanying newsletter based on social cognitive theory. A Fitbit is used to monitor activity throughout the programme. Process, resource and management metrics will be recorded (eg, retention, time required for communication during the trial). Sedentary and physical activities and MS-related symptoms are measured before and after the intervention and again during follow-up. Experiences with the programme are explored through an online survey and one-on-one interviews.Ethics and disseminationThe Health Research Ethics Board at the University of Alberta granted permission to conduct this study. Results will be disseminated in scientific journals and conferences, and the MS Society of Alberta. Physical therapists and kinesiologists are important stakeholders and will be targeted during dissemination.Trial registration numberNCT03136744.

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The effectiveness of interventions targeting physical activity and/or sedentary behaviour in people with Multiple Sclerosis: a systematic review

Cited by 31 publications

References 72 publications

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

The Association between Body Mass Index and Leisure-Time Physical Activity in Adults with Multiple Sclerosis

Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis

Management of multiple sclerosis symptoms through reductions in sedentary behaviour: protocol for a feasibility study

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