How can lifestyle physical activity behavioral interventions improve MS?

To see if behavioral interventions to increase lifestyle physical activity could improve multiple sclerosis (MS), researchers conducted such an intervention via a website. The website and its content -- based on researchers' experiences with MS, a brief survey and feedback from a focus group -- targeted self­monitoring, goal setting, beliefs about the benefits of physical activity, self­confidence and overcoming barriers. Fifty-four participants were randomized into either behavioral intervention or waitlist control conditions, and researchers measured self­reported physical activity before and after the three­month pilot randomized control trial.

The intervention group reported a large increase in physical activity over time, whereas the control group had minimal change. The intervention worked mostly by promoting self­monitoring and goal setting, and there were no adverse events. The researchers have replicated the increase in lifestyle physical activity in three subsequent studies involving people with MS, and one study reported that the increase in physical activity persisted for three additional months even after the website was removed. These studies suggest people with MS can learn to self­manage their lifestyle physical activity.

Researchers also tested the same behavioral intervention for increasing lifestyle physical activity and improving secondary outcomes of walking mobility, cognition, symptoms and quality of life over a six­month period in 82 persons with MS. Importantly, the intervention condition yielded 40 minutes per week more lifestyle physical activity than the control condition, and the average minutes per day of lifestyle physical activity for the intervention group translated into 140 minutes per week. This nearly meets the current public health recommendation of accumulating 150 minutes per week of lifestyle physical activity. The behavioral intervention proved beneficial by reducing fatigue, depression, anxiety and pain, and improving sleep and quality of life. There were further improvements in the distance walked during a six­minute walk test and performance on a neuropsychological test of cognitive processing speed.

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