Feasibility study of a 10-week community-based program using the WalkWithMe application on physical activity, walking, fatigue and cognition in persons with Multiple Sclerosis

Mult Scler Relat Disord. 2020 Jul:42:102067. doi: 10.1016/j.msard.2020.102067. Epub 2020 Apr 18.

Abstract

Background: People with Multiple Sclerosis (pwMS) show diverse symptoms, such as fatigue and decline in motor and cognitive function. Physical activity shows to have a positive impact on many of these symptoms. However, many pwMS lead sedentary lives. Objectives of this study were to evaluate the feasibility of prolonged use of the WalkWithMe, a personalized mobile application that supports pwMS in walking at home, and its effect on physical activity, walking, fatigue and cognition in persons with MS.

Methods: Nineteen pwMS were enrolled in a 10-week home-based intervention with the WalkWithMe application after setting personal goals based on baseline testing values, where twelve patients completed the program. Before and after the intervention, motor (6MWT, T25FW, 5-STS, NHPT) and cognitive function (PASAT and SDMT) were evaluated, together with the patient reported impact on walking, physical activity, quality of life and fatigue by MSWS-12, IPAQ, SF-36, MSIS-29, MFIS and FSS, respectively.

Results: Significant improvement was seen for some parts of self-reported physical activity and quality of life (IPAQ: walking, p = 0.04, leisure, p = 0.02; SF-36: physical functioning, p = 0.02), cognition (SDMT, p = 0.01), cognitive fatigability (PASAT, p = 0.05), lower limb strength (5-STS, p = 0.05) and dominant hand function (NHPT, p = 0.002).

Conclusion: This feasibility study was successful at improving categories of self-reported physical activity, lower limb functional strength, hand function and cognition, but results need to be interpreted with caution, given the small and not always clinically relevant changes. Larger sample sizes in a controlled experimental design are needed to confirm these results.

Keywords: Fatigue; Mobile application; Multiple Sclerosis; Physical activity; Walking; mHealth.

MeSH terms

  • Adult
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / rehabilitation*
  • Exercise Therapy*
  • Fatigue / etiology
  • Fatigue / rehabilitation*
  • Feasibility Studies
  • Female
  • Humans
  • Middle Aged
  • Mobile Applications
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / rehabilitation*
  • Outcome Assessment, Health Care*
  • Telemedicine
  • Walking* / physiology