Feasibility of a theory-based physical activity intervention for persons newly diagnosed with multiple sclerosis

Abstract

Background: Physical activity (PA) is beneficial for rehabilitation and symptom management in multiple sclerosis (MS), yet persons newly diagnosed with MS are insufficiently active and have not been the focus of PA research. This is important as early initiation of lifestyle PA, alongside other disease modifying therapies, might maximize the lasting benefits of this behavior on health outcomes and health-related quality of life (HRQOL) in MS.

Purpose: This single group, pre-post study examined the feasibility and initial efficacy of a 12-week remotely delivered COM-B-based behavior change intervention targeting lifestyle PA in persons newly diagnosed with MS.

Methods: Persons newly diagnosed with MS (diagnosis of 2 years or less) were recruited for the study. The intervention was designed based on COM-B and formative research, and included a program manual, newsletters, video coaching calls, pedometer, logbook, and calendar. Feasibility was assessed in four domains: process (e.g., recruitment, retention), resource (e.g., time and costs), management (e.g., data management), and scientific evidence (e.g., safety, treatment effects).

Results: Thirty-two persons newly diagnosed with MS underwent screening, 17 were eligible, and 14 started the intervention. Twelve participants completed the study (86 % retention rate). All participants in the intervention engaged in 100 % of video coaching calls and participants provided 73 % of online step count entries. Eighty-three percent of participants fully complied with reviewing the newsletters. No relapses were reported during the intervention. There were moderate-to-large increases in PA outcomes, as measured by the Godin Leisure-Time Exercise Questionnaire, International Physical Activity Questionnaire, and accelerometry (light PA) (d ≥ 0.5). There were no significant changes in other accelerometry outcomes, including step counts and moderate-to-vigorous PA (d = 0.2). There were large, positive effects of the intervention on physical and mental health-related quality of life with (d ≥ 1), but the change in fatigue severity was small and not statistically significant among the study participants (d = 0.3).

Conclusions: This study provides evidence for feasibility and initial efficacy of a COM-B-based PA intervention for persons newly diagnosed with MS. The results indicate that this intervention was feasible, safe, acceptable, and promising for promoting lifestyle PA in persons newly diagnosed with MS.

Keywords: Behavior change; COM-B model; Multiple sclerosis; Newly diagnosed MS; Physical activity.