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The Effect of Telephone-Based Physical Activity Counseling on Fatigue Impact in MS
Abstract
Background: Fatigue is one of the most disabling and prevalent symptoms reported in individuals with multiple sclerosis (MS). Fatigue adversely affects quality of life and is associated with greater pain and depression. A recent systematic review concluded that exercise improves fatigue, however few studies have used validated measures of fatigue or community-based, telerehabilitation approaches to improve physical activity as a treatment for fatigue in individuals with MS.
Objectives: This presentation reports on a secondary analysis of a study in which the primary objective was to assess the efficacy of a telephone-based physical activity counseling to treat major depressive disorder (MDD) in MS. We collected data on the effect of the intervention on fatigue impact and report the results here.
Methods: Ninety-two adults with MS and MDD participated in this study (M age= 48 years, 86% female). The study was a single-blind, two armed randomized control trial (RCT) comparing a 12-week telephone-based physical activity counseling intervention to increase physical activity (n=44) to a wait-list control group (n=48). The treatment group had a mean duration disease course of 11.7 years and the control group had a mean duration of disease of 9.4 years. Both groups had an EDSS score of less than 5.5. The Modified Fatigue Impact Scale (MFIS) was administered to participants at baseline pre-intervention, at 12 weeks post-intervention and at 24 weeks post-intervention.
Results: The analysis was based on intent to treat (ITT) and regression analyses showed that the intervention group reported a significantly lower post-treatment fatigue impact than did controls, after the baseline MFIS was controlled. Based on the Wald test for treatment in a linear regression model controlling for pre-intervention score, the mean MFIS in the treatment group (11.0) was significantly less than the mean in the control group (13.5) at the end of treatment (p= 0.0001). At 24 weeks, the participants in the treatment group maintained the same mean MFIS score as they did at the end of treatment, and remained as physically active as well.
Conclusions: The results of this study represent a novel and potentially promising approach to the treatment of fatigue impact in individuals with MS. Further research is warranted on ways to bolster the impact of the intervention and on mediators of the treatment effect.
Authors
Charles H Bombardier
University of Washington
Anna E Evans
University of Washington
George H Kraft
University of Washington School of Medicine
Abstract
Background: Fatigue is one of the most disabling and prevalent symptoms reported in individuals with multiple sclerosis (MS). Fatigue adversely affects quality of life and is associated with greater pain and depression. A recent systematic review concluded that exercise improves fatigue, however few studies have used validated measures of fatigue or community-based, telerehabilitation approaches to improve physical activity as a treatment for fatigue in individuals with MS.
Objectives: This presentation reports on a secondary analysis of a study in which the primary objective was to assess the efficacy of a telephone-based physical activity counseling to treat major depressive disorder (MDD) in MS. We collected data on the effect of the intervention on fatigue impact and report the results here.
Methods: Ninety-two adults with MS and MDD participated in this study (M age= 48 years, 86% female). The study was a single-blind, two armed randomized control trial (RCT) comparing a 12-week telephone-based physical activity counseling intervention to increase physical activity (n=44) to a wait-list control group (n=48). The treatment group had a mean duration disease course of 11.7 years and the control group had a mean duration of disease of 9.4 years. Both groups had an EDSS score of less than 5.5. The Modified Fatigue Impact Scale (MFIS) was administered to participants at baseline pre-intervention, at 12 weeks post-intervention and at 24 weeks post-intervention.
Results: The analysis was based on intent to treat (ITT) and regression analyses showed that the intervention group reported a significantly lower post-treatment fatigue impact than did controls, after the baseline MFIS was controlled. Based on the Wald test for treatment in a linear regression model controlling for pre-intervention score, the mean MFIS in the treatment group (11.0) was significantly less than the mean in the control group (13.5) at the end of treatment (p= 0.0001). At 24 weeks, the participants in the treatment group maintained the same mean MFIS score as they did at the end of treatment, and remained as physically active as well.
Conclusions: The results of this study represent a novel and potentially promising approach to the treatment of fatigue impact in individuals with MS. Further research is warranted on ways to bolster the impact of the intervention and on mediators of the treatment effect.
Authors
Charles H Bombardier
University of Washington
Anna E Evans
University of Washington
George H Kraft
University of Washington School of Medicine