Randomized controlled trial of an e-learning designed behavioral intervention for increasing physical activity behavior in multiple sclerosis.

ABSTRACT

BACKGROUND: Internet-delivered, behavioral interventions represent a cost-effective, broadly disseminable approach for teaching persons with multiple sclerosis (MS) the theory-based skills, techniques, and strategies for changing physical activity. OBJECTIVES: This pilot, randomized controlled trial examined the efficacy of a newly developed Internet website based on e-learning approaches that delivered a theory-based behavior intervention for increasing physical activity and improving symptoms, walking impairment, and neurological disability. METHODS: Participants with MS (N = 47) were randomly assigned into behavioral intervention (n = 23) or waitlist control (n = 24) conditions delivered over a six-month period. Outcomes were administered before and after the six-month period using blinded assessors, and data were analyzed using analysis of covariance in SPSS. RESULTS: There was a significant, positive intervention effect on self-reported physical activity (P = 0.05, [Formula see text] = 0.10), and non-significant improvement in objectively measured physical activity (P = 0.24, [Formula see text] = 0.04). There were significant, positive effects of the intervention on overall (P = 0.018, [Formula see text] = 0.13) and physical impact of fatigue (P = 0.003, [Formula see text] = 0.20), self-reported walking impairment (P = 0.047, [Formula see text] = 0.10), and disability status (P = 0.033, [Formula see text] = 0.11). There were non-significant improvements in fatigue severity (P = 0.10, [Formula see text] = 0.06), depression (P = 0.10, [Formula see text] = 0.07) and anxiety (P = 0.06, [Formula see text] = 0.09) symptoms, and self-reported disability (P = 0.10, [Formula see text] = 0.07). CONCLUSIONS: We provide evidence for the efficacy of an Internet-based behavioral intervention with content delivered through interactive video courses grounded in e-learning principles for increasing physical activity and possibly improving secondary outcomes of fatigue, depression, anxiety, and walking impairment/disability in persons with MS.