Preliminary efficacy of the “SitLess with MS” intervention for changing sedentary behaviour, symptoms, and physical performance in multiple sclerosis

Abstract

Purpose

People with multiple sclerosis (MS) sit (i.e., are sedentary) more than peers. We examined the preliminary efficacy of an internet-based intervention that focuses on sitting less and moving more for changing sedentary behaviour outcomes, symptoms, QOL, and physical performance in adults with MS.

Methods

Persons with mild-to-moderate disability from MS took part in a 15-week pre–post trial. Outcomes including sedentary behaviour, representative symptoms (e.g., fatigue, pain), QOL and physical performance measures (e.g., walking speed) were measured at three time points: pre–post intervention and at follow-up. An unstructured linear mixed-effects model was used to determine change over time per outcome.

Results

Forty-one persons with MS participated (age 50 ± 10.3 years). There were significant reductions in total sedentary time (d = 0.34) and the number of long (≥30 min) bouts of sedentary time (d = 0.39) post-intervention. All symptoms and physical performance measures were significantly improved following the intervention, with effects sizes greatest for fatigue (d = 0.61) and depression (d = 0.79). Changes were maintained during the 7-week follow-up, except for all sedentary behaviour outcomes and sleep quality. Cognition did not change.

Conclusions

This study provides preliminary support for the efficacy of an intervention focused on sitting less and moving more for improving symptoms in adults with MS.

IMPLICATIONS FOR REHABILITATION

• This research provides preliminary evidence that an intervention aimed at reducing sedentary behaviour and increasing light intensity activity throughout the day can have an impact.

• Fatigue, depression and anxiety, symptoms frequently encountered by people with MS, showed the greatest improvement following the intervention.

• Weekly coaching sessions including discussions about results from activity monitoring provided motivation for participants.

Trial Registration

The “SitLess with MS” feasibility study was registered at ClinicalTrials.gov Trial Registration Number: NCT03136744. Date of registration was 2 May 2017. Find at https://clinicaltrials.gov/ct2/show/NCT03136744

Keywords:

• Multiple sclerosis
• sedentary behaviour
• MS-related symptoms
• physical performance
• activity behaviour change
• ActivPAL

Acknowledgments

The authors would like to thank Dr. Penny Smyth, Dr. Jennifer McCombe, and Margaret Prociuk, from the Northern Alberta MS Clinic at the University of Alberta, for their invaluable help with recruitment in this project. Finally, we are grateful to Dr. Kate Lyden who generously provided guidance specific to the analysis of ActivPAL data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was financially supported by the Alberta Innovates, Novartis Translational Research Fund.