Abstract
Objective
To compare the effectiveness of telephone-delivered interventions on fatigue, physical
activity, and quality of life outcomes in adults with multiple sclerosis (MS).
Design
A single-blinded, randomized controlled trial. Participants were randomized to contact-control
intervention (CC), physical activity–only intervention (PA-only), and physical activity
plus fatigue self-management intervention (FM+). Outcomes were measured at baseline
(2wk prerandomization), posttest (14wk postrandomization), and follow-up (26wk postrandomization).
Setting
Telephone-delivered in Midwest and Northeast regions of the United States.
Participants
Inactive adults with MS (N=208) and moderate-to-severe fatigue.
Interventions
Three or 6 group teleconferences followed by 4 individually tailored phone calls delivered
during 12 weeks. An occupational therapist and research assistant delivered the teleconferences
and tailored phone calls, respectively.
Main Outcome Measures
Primary outcomes were self-report fatigue and physical activity measured with the
Fatigue Impact Scale and Godin Leisure-Time Exercise Questionnaire, respectively.
Secondary outcomes included quality of life measured with the Multiple Sclerosis Impact
Scale and moderate-to-vigorous exercise and step count measured with an accelerometer.
Results
Linear mixed effects models showed FM+ significantly improved self-reported fatigue
(β=−11.08; P=.03) and physical activity (β=0.54; P=.01) compared with CC at posttest. However, FM+ had nonsignificant differences compared
with PA-only on self-report fatigue (β=−1.08, P=.84) and physical activity (β=0.09; P=.68) at posttest. PA–only had significant improvements compared with CC on moderate-to-vigorous
exercise (β=0.38; P=.02) at posttest and step count at posttest (β=1.30; P<.01) and follow-up (β=1.31; P=.01) measured with an accelerometer. FM+ and PA-only had nonsignificant differences
compared with CC on quality of life.
Conclusions
Group teleconferences followed by tailored phone calls have a small yet statistically
significant effect in promoting physical activity and reducing fatigue impact in people
with MS.
Keywords
List of abbreviations:
CC (contact-control social support intervention), FIS (Fatigue Impact Scale), FM+ (physical activity plus fatigue self-management intervention), GLTEQ (Godin Leisure-Time Exercise Questionnaire), MS (multiple sclerosis), MSIS (Multiple Sclerosis Impact Scale), PA-only (physical activity–only intervention), OT (occupational therapist), RCT (randomized controlled trial)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 20, 2019
Footnotes
Funding Acknowledgment: This work was supported through the National Multiple Sclerosis Society (NMSS, grant no. RG4665-A-1). The information presented in this article does not necessarily reflect the position, ideas, or opinions of the NMSS.
Clinical Trial Registration No.: NCT01572714.
Disclosures: Dr Bethoux's ICMJE form reports financial relationships with Biogen, GW Pharma, Adamas Pharmaceuticals, Acorda Therapeutics, and Ipsen outside the submitted work. The other authors have nothing to disclose.
Identification
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© 2019 by the American Congress of Rehabilitation Medicine
