Can behavioral strategies increase physical activity and influence depressive symptoms and quality of life among children with epilepsy? Results of a randomized controlled trial

Denver M Y Brown; Nadilein Mahlberg; Daniela Pohl; Brian W Timmons; Steven R Bray; David L Streiner; Mark A Ferro; Sabrina Hamer; Peter L Rosenbaum; Gabriel M Ronen

doi:10.1016/j.yebeh.2019.03.011

Can behavioral strategies increase physical activity and influence depressive symptoms and quality of life among children with epilepsy? Results of a randomized controlled trial

Epilepsy Behav. 2019 May:94:158-166. doi: 10.1016/j.yebeh.2019.03.011. Epub 2019 Mar 30.

Authors

Affiliations

¹ Department of Kinesiology, McMaster University, 1280 Main Street W, Hamilton, ON L8S 4L8, Canada. Electronic address: brownd32@mcmaster.ca.
² Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada. Electronic address: mahlbn@mcmaster.ca.
³ Division of Neurology, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada. Electronic address: dpohl@cheo.on.ca.
⁴ Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada. Electronic address: timmonsbw@mcmaster.ca.
⁵ Department of Kinesiology, McMaster University, 1280 Main Street W, Hamilton, ON L8S 4L8, Canada. Electronic address: sbray@mcmaster.ca.
⁶ Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON L9C 3N6, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada. Electronic address: streiner@mcmaster.ca.
⁷ School of Public Health and Health Systems, University of Waterloo, 200 University Avenue W, Waterloo, ON N2L 3G1, Canada. Electronic address: mark.ferro@uwaterloo.ca.
⁸ Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Research Institute Building 2, Room R2109, Ottawa, ON K1H 8L1, Canada. Electronic address: shamer@cheo.on.ca.
⁹ Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada. Electronic address: rosenbau@mcmaster.ca.
¹⁰ Department of Pediatrics, McMaster University, 1400 Main Street W, Institute for Applied Health Sciences, Room 408, Hamilton, ON L8S 1C7, Canada. Electronic address: roneng@mcmaster.ca.

PMID: 30939411
DOI: 10.1016/j.yebeh.2019.03.011

Abstract

Purpose: This study examined whether increasing physical activity (PA) through 6 months of behavioral counseling positively influenced depressive symptoms and quality of life (QoL) over 12 months among children with epilepsy (CWE).

Methods: A longitudinal multisite randomized controlled trial (RCT) was conducted with 8-14-year-old children with active epilepsy. Participants wore a pedometer to track daily PA and completed 3 measures at 4 time points to examine depressive symptoms and QoL. Stratified by site and activity level, participants were randomized to an intervention or control group. The 6-month intervention included 11 behavioral counseling sessions targeting self-regulation of PA. To assess the associations among PA, depression scores, and QoL, primary analysis involved mixed-effects models.

Results: We recruited 122 CWE, of whom 115 were randomized (M_age = 11 ± 2; 50% female) and included in the analysis. The intervention did not increase PA in the treatment compared with the control group. No differences were found between groups over time during the subsequent 6 months, where PA decreased among all participants. Results did not show differences between the groups and over time for measures of depressive symptoms and QoL.

Significance: The intervention did not improve or sustain PA levels over 12 months. Both groups demonstrated declines in PA over one year, but there were no changes in depression scores or QoL. As most participants were already nearly reaching the Canadian average of step counts of children their age, with a baseline daily step count of over 9000, there may be a challenge for further increasing PA over a longer period.

Keywords: Behavior change; Childhood epilepsy; Exercise; Patient-reported outcomes; Quality of life; Self-management intervention.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Counseling
Depression / etiology
Depression / psychology*
Depression / therapy*
Epilepsy / complications
Epilepsy / psychology*
Epilepsy / therapy*
Exercise Therapy / methods
Exercise*
Female
Humans
Longitudinal Studies
Male
Negative Results
Quality of Life*
Self Care