Comparing individualized rehabilitation to a group wellness intervention for persons with multiple sclerosis

Abstract

Purpose: Compare the efficacy of two interventions designed to promote health and physical activity (PA).

Design: This study was a randomized clinical trial using a time series design. Subjects were randomized into individualized physical rehabilitation (IPR) and group wellness intervention (GWI). Primary questionnaires were administered twice preintervention and twice postintervention. Physical fitness and PA frequency were assessed preintervention and postintervention.

Setting: Clinic based in a metropolitan area.

Subjects: Fifty volunteers with multiple sclerosis.

Interventions: IPR consisted of four physical therapy sessions plus three telephone calls. GWI consisted of seven educational sessions.

Measures: Primary: SF-36 Health Survey, Modified Fatigue Impact Scale, Mental Health Inventory. Secondary: physical assessment, PA frequency.

Analysis: Stability of primary questionnaires between the two pretests was examined. Efficacy of interventions was evaluated by multivariate analysis of variance (MANOVA) and effect sizes.

Results: Primary measures were stable between pretests. MANOVA showed nonsignificant differences between interventions. Eight weeks postintervention, both groups had improved PA, fatigue, resting heart rate, and strength. Effect sizes suggested that IPR had a greater effect on preventing decline of physical health, whereas GWI had a greater effect on improving mental health.

Conclusion: Preliminary evidence indicated that health and PA improved in both groups. Effect sizes suggested that participants benefited more physically from IPR and more mentally from GWI. Future research should determine whether combining therapeutic exercise with group education improves both mental and physical health.