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.


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 (Mage = 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