Randomized Controlled Trial of a Telephone-Delivered Physical Activity and Fatigue Self-management Interventions in Adults With Multiple Sclerosis

Arch Phys Med Rehabil. 2019 Nov;100(11):2006-2014. doi: 10.1016/j.apmr.2019.04.022. Epub 2019 Jun 21.

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.

Trial registration: ClinicalTrials.gov NCT01572714.

Keywords: Behavior; Comparative effectiveness research; Exercise; Fatigue; Multiple sclerosis; Rehabilitation; Self-management.

Publication types

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

MeSH terms

  • Accelerometry
  • Adult
  • Exercise / physiology*
  • Fatigue / etiology
  • Fatigue / rehabilitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / rehabilitation*
  • Occupational Therapy / methods
  • Quality of Life*
  • Self-Management / methods*
  • Single-Blind Method
  • Socioeconomic Factors
  • Telemedicine / methods
  • Telephone*
  • United States

Associated data

  • ClinicalTrials.gov/NCT01572714