The SitLess With MS Program: Intervention Feasibility and Change in Sedentary Behavior

Patricia J Manns; Golnoush Mehrabani; Sarah Norton; Saeideh Aminian; Robert W Motl

doi:10.1016/j.arrct.2020.100083

The SitLess With MS Program: Intervention Feasibility and Change in Sedentary Behavior

Arch Rehabil Res Clin Transl. 2020 Sep 16;2(4):100083. doi: 10.1016/j.arrct.2020.100083. eCollection 2020 Dec.

Authors

Patricia J Manns¹, Golnoush Mehrabani¹, Sarah Norton¹, Saeideh Aminian¹, Robert W Motl²

Affiliations

¹ Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
² Department of Physical Therapy, University of Alabama at Birmingham, Urbana, AL.

Abstract

Objectives: This study reports on the feasibility of the SitLess with MS trial, an intervention targeting sedentary behavior in individuals with multiple sclerosis (MS).

Design: Single group, pre-post intervention design.

Setting: Community.

Participants: Participants (N=41) with mild to moderate disability from MS.

Intervention: The intervention was 15 weeks, with a 7-week follow-up, and included 2 stages: SitLess and MoveMore. During the SitLess stage, participants were encouraged to break up prolonged sitting bouts over a 7-week period, whereas the MoveMore stage promoted increased steps per day and interrupting sitting over a 7-week period. The intervention was delivered through weekly one-on-one coaching sessions via telerehabilitation and an accompanying newsletter based on social-cognitive theory. Activity was monitored throughout the program using a Fitbit.

Main outcome measures: Process (eg, recruitment) and resource and management (eg, personnel requirements) metrics were assessed, along with efficacy outcomes (eg, effect). Progression criteria were set a priori and were related to safety, fatigue, satisfaction, and attrition. Sedentary behavior, measured using the ActivPal, was reported pre- and postintervention, as well as 7 weeks postintervention. Effect sizes (pre to post, pre to 7 weeks post) were calculated for the sedentary behavior outcomes (eg, time sitting, transitions from sitting to standing, number of long sitting bouts). Experiences with the intervention were explored through an online survey.

Results: Forty-one participants enrolled, 39 of whom completed the intervention. All participants but 1 were satisfied with the experience. Pre-post intervention effect sizes for change in total sedentary time, number of transitions from sit to stand, and number of long (>30 min) sedentary bouts were 0.34, 0.02, and 0.39 respectively. All a priori progression criteria were met.

Conclusions: The SitLess with MS program, a novel intervention that emphasized and facilitated sitting less and moving more, was feasible and resulted in small changes in sedentary behavior in individuals with MS.

Keywords: EDSS, expanded disability status scale; FSS, Fatigue Severity Scale; Feasibility studies; MS, multiple sclerosis; Multiple sclerosis; Rehabilitation; Telerehabilitation.