Comparing Individualized Rehabilitation to a Group Wellness Intervention for Persons With Multiple Sclerosis

Brown University, Department of Community Health, Center for Gerontology & Health Care Research, 2 Stimson Avenue, G-ST311, Providence, RI 02912, USA.
American journal of health promotion: AJHP (Impact Factor: 2.37). 09/2009; 24(1):23-6. DOI: 10.4278/ajhp.071211128
Source: PubMed


Compare the efficacy of two interventions designed to promote health and physical activity (PA).
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.
Clinic based in a metropolitan area.
Fifty volunteers with multiple sclerosis.
IPR consisted of four physical therapy sessions plus three telephone calls. GWI consisted of seven educational sessions.
Primary: SF-36 Health Survey, Modified Fatigue Impact Scale, Mental Health Inventory. Secondary: physical assessment, PA frequency.
Stability of primary questionnaires between the two pretests was examined. Efficacy of interventions was evaluated by multivariate analysis of variance (MANOVA) and effect sizes.
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.
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.

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Available from: Virgil Mathiowetz, Sep 20, 2015
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    • "In the USA, tailored compared to standard internet delivered intervention promoting physical activity in older women, produced inconclusive results (Hageman, Walker, and Pullen, 2005). Another study in the USA, showed that individualized physical rehabilitation and group wellness intervention were effective in improving health and physical activity among persons with multiple sclerosis (Plow, Mathiowetz, and Lowe, 2009). In Melbourne, Australia, primi-parous and multiparous women showed improved post natal well-being after receiving a combination of physical therapy exercise and HE program for eight weeks (Norman, Sherburn, Osborne, and Galea, 2010). "
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    ABSTRACT: Introduction: Physiotherapists are well positioned to use physical activity as a health promotion (HP) strategy. This review examines the degree to which physiotherapy literature includes physical activity as a component of HP in practice and education. Methods: Databases PubMed, Science Direct, CINAHL, Amed and Pedro were searched using a combination of keywords. If title, abstract or keywords were relevant, we proceeded to do a complete review. Only peer reviewed English work covering original research was included. Discussion and opinion papers, reviews, epidemiological studies, case studies or work not specifically addressing integration of HP were excluded. Results: The information from 29 source articles was synthesized under the headings of acceptability of the HP role to physiotherapists and physiotherapy students; integration of HP into physiotherapy practice; HP interventions in physiotherapy practice; and HP in physiotherapy education and training. The findings were heterogenous, thereby limiting this review study to a scoping review. Conclusion: More interventional research is needed to develop efficacious strategies integrating physical activity as a HP strategy in physiotherapy practice. Contemporary physiotherapy entry-level education curricula need benchmark standards for HP training such as physical activity.
    Physiotherapy Theory and Practice 06/2013; 30(1). DOI:10.3109/09593985.2013.783896
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    • "Ultimately, participants in the proposed study may experience fatigue because of primary and secondary factors. The fatigue management program involves teaching compensatory strategies, and physical activity may mitigate secondary factors associated with fatigue [47]. Thus, we expect the FM+ intervention to be the most effective because of its potential to facilitate engagement in compensatory strategies and address secondary fatigue factors. "
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    ABSTRACT: Background Chronic fatigue and inactivity are prevalent problems among individuals with multiple sclerosis (MS) and may independently or interactively have detrimental effects on quality of life and ability to participate in life roles. However, no studies to date have systematically evaluated the benefits of an intervention for both managing fatigue and promoting physical activity in individuals with MS. This study involves a randomized controlled trial to examine the effectiveness of a telehealth intervention that supports individuals with MS in managing fatigue and increasing physical activity levels. Methods/Design A randomly-allocated, three-parallel group, time-series design with a social support program serving as the control group will be used to accomplish the purpose of the study. Our goal is to recruit 189 ambulatory individuals with MS who will be randomized into one of three telehealth interventions: (1) a contact-control social support intervention, (2) a physical activity-only intervention, and (3) a physical activity plus fatigue management intervention. All interventions will last 12 weeks and will be delivered entirely over the phone. Our hypothesis is that, in comparison to the contact-control condition, both the physical activity-only intervention and the physical activity plus fatigue management intervention will yield significant increases in physical activity levels as well as improve fatigue and health and function, with the physical activity plus fatigue management intervention yielding significantly larger improvements. To test this hypothesis, outcome measures will be administered at Weeks 1, 12, and 24. Primary outcomes will be the Fatigue Impact Scale, the Godin Leisure-Time Exercise Questionnaire (GLTEQ), and Actigraph accelerometers. Secondary outcomes will include the SF-12 Survey, Mental Health Inventory, Multiple Sclerosis Impact Scale, the Community Participation Indicator, and psychosocial constructs (e.g., self-efficacy). Discussion The proposed study is novel, in that it represents a multi-disciplinary effort to merge two promising lines of research on MS: fatigue management and physical activity promotion. Collectively, the proposed study will be the largest randomized controlled trial to examine the effects of a lifestyle physical activity intervention in people with MS. Trial registration NCT01572714
    BMC Neurology 10/2012; 12(1):122. DOI:10.1186/1471-2377-12-122 · 2.04 Impact Factor
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    • "Scale (UKNDS), Nottingham Extend Activities of Daily Living Index (NEADLI), Barthel Index, Standart Day Dependency Record (SDDR), SF-36, Modified Fatigue Impact Scale (MFIS) and the Mental Health Inventory (MHI) [10] [43] [62] [68] "
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