Motiviational counseling and strengthening exercises in patients with multiple sclerosis.

Background: Exercise is important in managing multiple sclerosis (MS). However, little is known about methods of encouraging exercise in MS patients. Methods: Sequential ambulatory MS patients were randomized to motivational interviewing or usual care. Telephone counseling was repeated at 2 weeks and 1, 2, 3, 6, 9, 12, 18, and 24 months. Outcomes were measured at baseline and annually. Results: The 60 treatment and 63 control subjects were well matched for age, sex, race, marital status, and living situation. Minutes of strengthening/flexibility exercise per week in the treatment group increased from 33 ± 54 at baseline to 55.9 ± 83 at 1 year (paired t test, t = –1.876, P = .066) and 61 ± 70 at 2 years (t = –2.048, P = .046). Exercise in the control group was 30 ± 56 at baseline, 32 ± 53 at 1 year (t = –0.247, P = .81), and 50 ± 94 at 2 years (t = –1.742, P = .087). The difference between the treatment and control groups was significant at 1 year (P = .044) but not at baseline (P = .63) or 2 years (P = .63). No differences were found on the Modified Fatigue Impact Scale over the three measurements between the treatment group (9.48 ± 4.60, 8.96 ± 3.40, and 8.17 ± 3.90) and the controls (7.68 ± 7.40, P = .84; 8.07 ± 4.70, P = .26; and 8.35 ± 4.30, P = .83). Average pain on a scale of 1–10 was similar in the groups: treatment, 3.16 ± 1.80, 3.41 ± 2.10, and 3.55 ± 1.60; control: 3.26 ± 2.00 (P = .84), 3.50 ± 1.50 (P = .85), and 3.29 ± 2.30 (P = .67). Also, no difference was found in depression between the groups: treatment: 11.78 ± 8.70, 6.64 ± 23.90, and 10.21 ± 9.10; control: 6.87 ± 22.90 (P = .12), 10.53 ± 10.40 (P = .26), and 8.67 ± 7.70 (P = .36). Conclusions: Motivational interviewing increased the amount of strengthening/flexibility exercise at 2 years. This did not lead to changes in fatigue, pain, or depression, which may require more targeted or intensive exercise interventions.