Motiviational counseling and strengthening exercises in patients with multiple sclerosis.

TitleMotiviational counseling and strengthening exercises in patients with multiple sclerosis.
Publication TypeJournal Article
2008
AuthorsBowen JD, Madrone K, Wight K, Wadhwani R, Bombardier CH, Ehde DM, Kraft GH
JournalInternational Journal of MS Care
Volume10
IssueS1
Pagination11

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.

http://www.ijmsc.org/doi/pdf/10.7224/1537-2073-10.S1.i

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