Pilutti L A, Dlugonski D, Sandroff B M, Klaren R, Motl R W
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, USA.
Mult Scler. 2014 Apr;20(5):594-601. doi: 10.1177/1352458513503391. Epub 2013 Sep 5.
Exercise training is beneficial, but most persons with multiple sclerosis (MS) are sedentary and physically inactive. This has prompted a new focus on the promotion of lifestyle physical activity in MS. We previously designed, tested, and refined a behavioral intervention delivered through the Internet that successfully increased lifestyle physical activity in MS, but have not evaluated the effects on secondary symptomatic and health-related quality of life (HRQOL) outcomes.
We conducted a 6-month randomized controlled trial (RCT) that examined the efficacy of an Internet-delivered, behavioral intervention for improving outcomes of fatigue, depression, anxiety, pain, sleep quality, and HRQOL in 82 ambulatory persons with MS. The secondary aim was to replicate previous results regarding change in free-living physical activity.
There was a significant and positive effect of the intervention on fatigue severity (p=.001, η ρ (2)=.15) and its physical impact (p=.008, η ρ (2)=.09), depression (p=.006, η ρ (2)=.10), and anxiety (p=.006, η ρ (2)=.10). There were non-significant improvements in pain (p=.08, η ρ (2)=.04), sleep quality (p=.06, η ρ (2)=.05), and physical HRQOL (p=.06, η ρ (2)=.05). We replicated our previous results by demonstrating an increase in self-reported physical activity (p=.001, η ρ (2)=.13).
Our results support behavioral interventions targeting lifestyle physical activity as an alternative approach for managing symptoms in MS.
运动训练有益，但大多数多发性硬化症（MS）患者久坐不动且缺乏身体活动。这促使人们重新关注MS患者生活方式体力活动的推广。我们之前设计、测试并完善了一种通过互联网提供的行为干预措施，该措施成功增加了MS患者的生活方式体力活动，但尚未评估其对继发性症状和健康相关生活质量（HRQOL）结果的影响。
我们进行了一项为期6个月的随机对照试验（RCT），研究通过互联网提供的行为干预对82名非卧床MS患者的疲劳、抑郁、焦虑、疼痛、睡眠质量和HRQOL结果的改善效果。次要目的是重复之前关于自由生活体力活动变化的结果。
干预对疲劳严重程度（p = 0.001，ηρ(2)=0.15）及其身体影响（p = 0.008，ηρ(2)=0.09）、抑郁（p = 0.006，ηρ(2)=0.10）和焦虑（p = 0.006，ηρ(2)=0.10）有显著的积极影响。疼痛（p = 0.08，ηρ(2)=0.04）、睡眠质量（p = 0.06，ηρ(2)=0.05）和身体HRQOL（p = 0.06，ηρ(2)=0.05）有非显著改善。我们通过证明自我报告的体力活动增加（p = 0.001，ηρ(2)=0.13）重复了之前的结果。
我们的结果支持将针对生活方式体力活动的行为干预作为MS症状管理的替代方法。
