Motl Robert W, Dlugonski Deirdre, Pilutti Lara A, Klaren Rachel E
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA (RWM, LAP, REK); and the Department of Kinesiology, East Carolina University, Greenville, NC, USA (DD).
Int J MS Care. 2015 Mar-Apr;17(2):65-72. doi: 10.7224/1537-2073.2014-016.
Behavioral interventions have significantly increased physical activity in people with multiple sclerosis (MS). Nevertheless, there has been interindividual variability in the pattern and magnitude of change. This study documented the efficacy and variability of a behavioral intervention for changing physical activity and examined the possibility that efficacy varied by the characteristics of individuals with MS.
Eighty-two people with MS were randomly assigned to one of two conditions: behavioral intervention (n = 41) or waitlist control (n = 41). We collected information before the study on MS type, disability status, weight status based on body-mass index, and current medications. Furthermore, all participants completed the Godin Leisure Time Exercise Questionnaire and the abbreviated International Physical Activity Questionnaire and wore an accelerometer for 1 week to measure minutes of moderate-to-vigorous physical activity before and after the 6-month intervention period.
Analysis of covariance (ANCOVA) indicated that participants in the behavioral intervention had significantly higher levels of physical activity than control participants after the 6-month period (P < .001). There was substantial interindividual variability in the magnitude of change, and ANCOVA indicated that MS type (relapsing vs. progressive) (P < .01), disability status (mild vs. moderate) (P < .01), and weight status (normal weight vs. overweight/obese) (P < .05) moderated the efficacy of the behavioral intervention.
The behavioral intervention was associated with improvements in physical activity, particularly for those with mild disability, relapsing-remitting MS, or normal weight status.
行为干预显著增加了多发性硬化症（MS）患者的身体活动量。然而，变化的模式和程度存在个体差异。本研究记录了一种行为干预对改变身体活动的疗效和变异性，并探讨了疗效是否因MS患者的特征而异。
82名MS患者被随机分配到两种情况之一：行为干预组（n = 41）或等待名单对照组（n = 41）。我们在研究前收集了关于MS类型、残疾状况、基于体重指数的体重状况和当前用药情况的信息。此外，所有参与者都完成了戈丁休闲时间运动问卷和简化的国际身体活动问卷，并佩戴加速度计1周，以测量6个月干预期前后的中度至剧烈身体活动分钟数。
协方差分析（ANCOVA）表明，在6个月后，行为干预组的参与者身体活动水平显著高于对照组（P <.001）。变化幅度存在很大的个体差异，ANCOVA表明MS类型（复发型与进展型）（P <.01）、残疾状况（轻度与中度）（P <.01）和体重状况（正常体重与超重/肥胖）（P <.05）调节了行为干预的疗效。
行为干预与身体活动的改善有关，特别是对于那些轻度残疾、复发缓解型MS或正常体重状况的患者。
