Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
Arch Phys Med Rehabil. 2019 Nov;100(11):2006-2014. doi: 10.1016/j.apmr.2019.04.022. Epub 2019 Jun 21.
To compare the effectiveness of telephone-delivered interventions on fatigue, physical activity, and quality of life outcomes in adults with multiple sclerosis (MS).
A single-blinded, randomized controlled trial. Participants were randomized to contact-control intervention (CC), physical activity-only intervention (PA-only), and physical activity plus fatigue self-management intervention (FM+). Outcomes were measured at baseline (2wk prerandomization), posttest (14wk postrandomization), and follow-up (26wk postrandomization).
Telephone-delivered in Midwest and Northeast regions of the United States.
Inactive adults with MS (N=208) and moderate-to-severe fatigue.
Three or 6 group teleconferences followed by 4 individually tailored phone calls delivered during 12 weeks. An occupational therapist and research assistant delivered the teleconferences and tailored phone calls, respectively.
Primary outcomes were self-report fatigue and physical activity measured with the Fatigue Impact Scale and Godin Leisure-Time Exercise Questionnaire, respectively. Secondary outcomes included quality of life measured with the Multiple Sclerosis Impact Scale and moderate-to-vigorous exercise and step count measured with an accelerometer.
Linear mixed effects models showed FM+ significantly improved self-reported fatigue (β=-11.08; P=.03) and physical activity (β=0.54; P=.01) compared with CC at posttest. However, FM+ had nonsignificant differences compared with PA-only on self-report fatigue (β=-1.08, P=.84) and physical activity (β=0.09; P=.68) at posttest. PA-only had significant improvements compared with CC on moderate-to-vigorous exercise (β=0.38; P=.02) at posttest and step count at posttest (β=1.30; P<.01) and follow-up (β=1.31; P=.01) measured with an accelerometer. FM+ and PA-only had nonsignificant differences compared with CC on quality of life.
Group teleconferences followed by tailored phone calls have a small yet statistically significant effect in promoting physical activity and reducing fatigue impact in people with MS.
比较电话干预对多发性硬化症（MS）成人疲劳、身体活动和生活质量结局的影响。
单盲、随机对照试验。参与者被随机分配到接触控制干预（CC）、仅身体活动干预（PA-only）和身体活动加疲劳自我管理干预（FM+）。在基线（随机前 2 周）、后测（随机后 14 周）和随访（随机后 26 周）时测量结局。
美国中西部和东北部地区的电话干预。
不活跃的 MS 成人（N=208）和中度至重度疲劳。
3 或 6 次小组电话会议，随后在 12 周内进行 4 次个性化电话随访。一名职业治疗师和研究助理分别提供电话会议和个性化电话。
主要结局指标是使用疲劳影响量表（Fatigue Impact Scale）和 Godin 休闲时间运动问卷（Godin Leisure-Time Exercise Questionnaire）分别测量的自我报告疲劳和身体活动。次要结局指标包括使用多发性硬化症影响量表（Multiple Sclerosis Impact Scale）测量的生活质量以及使用加速度计测量的中度至剧烈运动和步数。
线性混合效应模型显示，与 CC 相比，FM+在干预后显著改善了自我报告的疲劳（β=-11.08；P=.03）和身体活动（β=0.54；P=.01）。然而，FM+在干预后在自我报告的疲劳（β=-1.08，P=.84）和身体活动（β=0.09；P=.68）方面与 PA-only 无显著差异。PA-only 在干预后与 CC 相比，中度至剧烈运动（β=0.38；P=.02）和加速度计测量的步数在干预后（β=1.30；P<.01）和随访（β=1.31；P=.01）方面有显著改善。FM+和 PA-only 在生活质量方面与 CC 无显著差异。
小组电话会议后进行个性化电话随访可在促进 MS 患者身体活动和减轻疲劳影响方面产生小而有统计学意义的效果。
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