Internet-based Physical Activity Promotion and Exercise Prescription for People With Multiple Sclerosis (Feasibility Study)

Study Overview
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Brief Summary
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This study evaluates the feasibility of a 12-week internet-based exercise and physical activity counseling intervention for people with Multiple Sclerosis (MS).

Detailed Description
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Due to high inactivity rates in persons with Multiple Sclerosis (pwMS) physical activity promotion for this target group is needed. The internet is an attractive and feasible medium for physical activity promotion, however interventions have to be adapted to the special needs of pwMS. This study aims to evaluate the feasibility of a 12-week internet-based exercise and physical activity counseling intervention. 26 pwMS will be enrolled in the study. All of them receive the intervention. Focus groups and interviews will be conducted with participating pwMS to determine acceptability of the intervention and to explore participants experiences. Compliance with the intervention will be monitored. Additionally, changes in objective physical activity, subjective physical activity, fatigue, walking ability and level of depression will be calculated.

Official Title
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Internet-based Physical Activity Promotion and Exercise Prescription for People With Multiple Sclerosis. A Feasibility Study.

Conditions
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Multiple Sclerosis

Intervention / Treatment
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* Behavioral: Physical activity counseling
* Behavioral: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosed Multiple Sclerosis (McDonald criteria) expanded Disability Status Scale between 0 - 6.5 neurologically stable (no exacerbation within 30 days prior to enrollment) internet access (WiFi) basic knowledge on handling personal computer and the internet owning a smartphone with the operating system Android or IOS and with access to Google Play Store or Apple App score ability to read, write and comprehend as well as communicate electronically not regularly physically active (more than 30 minutes twice a week with a moderate intensity (includes aerobic training, resistance training and other sports e.g. Tennis; excludes physiotherapy, physical activity during work or household, grocery shopping, gardening, walking the dog etc.) Exclusion Criteria: clinically relevant cardiovascular diseases cortisone therapy in the last 30 days cognitive impairment severe impairment of hand function (ataxia or paresis impeding the use of a smartphone app or smartwatch) severe internal, orthopaedic and metabolic diseases that restrict mobility

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Participants receive physical activity counseling as well as an individualized exercise plan. | Behavioral: Physical activity counseling<br>* Physical activity counseling consists of two phone or video calls with a therapists, two group video calls with a therapist and a complementary e-learning course.<br>Behavioral: Exercise<br>* Participants will agree with their therapist on an exercise plan (endurance and resistance training) that will be made available through the studies mobile app. Frequency and duration of endurance and strength training shall be prescribed in accordance with exercise guidelines for pwMS. However, they can be adjusted according to participants prior physical activity level and their available time slots for exercise during the week.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability of the Intervention and participants' experiences (focus groups) | Focus groups (1,5 hrs) with participants to determine extent to which they perceived intervention as appropriate. | 1 week after the end of the intervention | 
| Compliance with intervention protocol (completed training sessions and e-learning modules) | Completed training sessions and e-learning modules will be documented for each participant with the interventions mobile app and e-learning course. | over the 12 weeks of intervention | 
| Acceptability of the Intervention and participants' experiences (interviews) | With those participants that cannot take part in the focus groups, semistructured interviews (30 min) will be conducted to determine extent to which participants' perceived intervention as appropriate. Interview questions are based on focus group questions. The wording is slightly adapted to fit the interview situation. | 1 week after the end of the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in objectively measures physical activity | The physical activity level of participants is measured over a 7 day period with the accelerometer Actigraph GT3X+. The Actigraph GT3X+ measures acceleration on three axes. Steps per day, physical activity per day (activity counts) and time in moderate and vigorous physical activity per day will be calculated. | 1 week before start of the intervention (T0), 1 week after the end of the intervention (T1) | 
| Changes in subjectively measured physical activity: European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ) | 8-item questionnaire to assess time spent for work related physical activity, physical activity for transportation (walking, biking), muscle strengthening exercises and sports, fitness or recreational physical activity during a typical week. | 1 week before start of the intervention (T0), 1 week after end of the intervention (T1) | 
| Würzburger Fatigue Inventory for MS (WEIMuS) | This questionnaire contains 17 items that form a physical and cognitive subscale. The total score ranges from zero to a maximum of 68 points (maximum fatigue). The cut-off value for the presence of fatigue is above 32. | 1 week before start of the intervention (T0), 1 week after the end of the intervention (T1) | 
| Allgemeine Depressionsskala (ADS-L) | German version of the Center for Epidemiologic Studies Depression Scale, 20 item questionnaire. Each item is rated on a 4-point Likert scale. Answers are scored from 0 to 3. The scores for all items are added up to receive the total score. The total score ranges from 0 to 60 with higher scores representing higher levels of depression. | 1 week before start of the intervention (T0), 1 week after the end of the intervention (T1) | 
| Multiple Sclerosis Walking Scale-12 | 12-item questionnaire measuring self reported walking ability. Each item is answered on a 5-point Likert scale. Answers are scored from 1 to 5. The scores for all items are added up to receive a total score. The total score ranges from 12 to 60 with higher scores representing higher levels of depression. As a last step the total score is transformed into the walk12-score ranging from 0 to 100 ((total score -12)/48 x 100 = walk12-score). | 1 week before start of the intervention (T0), 1 week after the end of the intervention (T1) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multiple sclerosis, e-health, physical activity promotion, exercise, feasibility, online, internet based