Randomized Controlled Trial of a Telephone-Delivered Physical Activity and Fatigue Self-management Interventions in Adults With Multiple Sclerosis

Objective: To compare the effectiveness of telephone-delivered interventions on fatigue, physical activity, and quality of life outcomes in adults with multiple sclerosis (MS). Design: 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). Setting: Telephone-delivered in Midwest and Northeast regions of the United States. Participants: Inactive adults with MS (N=208) and moderate-to-severe fatigue. Interventions: 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. Main Outcome Measures: 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. Results: Linear mixed effects models showed FM+ significantly improved self-reported fatigue (beta=-11.08; P=.03) and physical activity (beta=0.54; P=.01) compared with CC at posttest. However, FM+ had nonsignificant differences compared with PA-only on self-report fatigue (beta=1.08, P=.84) and physical activity (beta=0.09; P=.68) at posttest. PA-only had significant improvements compared with CC on moderateto-vigorous exercise (beta=0.38; P=.02) at posttest and step count at posttest (beta=1.30; P<.01) and follow-up (beta=1.31; P=.01) measured with an accelerometer. FM+ and PA-only had nonsignificant differences compared with CC on quality of life. Conclusions: 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. (C) 2019 by the American Congress of Rehabilitation Medicine