Ian M Rice1, Laura A Rice2, Robert W Motl2. 1. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL. Electronic address: ianrice@illinois.edu. 2. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL.
Abstract
OBJECTIVE: To examine the efficacy and feasibility of a multifactorial intervention to increase lifestyle physical activity in nonambulatory persons with multiple sclerosis (MS) based on wheelchair optimization, propulsion skill/technique training, and behavioral strategies based on social cognitive theory. DESIGN: Randomized controlled trial, 3-month postintervention follow-up. SETTING: Home and general community, and university research laboratory. PARTICIPANTS: Nonambulatory individuals with MS (N=14; mean age ± SD, 53.6±8.7y) were randomly assigned to an intervention group (IG) or a control group (CG). INTERVENTIONS: After baseline testing, the IG participants received custom-fit, ultralightweight manual wheelchairs with propulsion/skills training, followed by 3 months of at-home use with the custom ultralightweight wheelchair and weekly phone calls to deliver support through a multifactorial intervention. The CG participants received no training and used their own wheelchairs at home during this time. MAIN OUTCOME MEASURES: All subjects were assessed at baseline and 3 months later for fatigue (Fatigue Severity Scale), upper extremity strength (digital handheld dynamometer), and propulsion technique (on a treadmill [0.5m/s] with instrumented wheels). Two 1-week bouts of physical activity were measured in both groups from home with wrist-worn accelerometry at the beginning (IG and CG in own wheelchairs) and end (IG in study wheelchair, CG in own) of the 3-month period of home use. RESULTS: The intervention was well tolerated, and no adverse events were reported. The IG demonstrated increased strength (P=.008) and a trend toward less fatigue (P=.068), both with large effect sizes (d>0.8), as well as reduced application of braking torque during propulsion (P=.003) with a moderate/large effect size (d=.73), compared with the CG. CONCLUSIONS: Findings suggest a 3-month physical activity intervention based on manual wheelchair propulsion and training is safe and feasible for some wheelchair users living with MS and may produce secondary benefits in strength, fatigue, and propulsion technique.
RCT Entities:
OBJECTIVE: To examine the efficacy and feasibility of a multifactorial intervention to increase lifestyle physical activity in nonambulatory persons with multiple sclerosis (MS) based on wheelchair optimization, propulsion skill/technique training, and behavioral strategies based on social cognitive theory. DESIGN: Randomized controlled trial, 3-month postintervention follow-up. SETTING: Home and general community, and university research laboratory. PARTICIPANTS: Nonambulatory individuals with MS (N=14; mean age ± SD, 53.6±8.7y) were randomly assigned to an intervention group (IG) or a control group (CG). INTERVENTIONS: After baseline testing, the IG participants received custom-fit, ultralightweight manual wheelchairs with propulsion/skills training, followed by 3 months of at-home use with the custom ultralightweight wheelchair and weekly phone calls to deliver support through a multifactorial intervention. The CG participants received no training and used their own wheelchairs at home during this time. MAIN OUTCOME MEASURES: All subjects were assessed at baseline and 3 months later for fatigue (Fatigue Severity Scale), upper extremity strength (digital handheld dynamometer), and propulsion technique (on a treadmill [0.5m/s] with instrumented wheels). Two 1-week bouts of physical activity were measured in both groups from home with wrist-worn accelerometry at the beginning (IG and CG in own wheelchairs) and end (IG in study wheelchair, CG in own) of the 3-month period of home use. RESULTS: The intervention was well tolerated, and no adverse events were reported. The IG demonstrated increased strength (P=.008) and a trend toward less fatigue (P=.068), both with large effect sizes (d>0.8), as well as reduced application of braking torque during propulsion (P=.003) with a moderate/large effect size (d=.73), compared with the CG. CONCLUSIONS: Findings suggest a 3-month physical activity intervention based on manual wheelchair propulsion and training is safe and feasible for some wheelchair users living with MS and may produce secondary benefits in strength, fatigue, and propulsion technique.
Authors: Stephanie L Silveira; Trinh Huynh; Ariel Kidwell; Dena Sadeghi-Bahmani; Robert W Motl Journal: Arch Phys Med Rehabil Date: 2021-02-05 Impact factor: 4.060
Authors: Rosalind Kalb; Theodore R Brown; Susan Coote; Kathleen Costello; Ulrik Dalgas; Eric Garmon; Barbara Giesser; June Halper; Herb Karpatkin; Jennifer Keller; Alexander V Ng; Lara A Pilutti; Amanda Rohrig; Paul Van Asch; Kathleen Zackowski; Robert W Motl Journal: Mult Scler Date: 2020-04-23 Impact factor: 6.312