Changing Physical Activity Behavior in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis

Area of Science:

• Rehabilitation science
• Behavioral medicine
• Neurology

Background:

• Physical activity (PA) is crucial for managing multiple sclerosis (MS).
• Behavioral interventions aim to modify PA behavior in individuals with MS.
• Understanding the effectiveness and theoretical underpinnings of these interventions is essential.

Purpose of the Study:

• To systematically review behavioral interventions targeting PA behavior change in people with MS.
• To assess the clinical effectiveness of these interventions on PA.
• To determine if interventions are theory-based and utilize established behavior change techniques (BCTs).

Main Methods:

• Systematic literature search across multiple databases (EBSCO, PubMed, EMBASE, Web of Science).
• Inclusion criteria: interventions for MS targeting PA behavior, PA as a primary outcome, randomized controlled trial (RCT) design.
• Interventions coded using Theory Coding Scheme and CALO-RE taxonomy; meta-analysis for effectiveness.

Main Results:

• Fourteen RCTs were included in the review.
• Significant short-term improvements in self-reported PA were observed (P=.0003, d=1.00).
• No significant changes in objective or long-term PA were found; interventions rarely discussed or refined theory; "goal-setting" and "action-planning" were common BCTs.

Conclusions:

• Current evidence supports PA interventions for subjective PA outcomes in MS, but not objective ones.
• Conclusions require caution due to limited study numbers and sample sizes.
• Future interventions should aim to refine theory and explore a broader range of BCTs to enhance PA behavior change.