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Randomized Controlled Trial of a Telephone-Delivered Physical Activity and Fatigue Self-management Interventions in
Matthew Plow1, Marcia Finlayson2, Jintao Liu3
1Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
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 (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.
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.
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