Developing optimized physical activity interventions for drug-resistant epilepsy: Challenges and lessons learned from...

Area of Science:

• Neurology
• Exercise Science
• Public Health

Background:

• Physical activity offers significant benefits for people with epilepsy (PWE).
• Promoting exercise in PWE, particularly those with drug-resistant epilepsy (DRE), faces unique challenges and barriers.
• The Multiphase Optimization Strategy (MOST) emphasizes iterative pilot and optimization research for complex interventions.

Purpose of the Study:

• To explore the feasibility of a remotely delivered, 12-week aerobic exercise program for adults with DRE.
• To identify barriers and facilitators to participation in such a program.
• To inform future large-scale efficacy trials and implementation strategies.

Main Methods:

• A 12-week, remotely delivered aerobic exercise program based on social cognitive theory principles.
• Recruitment of adults with DRE.
• Assessment of feasibility through recruitment, retention, and acceptability measures.

Main Results:

• Ten participants were recruited, with four completing the study (40% retention).
• Recruitment rate was 3.8% of preliminarily eligible individuals.
• Acceptability was high among completers, but overall recruitment, retention, and uptake were low.
• Key barriers identified included low intervention appeal, comorbid mental health issues, and fear of seizures.

Conclusions:

• The feasibility of a remotely delivered aerobic exercise program for adults with DRE is limited by low recruitment and retention.
• Barriers such as intervention appeal, mental health comorbidities, and seizure fears significantly impact participation.
• Future physical activity promotion strategies for PWE, especially DRE, require novel approaches involving iterative pilot testing and optimization.