Understanding adherence and its impact on function in a six-month step exergame intervention for people with multiple...

Area of Science:

• Neurology
• Rehabilitation Science
• Digital Health

Background:

• Falls are a significant concern for individuals with Multiple Sclerosis (MS).
• Home-based exergame interventions show promise for fall prevention.
• Predictors of adherence and impact of adherence on outcomes in MS are not fully understood.

Purpose of the Study:

• To identify predictors of adherence to a six-month home-based step exergame intervention for fall prevention in people with MS.
• To determine the effects of adherence on physical, cognitive, and psychological outcomes.

Main Methods:

• Secondary analysis of a multi-site randomized controlled trial (n=469) involving a home-based step exergame intervention.
• Baseline characteristics analyzed as predictors of adherence (target: 120 min/week).
• Comparison of high adherers (≥100 min/week) versus control group on outcome measures.

Main Results:

• Older age, lower BMI, site location, and fewer depressive symptoms predicted higher adherence.
• High adherers (n=71) reported less fatigue compared to controls (n=228).
• High adherers (n=25) made fewer errors on the Stroop stepping test compared to controls (n=104).

Conclusions:

• Older individuals with MS, lower BMI, and fewer depressive symptoms are more likely to adhere to step exergame interventions.
• Higher adherence leads to clinically meaningful benefits like reduced fatigue and improved cognitive-motor function.
• Findings can guide personalized support for individuals with MS in exergame programs.