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Effect of exercising at minimum recommendations of the multiple sclerosis exercise guideline combined with structured education or attention control education – secondary results of the step it up randomised controlled trial

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dc.contributor.author Coote, Susan
dc.contributor.author Uszynski, Marcin Kacper
dc.contributor.author Herring, Matthew P.
dc.contributor.author Hayes, Sara
dc.contributor.author Scarrott, Carl
dc.contributor.author Newell, John
dc.contributor.author Gallagher, Stephen
dc.contributor.author Larkin, Aidan
dc.contributor.author Motl, Robert W.
dc.date.accessioned 2017-07-06T07:54:19Z
dc.date.available 2017-07-06T07:54:19Z
dc.date.issued 2017
dc.identifier.uri http://hdl.handle.net/10344/5881
dc.description peer-reviewed en_US
dc.description.abstract Background: Recent exercise guidelines for people with multiple sclerosis (MS) recommend a minimum of 30 min moderate intensity aerobic exercise and resistance exercise twice per week. This trial compared the secondary outcomes of a combined 10-week guideline based intervention and a Social Cognitive Theory (SCT) education programme with the same exercise intervention involving an attention control education. Methods: Physically inactive people with MS, scoring 0–3 on Patient Determined Disease Steps Scale, with no MS relapse or change in MS medication, were randomised to 10-week exercise plus SCT education or exercise plus attention control education conditions. Outcomes included fatigue, depression, anxiety, strength, physical activity, SCT constructs and impact of MS and were measured by a blinded assessor pre and post-intervention and 3 and 6 month follow up. Results: One hundred and seventy-four expressed interest, 92 were eligible and 65 enrolled. Using linear mixed effects models, the differences between groups on all secondary measures post-intervention and at follow-up were not significant. Post-hoc, exploratory, within group analysis identified improvements in both groups post intervention in fatigue (mean Δ(95% CI) SCT -4.99(−9.87, −0.21), p = 0.04, Control −7.68(−12.13, −3.23), p = 0.00), strength (SCT -1.51(−2.41, −0.60), p < 0.01, Control −1.55(−2.30, −0.79), p < 0.01), physical activity (SCT 9.85(5.45, 14.23), p < 0.01, Control 12.92(4.69, 20.89), goal setting (SCT 7.30(4.19, 10.4), p < 0.01, Control 5.96(2.92, 9.01), p < 0.01) and exercise planning (SCT 5.88(3.37, 8.39), p < 0.01, Control 3.76(1.27, 6.25), p < 0.01) that were maintained above baseline at 3 and 6 month follow up (all p < 0.05). Only the SCT group improved at 3 and 6 month follow up in physical impact of MS(−4.45(−8.68, −0.22), −4.12(−8.25, 0.01), anxiety(−1.76(−3.20, −0.31), −1.99(−3.28, −0.71), depression(−1.51(−2.89, −0. 13), −1.02(−2.05, 0.01)) and cognition(5.04(2.51, 7.57), 3.05(0.81, 5.28), with a medium effect for cognition and fitness (Hedges’ g 0.75(0.24, 1.25), 0.51(0.01, 1.00) at 3 month follow up. Conclusions: There were no statistically significant differences between groups for the secondary outcomes once age, gender, time since diagnosis and type of MS were accounted for. However, within the SCT group only there were improvements in anxiety, depression, cognition and physical impact of MS. Exercising at the minimum guideline amount has a positive effect on fatigue, strength and PA that is sustained at 3 and 6 months following the cessation of the program. Trial registration: ClinicalTrials.gov, NCT02301442, retrospectively registered on November 13th 2014. en_US
dc.language.iso eng en_US
dc.publisher BioMed Central en_US
dc.relation.ispartofseries BMC Neurology;17:119
dc.relation.uri http://dx.doi.org/10.1186/s12883-017-0898-y
dc.subject multiple sclerosis en_US
dc.subject exercise en_US
dc.subject fatigue en_US
dc.subject cognition en_US
dc.subject behaviour change techniques en_US
dc.subject social cognitive theory en_US
dc.subject randomised controlled trial en_US
dc.title Effect of exercising at minimum recommendations of the multiple sclerosis exercise guideline combined with structured education or attention control education – secondary results of the step it up randomised controlled trial en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1186/s12883-017-0898-y
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 2717704


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