title: Randomized controlled trial of a behavioral intervention targeting symptoms and physical activity in multiple sclerosis.
abstract: BACKGROUND
  Exercise training is beneficial, but most persons with multiple sclerosis (MS) are sedentary and physically inactive. This has prompted a new focus on the promotion of lifestyle physical activity in MS. We previously designed, tested, and refined a behavioral intervention delivered through the Internet that successfully increased lifestyle physical activity in MS, but have not evaluated the effects on secondary symptomatic and health-related quality of life (HRQOL) outcomes.
  
  
  OBJECTIVE
  We conducted a 6-month randomized controlled trial (RCT) that examined the efficacy of an Internet-delivered, behavioral intervention for improving outcomes of fatigue, depression, anxiety, pain, sleep quality, and HRQOL in 82 ambulatory persons with MS. The secondary aim was to replicate previous results regarding change in free-living physical activity.
  
  
  RESULTS
  There was a significant and positive effect of the intervention on fatigue severity (p=.001, η ρ (2)=.15) and its physical impact (p=.008, η ρ (2)=.09), depression (p=.006, η ρ (2)=.10), and anxiety (p=.006, η ρ (2)=.10). There were non-significant improvements in pain (p=.08, η ρ (2)=.04), sleep quality (p=.06, η ρ (2)=.05), and physical HRQOL (p=.06, η ρ (2)=.05). We replicated our previous results by demonstrating an increase in self-reported physical activity (p=.001, η ρ (2)=.13).
  
  
  CONCLUSIONS
  Our results support behavioral interventions targeting lifestyle physical activity as an alternative approach for managing symptoms in MS.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Pilutti
authors.forename: D
authors.initials: D
authors.lastname: Dlugonski
authors.forename: B M
authors.initials: BM
authors.lastname: Sandroff
authors.forename: R
authors.initials: R
authors.lastname: Klaren
authors.forename: R W
authors.initials: RW
authors.lastname: Motl
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001521:Behavior Therapy; D003863:Depression / Q000523:psychology / Q000628:therapy; D004185:Disability Evaluation; D005221:Fatigue / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D007087:Illinois; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome
keywords: Randomized controlled trial; behavioral intervention; lifestyle physical activity; social cognitive theory; symptoms