Changing physical activity behavior in people with Multiple Sclerosis: A Systematic Review and Meta-Analysis

Publication date: Available online 11 January 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Blathin Casey, Susan Coote, Sara Hayes, Stephen Gallagher
ObjectiveTo systematically review the literature on behavioural interventions for people with Multiple Sclerosis (pwMS) that aim to change physical activity (PA) behaviour. To explore if these interventions are clinically-effective in improving PA, theory-based and employ established behaviour change techniques (BCTs).Data SourcesA systematic electronic search was conducted on databases EBSCO (including AMED, Biomedical Reference Collection: Expanded, CINHAL, MEDLINE, PsycArticles, PsycInfo), PubMed, EMBASE, and Web of Science from April 2017 to May 2017.Study SelectionStudies were included if 1) the interventions aimed to change PA behaviour among people with MS , 2) PA was recognised as a primary outcome measure and 3) were of randomised control design (RCT).Data ExtractionThe resulting behavioural interventions were coded using 'The Theory Coding Scheme' and the 'CALO-RE Taxonomy' to assess theory-base and BCTs. A meta-analysis was conducted to assess effectiveness.Data SynthesisFourteen randomised controlled trials (RCTs) were included. Combined, there was a significant (p =0.0003, d=1.00, CI's= 0.46, 1.53) short-term change in self-report PA behaviour for studies with non-active control groups. There was no change in objective or long-term PA. Studies failed to discuss results in relation to theory and did not attempt to refine theory. 50% of BCTs within the CALO-RE were employed with BCTs of 'goal-setting' and 'action-planning' being the most frequently employed.ConclusionCurrent evidence supports the efficacy of PA intervention on subjective but not objective outcomes. However, conclusions from this review should be interpreted with caution due to the low of number of studies included and low sample size. Further, whilst using theory in intervention design, these interventions have not reported the refining of theory. Exploration of the use of additional BCTs to change PA behaviour is also required within future interventions.



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