AUTHOR=van der Ven Eva , Patra Stefan , Riemann-Lorenz Karin , Kauschke Katrin , Freese-Schwarz Katrin , Welsch Götz , Krause Nicole , Heesen Christoph , Rosenkranz Sina Cathérine 

TITLE=Individualized activity recommendation based on a physical fitness assessment increases short- and long-term regular physical activity in people with multiple sclerosis in a retrospective cohort study

JOURNAL=Frontiers in Neurology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1428712

DOI=10.3389/fneur.2024.1428712

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Background</title><p>Despite the evidence of beneficial effects of physical activity (PA), people with multiple sclerosis (pwMS) are less physically active than the general population. To increase PA in pwMS, we developed a structured individually tailored PA promotion program which is conducted within clinical practice in a university-based outpatient clinic since 2016. This study serves as retrospective quality control of this program.</p></sec><sec id="sec2"><title>Objective</title><p>In a retrospective cohort study, we assessed the physical fitness of pwMS and the impact of the program on short- and long-term PA changes and behavioral determinants.</p></sec><sec id="sec3"><title>Methods</title><p>The program consisted of four appointments each 2–4 weeks apart. Spiroergometric test results of female pwMS were compared to female non-MS controls who underwent a voluntary physical fitness analysis. The short version of the Freiburger questionnaire, self-developed questions and the modified Physical activity screening questionnaire (PASQ) were sent to all participants assessing the PA levels before the program, 3 months after the program (short-term), and at the time of the survey (long-term). Additionally, established questionnaires assessed behavioral determinants before the program and long-term.</p></sec><sec id="sec4"><title>Results</title><p>A total of 166 participants [mean age 38.32 (± 10.61 SD), mean EDSS 2.30 (±1.29 SD)] and mostly females (63.3%, <italic>n</italic> = 105) were included in the study and started the program. A total of 136 participants completed the program. Out of these 63.9% (<italic>n</italic> = 87) answered the questionnaires in 12.38 (±11.34 SD) months after finishing the program. At baseline female pwMS (<italic>n</italic> = 100) showed a lower physical fitness in comparison to non-MS controls (<italic>n</italic> = 26) (maximal workload (Watts): 138.86 ± 37.85 vs. 191.73 ± 45.25, <italic>p</italic> &lt; 0.001; peak oxygen consumption (ml min<sup>−1</sup> kg<sup>−1</sup>): 26.40 ± 7.23 vs. 31.56 ± 10.10, <italic>p</italic> = 0.020). pwMS were more regularly active in short- (62.1%) and long-term (55.2%) compared to baseline (24.2%, <italic>p</italic> &lt; 0.001). Among the activated participants, we observed improved internal motivation (<italic>p</italic> = 0.002) and decreased perception of barriers (<italic>p</italic> = 0.006) compared to baseline.</p></sec><sec id="sec5"><title>Conclusion</title><p>PwMS showed a lower physical fitness in comparison to non-MS controls. An individually tailored PA promotion program might improve behavioral determinants and thereby increase short- and long-term PA levels of pwMS.</p></sec>