None listed
Conditions
Brief summary
The objective of this study is to assess the feasibility of a Flexible Exercise Participation Program (FEPP) for people with minimal disability from multiple sclerosis. The 12-week FEPP will guide participants to independently participate in their preferred sport or exercise at a location of their choice. Exercise progression will be guided by individual energy levels and a weekly telephone coaching session with a physiotherapist. Participation in exercise or sport will be recorded in parallel with assessment of disease biomarkers, subjective vitality and high-level mobility. The aim of the study is to help increase participation in sport or exercise for people with multiple sclerosis.
Interventions
All participants will undertake a Flexible Exercise Participation Program (FEPP) which is a 12-week program, in which participants choose their preferred mode of aerobic exercise (e.g. running, cycling, swimming, walking) as well as the time and location (e.g. indoor or outdoor setting) for exercise. The FEPP is a personally tailored exercise program to achieve exercise participation goals specific to the individual and is guided by the individual’s perceived energy levels.
The FEPP has two st
All participants will undertake a Flexible Exercise Participation Program (FEPP) which is a 12-week program, in which participants choose their preferred mode of aerobic exercise (e.g. running, cycling, swimming, walking) as well as the time and location (e.g. indoor or outdoor setting) for exercise. The FEPP is a personally tailored exercise program to achieve exercise participation goals specific to the individual and is guided by the individual’s perceived energy levels. The FEPP has two streams to enable progression of activity level relative to the individual’s baseline activity level. Stream 1 is for participants who do not meet the MS general aerobic exercise guidelines of at least 30 minutes of moderate intensity aerobic exercise three times per week (1). Moderate intensity exercise is defined as 40-59% of heart rate reserve and can be scored as 12-13 on a 6-20 rating of perceived exertion (RPE) scale (2). Participants progress through the stream modifying frequency and duration of exercise, guided by the FEPP, until they reach the MS general aerobic exercise guidelines (1). Participants can opt to maintain this activity level for the remainder of the program if they are satisfied with their participation in their chosen sport or exercise in accordance with their goals. Alternatively, participants can progress through stream 2. Stream 2 is for participants who meet MS general aerobic exercise guidelines. This stream is designed to incrementally progress exercise towards meeting or exceeding the MS advanced aerobic exercise guidelines (1). These guidelines recommend an exercise duration approaching 40 minutes; frequency approaching 5 days per week and intensity approaching 15 on a 6-20 point RPE scale (1). Participants progress through the stream by modifying frequency, intensity and duration of exercise until they are satisfied with their participation in their chosen sport or exercise in accordance with their goals. Participants continue with their optimum participation for the duration of the program. Prior to and throughout the 12-week period, participants will be supported to participate in exercise or sport via a 30-minute coaching session with a physiotherapist, once each week, via telephone. Behaviour change techniques known to assist with participation in exercise and sport (3) will be used. These techniques are: goal setting; action planning; barrier identification; self-monitoring and performance feedback. Goal setting, action planning and barrier identification will be explored in the initial interview with the participant. Weekly coaching sessions will continue to explore action planning and address any ongoing barriers if present. Self-monitoring will be weekly via completion of the exercise diary. Performance feedback will occur weekly in the coaching session. Goals will be reviewed in accordance with the time frame of the set goals. Progression of exercise with the FEPP is guided by the individual’s perceived energy levels. Participants will monitor and respond to energy levels, use a pacing technique to manage energy effectively, thereby enabling participation. A FEPP flowchart will also guide the participant to incrementally progress, maintain or regress their exercise based on performance feedback. The FEPP flowchart has been based on existing aerobic exercise guidelines for individuals with MS (1). An exercise diary will be used to record exercise adherence and participation. 1. Kim Y, Lai B, Mehta T, et al. Exercise training guidelines for multiple sclerosis, stroke, and Parkinson disease: Rapid review and synthesis. Am J Phys Med Rehabil. Jul 2019;98(7):613-621. doi: 10.1097/PHM.0000000000001174. 2. American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription 10th ed. Philadelphia, Pennsylvania: Wolters Kluwer Health; 2018. 3. Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. Nov 2011;26(11):1479-1498. doi: 10.1080/08870446.2010.540664.
Sponsors
Moira Smith
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(i) diagnosis of relapsing remitting MS as defined by the 2017 McDonald criteria; (ii) independent mobility as defined by Expanded Disability Status Scale (EDSS) level 0-3.5 33; (iii) stable i.e. not worsening in past three months on disease modifying drugs (e.g. alemtuzamab, natalizumab and ocrelizumab); (iv) aged 18 years or over; (v) able to provide informed consent.
Exclusion criteria
(i) any concomitant neurological condition or (ii) an additional health condition that would prohibit their participation in aerobic exercise or sport.
Outcome results
None listed