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

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

doi:10.3389/fneur.2024.1428712

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

Front Neurol. 2024 Aug 23:15:1428712. doi: 10.3389/fneur.2024.1428712. eCollection 2024.

Authors

Eva van der Ven^{1

2}, Stefan Patra², Karin Riemann-Lorenz^{1

2}, Katrin Kauschke³, Katrin Freese-Schwarz³, Götz Welsch^{3

4}, Nicole Krause^{1

2}, Christoph Heesen^#^{1

2}, Sina Cathérine Rosenkranz^#^{1

2}

Affiliations

¹ Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ University Center of Excellence for Sports and Movement Medicine (UKE Athleticum), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴ Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

^# Contributed equally.

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Results: A total of 166 participants [mean age 38.32 (± 10.61 SD), mean EDSS 2.30 (±1.29 SD)] and mostly females (63.3%, n = 105) were included in the study and started the program. A total of 136 participants completed the program. Out of these 63.9% (n = 87) answered the questionnaires in 12.38 (±11.34 SD) months after finishing the program. At baseline female pwMS (n = 100) showed a lower physical fitness in comparison to non-MS controls (n = 26) (maximal workload (Watts): 138.86 ± 37.85 vs. 191.73 ± 45.25, p < 0.001; peak oxygen consumption (ml min^-1 kg^-1): 26.40 ± 7.23 vs. 31.56 ± 10.10, p = 0.020). pwMS were more regularly active in short- (62.1%) and long-term (55.2%) compared to baseline (24.2%, p < 0.001). Among the activated participants, we observed improved internal motivation (p = 0.002) and decreased perception of barriers (p = 0.006) compared to baseline.

Conclusion: 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.

Keywords: multiple sclerosis; physical activity; physical activity promotion program; physical fitness assessment; training plan.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. SCR was supported by an Advanced Clinician–Scientist Fellowship from the BMBF (iSTAR, 01EO2106) and the Hertie Network of Excellence in Clinical Neuroscience of the Gemeinnützige Hertie-Stiftung. We acknowledge financial support from the Open Access Publication Fund of UKE - Universitätsklinikum Hamburg-Eppendorf.