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Efficacy of a behavioral intervention for reducing sedentary behavior in persons with multiple sclerosis: a pilot examination
Klaren RE, Hubbard EA, Motl RW
American Journal of Preventive Medicine 2014 Nov;47(5):613-616
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Sitting time (ST), a form of sedentary behavior, has been identified as a highly prevalent risk factor for multiple sclerosis (MS)-related morbidity. There is limited information on the efficacy of behavioral interventions for reducing ST in persons with MS. PURPOSE: To examine the efficacy of a behavioral intervention for reducing ST in persons with MS in a pilot RCT. METHODS: Seventy MS patients were randomly assigned to intervention and waitlist control conditions. The behavioral intervention was delivered April to September 2012 via the Internet and consisted of a dedicated website and one-on-one Skype video chats that taught participants the skills, techniques, and strategies for reducing sedentary behavior based on social cognitive theory. ST was measured by questions on the abbreviated International Physical Activity Questionnaire (IPAQ) before and after the 6-month RCT. Data were analyzed in SPSS, version 21.0 in March 2014. RESULTS: ANCOVA was performed on post-intervention scores controlling for pre-intervention values using an intent-to-treat analysis. The group main effect was statistically significant (F[1,67] = 4.03, p < 0.05, eta2 = 0.06) and yielded a parameter estimate of 98.9 (SE 49.3, t = 2.01, p < 0.05). The adjusted mean scores for intervention and control groups were 429.2 (201.2) and 528.2 (200.7) minutes of ST, respectively (d = 0.49). CONCLUSION: We provide the first data on the efficacy of a behavioral intervention for reducing ST in MS patients. This highlights the importance of designing and testing the effect of behavioral interventions that reduce ST on secondary outcomes such as function, symptoms, quality of life, and health status in persons with MS.

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