OBJECTIVE: To examine the efficacy and feasibility of a multifactorial intervention to increase lifestyle physical activity in non-ambulatory persons with multiple sclerosis (MS) based on: wheelchair optimization, propulsion skill/technique training, and a behavioral strategies based on social cognitive theory. DESIGN: Randomized control trial, 3-month post intervention follow-up. SETTING: Home and general community, university research laboratory. PARTICIPANTS: 14 non ambulatory individuals with MS (mean age +/- SD 53.6 +/- 8.7) were randomized into intervention group (IG) or control group (CG). INTERVENTIONS: After baseline testing, the IG received custom fit ultralightweight manual wheelchairs with propulsion/skills training, followed by three months of at home use with the custom ultralightweight wheelchair and weekly phone calls to deliver support through a multifactorial intervention. The CG received no training and used their own wheelchairs at home during this time. MAIN OUTCOME MEASURES: All subjects were assessed at baseline and 3 months later for fatigue (Fatigue Severity Scale (FSS)), upper extremity strength (digital handheld dynamometer), and propulsion technique (on a treadmill (0.5mps) with instrumented wheels). Two one week bouts of physical activity were measured in both groups from home with wrist worn accelerometry at the beginning (IG and CG in own wheelchairs) and end (IG in study wheelchair CG in own) of the three month period of home use. RESULTS: The intervention was well tolerated and no adverse events reported. The IG group demonstrated increased strength (p = 0.008) and a trend toward less fatigue (p = 0.068), both with large effect sizes (d > 0.8), as well as reduced application of braking torque during propulsion (p = 0.003) with a mod/large effect size (d = 0.73), compared to the CG. CONCLUSION: Findings suggest a 3 month physical activity intervention based in MWP and training is safe and feasible for some wheelchair users living with MS and may produce secondary benefits in strength, fatigue, and propulsion technique.

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