Efficacy of a Behavioral Intervention for Reducing Sedentary Behavior in Persons with Multiple Sclerosis

Background:

Sitting time (ST), a form of sedentary behavior, has been identified as a highly prevalent risk factor for morbidity in the general population and persons with MS, independent of physical activity (PA). To date, there is limited information on the efficacy of behavior interventions for reducing ST in persons with MS. Behavioral interventions involve teaching persons the skills, techniques, and strategies for behavior change, and have been effective for increasing PA in MS.

Objectives: This pilot, randomized controlled trial (RCT) examined the efficacy of a behavioral intervention for reducing ST in persons with MS. 

Methods: The sample consisted of 56 persons with MS who were randomly assigned into behavioral intervention and waitlist control conditions. The behavioral intervention was delivered 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 and was based on Social Cognitive Theory. The control condition involved a waitlist, and the behavioral intervention was delivered amongst participants in this condition after study completion. ST was measured by questions on the abbreviated International Physical Activity Questionnaire (IPAQ) before and after the 6-month RCT. The data were analyzed using mixed model ANOVA in SPSS 21.0.

Results: The mixed model ANOVA indicated a statistically significant condition by time interaction on ST (F(1,54)=6.24,p<0.05,η_p²=0.10). The behavioral intervention group had a statistically significant reduction in ST from pre-post intervention (p=0.027), and the magnitude of the reduction was moderate (Cohen’s d=−0.46). The control group had a non-statistically significant increase in ST (p=0.168) and the effect size small (Cohen’s d=0.26).

Conclusions: We provide the first data on the efficacy of a behavioral intervention for reducing ST in persons with MS. 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.