Effects on Quality of Life, Disease Impact and Physical Activity of a Day Wellness Program for People Living with Multiple Sclerosis before and during the COVID-19 Pandemic.

Background: The Multiple Sclerosis Achievement Center (MSAC) conducts day wellness programs to address physical, cognitive and social well-being. Program activities include exercise, cognitive stimulation, education, emotional wellness, socialization, and community outings. As previously reported, improvements were seen in quality of life measures with analysis of baseline to two and three year measures. Four year outcome measures include the time period of the COVID-19 pandemic. Some programs were moved to a virtual format because of the pandemic.

Objectives: To determine, through the use of patient reported outcome (PRO) measures, the impacts of a day wellness program on self-reported disease impact and quality of life over a four year period and determine the effects of the pandemic in these same areas.

Methods: Baseline data was collected through PRO measures for 110 people with multiple sclerosis (PwMS), who participated in MSAC day wellness programs, beginning in 2017. Of those 110, 52 completed PRO annually through 2021. Outcome measures include the Multiple Sclerosis Impact Scale (MSIS-29), Multiple Sclerosis Self-Efficacy Scale-10 item (MSSE), Godin Leisure Time Exercise Questionnaire (GTLEQ) and Neuro-QoL (Anxiety, Depression, Emotion & Behavior, Positive Affect, Cognition, Ability to Participate, and Social Roles sections were used). Analysis using t-tests compared data collected at baseline to four year data. A separate analysis was completed by comparing outcomes from January 2020 and January 2021.

Results: Analysis of baseline to four-year data demonstrated statistically significant changes in MSIS-29 (p=.01) and GTLEQ (p=.0002). Statistically significant changes noted at years two and three in Ability to Participate and Social Roles were no longer significant at year four (p=.33 and p=.49, respectively). Other notable changes include significant decreases in MSSE at year four when compared to both baseline (p=.02) and year three (p=.001).

Conclusions: Individuals who participate in a weekly, structured day wellness program show continued significant improvements in self-reported disease impact and with physical activity at year four compared to baseline. However, a decrease in self-efficacy and social domains was seen. The decrease coincides with disruptions brought on by the COVID-19 pandemic, which led to greater isolation and included the transition to virtual activities in many aspects of the participants’ lives. Further analysis is needed to understand the ongoing effects of the pandemic on program participants.