Article

OBJECTIVE: To examine the efficacy and feasibility of a multifactorial
intervention to increase lifestyle physical activity in nonambulatory persons
with multiple sclerosis (MS) based on wheelchair optimization, propulsion
skill/technique training, and behavioral strategies based on social cognitive
theory. DESIGN: Randomized controlled trial, 3-month postintervention follow-up.
SETTING: Home and general community, and university research laboratory.
PARTICIPANTS: Nonambulatory individuals with MS (N=14; mean age +/- SD,
53.6+/-8.7y) were randomly assigned to an intervention group (IG) or a control
group (CG). INTERVENTIONS: After baseline testing, the IG participants received
custom-fit, ultralightweight manual wheelchairs with propulsion/skills training,
followed by 3 months of at-home use with the custom ultralightweight wheelchair
and weekly phone calls to deliver support through a multifactorial intervention.
The CG participants 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), upper extremity strength
(digital handheld dynamometer), and propulsion technique (on a treadmill [0.5m/s]
with instrumented wheels). Two 1-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 3-month
period of home use. RESULTS: The intervention was well tolerated, and no adverse
events were reported. The IG demonstrated increased strength (P=.008) and a trend
toward less fatigue (P=.068), both with large effect sizes (d>0.8), as well as
reduced application of braking torque during propulsion (P=.003) with a
moderate/large effect size (d=.73), compared with the CG. CONCLUSIONS: Findings
suggest a 3-month physical activity intervention based on manual wheelchair
propulsion and training is safe and feasible for some wheelchair users living
with MS and may produce secondary benefits in strength, fatigue, and propulsion
technique.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS