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Testing iStep-MS, a new programme to encourage physical activity

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  1. The study in brief
  2. The study in more detail
  3. Find out more about staying active with MS
  4. Browse more from the latest research

The study in brief

Getting started and then continuing with regular physical activity can be a struggle. Researchers have developed a programme (iStep-MS) which encourages people with MS to be more active. Before testing it in a large-scale clinical study, the researchers wanted to be sure that the course was safe and acceptable for participants and suitable for physiotherapists to provide.

Participants who were able to walk at home with or without a walking aid were recruited to the study which was carried out at the Berkshire MS Therapy Centre. 30 people were assigned to take part in the programme and 30 had routine support.

Participants taking part in iStep-MS received four face-to-face sessions with a physiotherapist at the centre over 3 months, backed up by a printed handbook. The physiotherapist discussed benefits of increased exercise and encouraged and supported the participant to spend less time sitting down and increase time spent in physical activity. Participants set and recorded their own goals for physical activity, sedentary behaviour, and step-counts, and monitored and recorded these using diaries incorporated in the handbook.

Fatigue and pain did not increase in the iStep-MS group, indicating that encouraging people to be more active did not make symptoms worse. The number of people in the study was not enough to give an accurate indication of the effectiveness of this approach, but several measures, such as levels of pain and fatigue, were reduced in the programme group at 3 and 9 month assessments. Improvements at the 9 month assessment suggest that the course encourages long-term changes to levels of physical activity, lasting beyond the face-to-face sessions.

The researchers concluded that the course was safe, well-attended and well-received by both participants and physiotherapists. Feedback on materials and recording of physical activity will allow them to fine tune the course materials before testing the effectiveness of iStep-MS in a larger study.

The study in more detail

Background

In the past, people with MS were advised to avoid exertion but now regular, moderate exercise is recognised to be an important part of maintaining good health and wellbeing. There is evidence that it can help with many MS symptoms, and also with general quality of life. But getting started and sticking with regular physical activity can be a struggle. Researchers have developed a programme (iStep-MS) which encourages people with MS to be more active. Before testing it in a large-scale clinical study, the researchers wanted to be sure that the course was safe and acceptable for participants and suitable for physiotherapists to provide.

How this study was carried out

Participants who were able to walk in the home with or without a walking aid were recruited for the study which was carried out at the Berkshire MS Therapy Centre  in the UK. 30 people were randomly assigned to take part in the programme and 30 received routine support (treatment was given as needed, this could range from intensive physiotherapy to no treatment). All participants were given a pedometer.

Participants taking part in the programme received four face-to-face sessions each lasting 30-45 minutes with a physiotherapist at the centre over 3 months, backed up by a printed handbook. The physiotherapist discussed benefits of increased exercise and encouraged and supported the participant to reduce time spent sitting down and increase time spent in physical activity. Participants set and recorded their own goals for physical activity, sedentary behaviour, and step-counts, and monitored and recorded these using diaries incorporated in the handbook.

Assessments were carried out at the beginning, and at 3 and 9 months.

What was found?

Fatigue and pain levels did not increase in the iStep-MS group. Physiotherapists reported that the programme was feasible to deliver and they were able to cover the content of each session. All bar one of the participants attended at least 3 out of the 4 sessions. Participants found the programme acceptable but suggested improvements to usability of the handbook and alternative formats for recording activity.

The number of people in the study was not enough to give an accurate indication of the effectiveness of this approach to encourage physical activity, but several measures, such as levels of pain and fatigue, improved in the programme group at 3 and 9 month assessments.

One limitation of the study was the fact that all the participants were already regular attendees of a therapy centre and may not be representative of the wider population of people with MS in the UK.

What does it mean?

Fatigue and pain did not increase in the iStep-MS group, indicating that encouraging people to improve their levels of physical activity did not lead to more severe symptoms. Improvements at the 9 month assessment point suggest that the course does lead to long-term changes to levels of physical activity, which last beyond the end of the face-to-face sessions.

The researchers concluded that the course was safe, well-attended and well-received by both participants and physiotherapists. Feedback on materials and recording of physical activity will allow them to fine tune the course materials before testing the effectiveness of iStep-MS in a larger study.

Ryan JM, Fortune J, Stennett A, et al.
Safety, feasibility, acceptability and effects of a behaviour-change intervention to change physical activity behaviour among people with multiple sclerosis: Results from the iStep-MS randomised controlled trial.
Multiple Sclerosis 2019 Oct 31 [Epub ahead of print]
Summary 

Find out more about staying active with MS

If you are looking for ways to be more physically active, have a look at our web pages on exercise.

You’ll find information on how exercise can benefit MS, suggestions on how to get started and keep going with exercising, different types of exercise to suit your own circumstances as well as a selection of exercise routines, including a neuro-Pilates circuit, our stick-man exercises which you can use to build your own routine and Move it for MS, our exercise videos presented by Mr Motivator which are also available free of charge on DVD (UK only).

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