The long-term objective of this proposal is to advance research in the area of physical activity promotion for persons with multiple sclerosis (MS) by implementing and evaluating a multifaceted intervention that can be translated into public health and rehabilitation practice. MS is the most common chronic progressive neurological condition among young adults. Since there is no cure for MS, treatment goals focus on managing symptoms, slowing progression, and preventing co-morbid conditions. Achievement of treatment goals may be facilitated by promoting routine physical activity (PA). Research shows that regular exercise reduces the severity of symptoms and may slow progression of MS. Nonetheless, persons with MS are below the population norms for engaging in PA. Thus, clinically-relevant evidence-based interventions need to be developed to promote the initiation and maintenance of exercise. A minimal contact intervention that can be administered by allied health professionals may be a cost-effective method to promote exercise. The objective of the proposed research is to adapt a print-based PA intervention, proven to be effective in sedentary healthy adults, for persons with MS.
The specific aims of the study are: 1) to conduct formative research to adapt the print-based intervention by having an expert panel review the content of the print material and interviewing persons with MS;2) to conduct a pilot randomized controlled trial of the modified intervention to obtain effect size calculations and participant feedback on how to further refine it. The study hypotheses are that: 1) prescription of an exercise program and follow-up print material, which is matched to a stage of change and encourages self-management of symptoms, will promote PA;2) this multifaceted intervention will increase confidence to exercise and self-manage symptoms, as well as increase the number of strategies that persons with MS use to engage in PA;3) promoting PA and teaching self-management strategies will decrease the impact of MS symptoms and improve quality of life. Questionnaires on physical function, quality of life, and PA adherence as well as objective tests of physical fitness, such as estimated VO2max, will be administered and analyzed to evaluate the intervention. Data on participants'attitudes towards the intervention, the psychosocial impact of the intervention, and suggestions about improving it will be collected through interviews and questionnaires. This pilot study will be used to develop an R01 proposal to evaluate the intervention using a sufficient sample size, detect subgroup differences, test mediating and moderating relationships, determine the long-term effects of the intervention, and explore the different components of the intervention.

Public Health Relevance

Identifying clinically-relevant/minimal contact interventions that promote physical activity in persons with chronic disabling conditions, such as multiple sclerosis, could reduce the escalating cost of healthcare by helping diminish disease impact and slowing the development of secondary conditions.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Research Grants (R03)
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Pediatrics Subcommittee (CHHD)
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Quatrano, Louis A
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Cleveland Clinic Lerner
Other Basic Sciences
Schools of Medicine
United States
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