inMotion: A phone-based randomized controlled trial to increase physical activity and improve mood

TitleinMotion: A phone-based randomized controlled trial to increase physical activity and improve mood
Publication TypeJournal Article
AuthorsArtherholt S, Smith AE, Acosta Garcia MJ, Bombardier CH
JournalInternational Journal of MS Care

Background: Major depressive disorder (MDD) is a common secondary condition in individuals with multiple sclerosis (MS), with a lifetime prevalence estimated to be near 50%. MDD is highly disabling in this population, contributing to time lost from work, low quality of life, and poor health. Commonly used treatments for MDD are not effective for many with MS, and there are often major barriers to treatment. Numerous studies have shown that inactivity is a risk factor for MDD, while increased activity is associated with reduced risk of MDD. We have previously shown that physical activity has promise as a treatment for MDD, especially for people with disabilities such as MS who may be inactive. The current study extends this model to people aging with MS and/or with limited mobility, including wheelchair users. Objectives: The inMotion Study is an ongoing randomized controlled trial (RCT) for people aged ≥45 with depressive symptoms (10 or higher on the PHQ-9). The objectives are to increase physical activity and improve mood. Methods: Participation is entirely by phone. Participants in the treatment condition receive seven motivational interviewing (MI) sessions over 12 weeks in which they review exercise history, goals, benefits, and barriers with a study counselor. Half of the intervention group receives two booster calls during the maintenance phase of the study (weeks 13–24). Participants in the control condition receive a single psychoeducational session at week 0. All participants are mailed an MS exercise DVD. Physical activity is recorded via actigraphy at baseline, 12 weeks, and 24 weeks. An independent examiner assesses outcomes in both groups at 12 and 24 weeks. Results: To date, 219 potential participants with MS have been screened, with 52 enrolled (24%), 6 refused (3%), and 161 ineligible (74%). Ineligibility has been due primarily to lack of depressive symptoms (N = 98, 61%). Conclusions: A phone-based intervention to increase physical activity and improve depression in people with MS is feasible, although recruitment challenges have been significant. Results of this RCT will determine the efficacy of this phone-based MI approach to improving mood in people with MS, and will explore potential mediators such as fatigue, pain, and general health.