Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
Contemp Clin Trials. 2018 Dec;75:1-8. doi: 10.1016/j.cct.2018.10.009. Epub 2018 Oct 18.
Exercise training is a promising approach for managing multiple sclerosis (MS), but existing research has not focused on black individuals with MS. This is important as black individuals with MS may experience a more aggressive disease course, increased comorbidities, and have a poorer prognosis with disease modifying therapies.
Thirty-two black adults with mild-to-moderate MS related disability participated in a patient-informed, three-month, home-based, racially tailored, exercise program. The exercise program, Project GEMS, was modified for black persons with MS through patient feedback. The feasibility of the modified exercise program was measured through the four domains of process (e.g., recruitment and retention), resources (e.g., communication and monetary costs), management (e.g., of data management and safety reporting), and scientific outcomes (e.g., safety, burden, adherence, experience, and treatment effect).
This exercise program was feasible, safe, and well received based on data analysis and formative evaluation. Twenty-four participants completed post-assessment (75%; two dropped out, six did not return follow-up assessments). The exercise program cost a total of $3726.57 (personnel costs = $2128.74 USD, $20.87 USD per/h; exercise program costs = $1597.83 USD, mean cost per person = $46.93). Participants were adherent with 70% of the 48 exercise sessions via self-reported exercise logs. There was a significant and large increase (t = -5.1, p < .001, d = -1.0) in exercise behavior as measured by the Godin Leisure-Time Exercise Questionnaire.
The results support the feasibility, acceptability, safety, and efficacy of this intervention for increasing exercise behavior among black adults with mild-to-moderate MS.
运动训练是管理多发性硬化症(MS)的一种很有前景的方法,但现有的研究并未关注患有 MS 的黑人个体。这一点很重要,因为患有 MS 的黑人个体可能经历更具侵袭性的疾病进程、更多的合并症,并且在使用疾病修正疗法时预后更差。
32 名轻度至中度 MS 相关残疾的黑人成年人参与了一项基于患者信息的、为期三个月的、家庭为基础的、针对种族的、运动方案。该运动方案,即 GEMS 项目,通过患者反馈进行了修改以适应 MS 黑人患者。通过过程(例如招募和保留)、资源(例如沟通和货币成本)、管理(例如数据管理和安全报告)和科学结果(例如安全性、负担、依从性、体验和治疗效果)的四个方面来衡量修改后的运动方案的可行性。
根据数据分析和形成性评估,该运动方案具有可行性、安全性和良好的接受度。24 名参与者完成了后期评估(75%;两人退出,六人未返回后续评估)。该运动方案的总费用为 3726.57 美元(人员费用为 2128.74 美元,每小时 20.87 美元;运动方案费用为 1597.83 美元,人均费用为 46.93 美元)。参与者通过自我报告的运动日志记录,对 48 次运动课程中的 70%保持了依从性。Godin 休闲时间运动问卷测量的运动行为有显著且较大的增加(t= -5.1,p<0.001,d= -1.0)。
这些结果支持该干预措施在增加轻度至中度 MS 黑人成年人运动行为方面的可行性、可接受性、安全性和有效性。