Improving Health of People With Multiple Sclerosis From a Multicenter Randomized Controlled Study in Parallel Groups: Preliminary Results on the Efficacy of a Mindfulness Intervention and Intention Implementation Associated With a Physical Activity Program

Abstract

Objectives: The objective of this study is to investigate the efficacy of psychological Interventions – Mindfulness or Implementation Intention – associated with a Physical Activity program, delivered via internet, in reducing Multiple Sclerosis symptoms.Method: Thirty-five adults were randomly assigned to one of the three groups: a Mindfulness-Based Intervention group (N = 12), Implementation Intention group (N = 11), and a Control Group (N = 12). All the groups received the same Physical Activity program. The Mindfulness condition group received daily training in the form of pre-recorded sessions while the Implementation group elaborated their specific plans once a week. Mobility, fatigue, and the impact of the disease on the patient’s life were measured. Two measurement times are carried out in pre-post intervention, at baseline and after eight weeks.Results: Overall, after 8 weeks intervention, results show that there was a significant increase in Walking distance in the three groups. In addition, the within-group analysis showed a statistically significant improvement between pre and post intervention on the physical component of the Disease Impact scale in the Implementation Intention group (p = 0.023) with large effect size, in the Mindfulness-Based Intervention group (p = 0.008) with a medium effect size and in the control group (p = 0.028) with small effect size. In the Implementation Intention group, all physical, psychosocial and cognitive Fatigue Impact subscales scores decreased significantly (p = 0.022, p = 0.023, and p = 0.012, respectively) and the physical component was statistically and negatively correlated (r = −0.745; p = 0.008) when Implementation Intention group practice a mild to moderate physical activity. In the Mindfulness-Based Intervention group, the physical component (MFIS) showed a statistically significant improvement (p = 0.028) but no correlation with moderate-to-vigorous physical activity (MVPA); the control group outcomes did not reveal any significant change.Conclusion: The results of this study are very encouraging and show the feasibility of Mindfulness interventions associated with physical activity to improve the health of people with MS. Further study should assess Mindfulness interventions tailored to MS condition and using both hedonic and eudemonic measures of happiness.

A systematic review and meta-analysis exploring the efficacy of mindfulness-based interventions on quality of life in people with multiple sclerosis

“…Following deduplication and the addition of four further studies identified via reference list searching there were 1,312 potential studies for inclusion. After title and abstract screening, 30 full text studies were reviewed, of which 14 were included in the final analyses [50][51][52][53][54][55][56][57][58][59][60][61][62][63] (Fig. 1).…”

“…Eight of the 14 studies reported carrying out power calculations to determine necessary sample size [52, 55, 56, 58-60, 62, 63]; of the remaining, five did not [51,53,57,58,61] and one provided insufficient detail [54]. Studies took place across four continents, in eight different countries: three from Iran [54,57,63], two from Italy [55,56], the UK [51,53], Australia [59,61], the USA [50,60], and one each from Switzerland [52], Canada [62], and France [58]. Sample size ranged from 21-150.…”

“…Sample size ranged from 21-150. Six studies [50,55,56,58,60,61] compared MBI against an active treatment (psychoeducation, physical activity, adaptive cognitive training, chair yoga), five usual care [51-53, 62, 63], one waitlist control [59], and in two the control condition was unclear [54,57]. Most studies collected outcome measures thrice (pre-, post-, follow-up), but three studies were pre-post design [54,57,58] (Table 1).…”

“…One study did not report the percentage of women [59], but most studies predominantly recruited women (total women = 621; 78%). Two studies did not report mean (SD) age, but rather, an age range of 20-50 [63], and a median age of 43 [58]. Of the remainder, mean (SD) age was 44.04 (9.1).…”

“…Two studies employed Mindfulness-based cognitive therapy (MBCT) [53,57], while another adapted MBCT to an approach titled, "Mindfulness for MS" (M4MS) [61]. One study employed an MBI with physical activity [58], another used the Mindfulness Ambassador Program (MAP) [62]. All but two studies [54,57] provided details on MBI instructor characteristics, which included certified MBSR teachers and clinical psychologists.…”