Professional Documents
Culture Documents
Author/
Year
Study
Objectives
Level/Design/
Subjects
Intervention and
Outcome Measures
Results
Study
Limitations
Implications for OT
Ennis, Thain,
Boggild, Baker,
& Young (2006).
-Level I
-Randomized
Controlled Trial
-Subjects: 61
participants all
with a diagnosis
of MS
-Participants
ranged from 1865 years of age
-38 participants
were female and
23 were male
-32 participants
were in the
treatment group
and 30 were in
the control group
-Intervention: OPTIMISE
was an outpatient health
promotion education
program aimed at
increasing knowledge,
skills, and confidence
-It was delivered over 8
weekly sessions of 3
hours
-Group format
-Education divided into 5
components (exercise and
physical activity, lifestyle
adjustment and fatigue
management, stress
management, nutritional
awareness, and
responsible health
practices)
-Measures: Health
Promoting Lifestyle
Profile II (HPLP);
Self-Rated Abilities for
Health Practices Scale
(SRAHP);
36-Item Short Form
Health Survey (SF-36)
-Participants
were not
blinded as to
what group
they were in
-All
participants
wanted
information
on health
promotion
activity
-Did not look
at the long
term benefits
of the
program
Feys, Tytgat,
Gijbels, De
Groote, Baert, &
Van Asch (2012).
-To investigate
effects of a one
day education
program about
exercises and
sports, physical
activity
behavior, related
outcome
measures as selfefficacy,
perceived
walking ability,
fatigue, and
perceived impact
of MS and QOL.
- Level III
-Single Case
Design
-Subjects: 42
community
dwelling adults
with MS
-9 males and 33
females
-The researchers
divided the
participants into
two groups based
on self-report of
gait disability (24
with no gait
disability and 18
with gait
disability)
-Originally had
57 participants15 dropped for
unspecified
reasons
-Intervention:
Participants attended a
one-day workshop
involving physical activity
and exercise
-The first half of the
workshop was a
theoretical session
regarding exercise and
sports in MS
-The second half allowed
participants to experience
3 different types of fitness
and were given 6 options.
-Each mini-session lasted
45 minutes
-Measures:
Patient Determined
Disease Steps (PDDS);
Physical Activity Scale for
Individuals with Physical
Disabilities (PASIPD);
12-item MS Walking
Scale (MSWS-12);
Exercise Self-Efficacy
Scale (ESES);
Modified Fatigue Impact
Scale (MFIS);
Multiple Sclerosis Impact
Scale (MSIS-29); SF-36
-Measures were taken on
education day, at 3
months, and at 6 months.
-Small
sample size
-The study
only applies
to persons
with MS who
are ready and
willing to
exercise-does
not generalize
to all persons
with MS
-The groups
were divided
into gait
disability and
no gait
disability by
self-report
Hart, Fonareva,
Merluzzi, &
Mohr (2005).
-Level III
-Before and After
design
-Subjects: 60
participants with
an average age of
44.8 years
- 26.7% males;
73.3% females
-All participants
had a score of at
least 16 on the
Beck Depression
Inventory (BDI)
-Each participant
was randomly
assigned to
receive 1 of 3
types of
treatment
-Intervention:
Participants were
randomly assigned to 1 of
3 depression treatments
(cognitive behavioral
therapy [CBT],
supportive-expressive
group psychotherapy
[SEGP], or Sertraline
medication)
-There was no control
group and each participant
stayed with their treatment
for 16 weeks
-Measures:
Multiple Sclerosis Quality
of Life Question-54
(MSQOL-54); BDI; 25foot walk, and
Psychological Well-Being
(PWB) scales
-5 out of 6 components in
the PWB scales were
statistically significant:
autonomy (p=0.005),
environmental mastery
(p<0.001), purpose in life
(p<0.001), self-acceptance
(p=0.003), personal
growth (p=0.021)
-BDI scores were found to
predict follow-up scores
for the MSQOL-54
(p<0.001)
-No treatment found to
both decrease depression
and improve QOL
significantly
-Small
sample size
-No control
group to
compare the
results-cannot
determine if
the results are
due to
placebo effect
Huisinga, Filipi,
& Stergiou
(2011).
-Level III
-Single Case
design
-Subjects: There
-Intervention: Participants
completed 15 sessions of
elliptical exercise training
over the span of 6 weeks
-Small
sample size
-No followup was
Kargarfard,
Etemadifar,
Baker, Mehrabi,
& Hayatbakhsh
(2012).
were 26
participants all
with clinically
diagnosed MS
-5 of the
participants were
male and 21
were female
-Participants
could not have
had an
exacerbation
within the past
60 days
completed to
assess
maintenance
of
improvements
-Short
program
duration
-No control
group
as fatigue.
-Program Development: It has been shown
that 6 weeks of elliptical exercise training can
significantly improve fatigue and QOL in
individuals with MS; thus, when developing a
program it should be at least 6 weeks in length.
-Societal Needs: Research shows that an
exercise program utilizing common equipment
can be beneficial in reducing fatigue and
increasing QOL.
-Healthcare Delivery & Policy: All healthcare
practitioners should encourage an exercise
program utilizing the elliptical, as it is easily
accessible for all individuals.
-Education & Training of OT Students:
Students should be educated on the benefits of a
light exercise program on the MS population.
-Refinement, Revision, & Advancement of
Factual Knowledge or Theory: Future
research should include a longer program
duration to assess the full benefits of this
exercise program.
-Level I
-Randomized
Controlled Trial
-Subjects: 32
female
participants with
a diagnosis of
MS
-Intervention: Treatment
group received 8 weeks of
aquatic exercise
training
-Sessions were 60
minutes, 3 times a week
-Each session consisted of
a 10-minute warm-up, 40
-Participants in treatment
group had lower MFIS
scores (p<0.01) at both 4
and 8 weeks
-Significant differences in
both physical (p<0.01)
and mental health
(p<0.05) composite scores
-Small
number of
participants
-Sample
consisted of
only females
when that was
not one of the
Mathiowetz,
Finlayson,
Matuska, Chen,
& Luo (2005).
MS
of HRQOL in treatment
group
-Overall, participants in
treatment group showed
significant improvement
in fatigue and healthrelated QOL after both 4
and 8 weeks
variables in
question
-Level I
-Randomized
Controlled Trial
-Subjects: 169
participants with
a diagnosis of
MS over the age
of 18
-Power analysis
used to justify
sample size
-Randomly
-Intervention: The EC
course was 2 hours long,
once a week for 6 weeks
-Course administered by
12 occupational therapists
-Quizzes administered to
make sure participants
understood material
-Group1 received the EC
course during weeks 2-7,
while group2 received it
weeks 8-13
-High
attrition rate
of 23%
-There were
discrepancies
between the
number of
participants
reported
Ozge, Serkan,
Egemen, &
Algun (2012).
-To determine
the effects of a
home-based
exercise
program (HEP)
on aspects of
disability,QOL,
fatigue and
balance in adults
diagnosed with
MS
divided into 2
groups:
immediate
intervention
group (group1)
or delayed
control group
(group2)
-Level III
-Single Case
design
-Subjects: 31
participants with
a mean age of
43.6 years
-16 females and
15 males
-They all had a
clinical diagnosis
of MS and could
not have had an
exacerbation in
the past 30 days
- Intervention:
Participants were
provided with the same
instructions regarding the
number of repetitions and
sets to complete and the
frequency of exercise (i.e.,
5x/week)
-Each workout session
consisted of: a warm-up
(5-10min), strengthening
and balance exercises (2025min), and a cool-down
(5-10min)
-Measures: EDSS;
-The study
was
conducted
outside of the
United States,
thus the
standards for
the research
were different
-Small
sample size
Patti, Ciancio,
Reggio, Lopes,
Palermo,
Cacopardo, &
Reggio (2002).
-Level I
-Randomized
Controlled Trial
-Subjects: 111
individuals with
a diagnosis of
MS
-47 men (42%)
and 64 women
(58%)
-All participants
were blindly
randomized and
divided into 2
groups:
outpatient
(treatment, n=58)
and home
-Intervention:
The outpatient group
received outpatient
therapy services 6x/week
for 50-90 minutes
-Each session was
individualized to the client
-HEP was not discussed in
detail
-Measures: SF-36; BDI;
Tempelaar Social
Experience Checklist; FIS
-The
participants
received
multiple
forms of
therapy so we
cannot
account
which one
contributed to
the benefits
-Researchers
provided no
information
regarding the
frequency,
duration, or
contents of
exercise (control,
n=53)
Stuifbergen,
Becker, Blozis,
Timmerman, &
Kullberg (2013).
-Level I
-Randomized
Controlled Trial
-Subjects: 113
participants with
a mean age of
45.79 years
-A power
analysis
indicated they
needed at least
110 participants
-66 participants
were in the
control group
and 76 were in
the treatment
group
-Intervention: The
program was divided into
2 phases: an educational
and skill-building lifestyle
change program and a
supportive telephone
follow-up
-The 1st phase consisted
of 8 sessions lasting 90
minutes over an 8-week
period
-The sessions consisted of
providing information,
guiding participants to
self-assess their behaviors,
resources and barriers,
and supporting selfefficacy strategies
-The 2nd phase involved
the participants receiving
the HEP
- Participants
who
responded
were more
interested in
health
behaviors
than other
women with
MS
-Subsamples
of
participants in
the study also
completed
food diaries,
arm
ergometry
protocols, 6
minute walks,
-To determine
the effectiveness
of group
exercise training
on balance,
functional status,
spasticity,
fatigue and QOL
in individuals
with MS
-Level I
-Randomized
Controlled Trial
-Subjects: 99
individuals with
a diagnosis of
MS
-64 female (65%)
and 35 male
(35%)
-Power analysis
completed and
concluded that a
minimum sample
of 44 participants
needed
-Participants
were randomly
assigned to either
-Interventions: Three 60
minute sessions conducted
by physical therapists for
12 weeks
-The program included
flexibility, range of
motion (ROM),
strengthening, core
stabilization, balance,
coordination exercises,
and functional activities
-Participants were also
educated on exertion
levels and were allowed to
take breaks if they
reached 13/20 on a scale
of perceived exertion
-Measures:
Berg Balance Scale; 10-
-Improvements were
found for the control
group (p<0.01)
-Participants had
significant negative
changes on the Berg
Balance Test (p=0.002)
and the 10-meter walk test
(p=0.001)
-An increase in QOL
scores was also found
(p=0.006)
and goal
attainment
scaling which
could have
influenced the
results
-Study was
single blinded
which could
have resulted
in potential
beneficial
intervention
effect in the
treatment
group
-Depression
was not
assessed and
this is a
common
symptom
with MS that
could have
had an impact
Vikman,
Fielding,
Lindmark, &
Fredrikson
(2008).
control or
treatment group
by a neurologist
using the
function of
Microsoft Office
Excel software
-Level II
-Cohort design
-Subjects: 57
participants with
a mean age of
55.8 years
-46 female and
12 male
-Participants
were divided into
two groups:
cohort A (n=40)
and cohort B
-Intervention: Participants
in the cohort A received
an average of 15
physiotherapy and 9 OT
sessions in 3 weeks
-30 min physiotherapy
(strength, mobility,
balance, aquatic exercise)
& OT (hand-training)
sessions were provided
Mon-Fri
-Measures: Mean
Expanded Disability
-Cohort A improved
significantly in areas QOL
(p<0.05), 9-hole peg test,
Box and Block Test, Berg
Balance Scale, MSFC,
and COVS (p<0.01)
-Cohort B improved
significantly in emotional
well-being (p<0.05), Box
and Block Test, 25-foot
walk test, and MSFC
(p<0.01)
on fatigue
levels
-The 2
cohorts were
not even in
size
-Possible bias
in results due
to training
effects from
various
assessments
-Sample size
only
consisted of
(n=18)
Status Scale;
Barthel Index of ADL
(BI); Fatigue Severity
Scale (FSS); SF-36;
Functional Assessment of
Multiple Sclerosis
(FAMS); BDI; Multiple
Sclerosis Functional
Composite
individuals
with
moderate
disabilities