Multiple Sclerosis Clinical Trial
Official title:
An Eight-week Randomised Controlled Trial of Home-based Pilates for Symptoms of Anxiety, Depression, and Fatigue Among People With MS With Minimal-to-mild Mobility Disability: Study Protocol
This study will investigate the effects of eight-weeks home-based Pilates on symptoms of anxiety, depression, and fatigue among people with Multiple Sclerosis. Half of participants will perform two weekly home-based Pilates sessions guided by a DVD, while the other half will maintain their regular daily activities.
This will be a home-based, single blind, randomised, controlled trial comparing
immediate-start home-based Pilates with a delayed-start control group. The study protocol was
approved by the University Research Ethics Committee. Participants will provide written
informed consent prior to testing. The home-based setting promotes national recruitment of
participants through the MS Society of Ireland, via distribution of posters and participation
information leaflets on social media and text alerts to members. Interested participants will
be invited to contact the lead researcher via phone or email, who will answer any
study-related questions. Potential participants will be screened for selection criteria over
the phone and provided with Participant Information Sheet (PIS), informed consent, Physical
Activity Readiness Questionnaire (PAR-Q), and Patient Determined Disease Steps (PDDS) form
via post or email. Following screening and initial baseline testing, eligible participants
will be randomized to immediate-start home-based Pilates, or delayed-start control, by an
independent researcher who will not be involved in outcome assessments, using a
computer-generated randomisation tool (www.randomizer.org). The Home-based Pilates group will
perform two weekly sessions for eight weeks, completed with at least 48-hours between
sessions, in their own home, supported by a DVD developed and previously implemented and
evaluated by the lead researcher in a feasibility trial among people with Multiple Sclerosis.
The instructor on the DVD is a certified Pilates Instructor. Each participant will receive
documented details of the Pilates protocol, along with the DVD which will operate on a DVD
player or participant's laptop computer. On activating the DVD, participants will be provided
with an opening screen, offering four options to choose from; "Play all" plays the entire
contents of the DVD from start to finish; "Warm Up", provides introductory teaching points on
the core principles of Pilates along with teaching and demonstration of the Pilates' warm-up
exercises; "Main Phase" provides demonstrations and key teaching points of the fourteen
Pilates exercise routine, and "Post Stretch" demonstrates and teaches the post-stretch
exercises. Each Pilates session will last approximately one hour and is comprised of seven
Pilates warm-up exercises and fourteen mat-based beginner's level exercise. Four repetitions
of each Pilates movement will be performed during sessions in the first two weeks, with
intensity being self-regulated by the participant based on level of physical condition.
Repetitions will gradually progress at biweekly intervals, resulting in ten repetitions being
performed for the final two weeks of the trial (Weeks 7 and 8). Six post-training stretches
will be maintained for a minimum of thirty seconds. Fidelity, adherence, dose and compliance
shall be monitored via self-report exercise diaries containing session date, number of
repetitions completed per exercise, and session RPE (Rate of perceived exertion), recorded by
the participant immediately following session completion. Exercise diaries will be
supplemented by a weekly telephone call consisting of direct questions about the frequency,
intensity, and duration of the Pilates they have completed and whether they have experienced
difficulties with exercise completion, any adverse events or relapses.
The Delayed-Start Control group be instructed to maintain their pre-intervention physical
activity levels during the trial and will be contacted by the lead researcher by email or
telephone to ensure timely completion of the on-line outcome assessments at biweekly
intervals. Following the 8-week intervention, Delayed-Start participants will be provided
with the Pilates DVD for their own use, but no data will be collected. For both groups,
participants who experience a relapse will be immediately withdrawn from the study, which
will be recorded by the lead researcher.
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