Physical activity is an important priority for people affected by multiple sclerosis (MS). In 2015, the MS Society of Canada posted the MS Wellness Survey, an online questionnaire designed to capture the voices of people living with MS about how they view wellness, what they do to achieve optimal wellness, and areas related to wellness in which they would like to see more research. Many respondents were keen to see more research and programs in the area of physical activity, with nearly a third of respondents wishing to know the best type of activities suited to their level of ability, and another third also identifying a lack of access to facilities for physical activity as a significant barrier to being physically active.
To address the interests and gaps in wellness that were highlighted in the MS Wellness Survey, the MS Society and its affiliated MS Scientific Research Foundation launched a new funding opportunity in 2016 called the Hermès Canada | MS Society Wellness Research Innovation Grant (WRIG). The goal of the WRIG was to translate research findings into innovative wellness solutions that would improve health and quality of life for people affected by MS. Following a competitive review process, three applicants were each awarded $40,000 over one year to pursue research related to MS and wellness:
- Dr. Katherine Knox, University of Saskatchewan
- Dr. Charity Evans, University of Saskatchewan
- Dr. Ann Yeh, The Hospital for Sick Children
Collectively, the studies will address various aspects of integrating physical activity into MS care and lifestyle across the age spectrum, with the goal of providing people living with MS more options to manage their MS and improve their wellness and quality of life.
About the studies
Dr. Katherine Knox - Web-based physiotherapy in moderate to severe MS
Persons with MS may find it challenging to participate in regular physical activity or exercise, which is activity done to improve health and/or fitness. This is due to a number of reasons: exercise programs tailored to individuals with significant mobility impairments may be difficult to find, and exercise facilities such as gyms may be inaccessible to certain people living with MS due to geographic, economic, and/or mobility factors.
Dr. Knox will lead an interdisciplinary team of physiotherapy specialists, community health providers and people living with MS to address wellness through a web-based physiotherapy program for people with MS with moderate to severe disability. The study will assess the adherence, acceptability and safety of the web-based exercise program in forty-five people living with MS over six-months. The study will also seek to answer questions such as: how much physiotherapist care time does a web-based program require, and; how do participant-reported symptoms, emotional wellbeing, activity levels, and physical function compare over six months between web-based physiotherapy and usual care? A web-based approach may provide wellness benefits for persons with MS by being more widely accessible to persons with disability.
By including current health care providers and administrators on the research team, the program, if found to be acceptable and feasible, may be more readily adopted into clinical practice. Overall, this study may help to close a significant gap in access to physical activity for persons with more advanced levels of disability.
Dr. Charity Evans - Determining the Impact of a Pilates Program in Multiple Sclerosis
Pilates - a type of exercise that focuses on body positions and movement – is becoming popular among people living with MS as an alternative to the more traditional exercise programs. Although somewhat limited, previous research has suggested Pilates may have some beneficial effects in MS.
Dr. Evans will lead the first study in Canada to examine the impact of Pilates in MS. In collaboration with community co-investigator Jana Danielson, owner of multidisciplinary health and wellness studio Lead, Dr. Evans will conduct a 12-week, single-blinded, randomized controlled study in thirty people living with MS to evaluate the effects of two 50-minute Pilates classes twice weekly, plus weekly 1-hour massage therapy, compared to massage therapy alone. The impact of the Pilates treatment will be assessed by comparing between the two groups any changes in walking ability from the start to the end of the study using the 6-minute walk test. The study will also evaluate differences in other outcomes such as physical performance (balance, flexibility, independent mobility), muscle strength, and quality of life.
Results from this study will provide important insight into an exercise option that may benefit individuals with MS and provide them with another strategy to help manage their disease and enhance their wellness.
Dr. Ann Yeh - Development and Usability Testing of the ATOMIC (Active Teens MultIple sClerosis) Mobile App to Increase Physical Activity Levels in Youth with Multiple Sclerosis
Previous studies have demonstrated a relationship between higher self-reported physical activity and lower MS disease burden, as well as lower levels of fatigue and depression, in children and adolescents living with MS. Unfortunately, youth with MS overall tend to be highly inactive. In particular, social, psychological and environmental barriers may prevent youth from starting and sustaining group-based exercise programs.
Dr. Yeh proposes to address this important issue by developing an intervention to increase physical activity in youth with MS by providing an accessible and sustainable alternative to group-based exercise programs. By taking advantage of widespread access to internet and mobile devices among youth, Dr. Yeh and her team will develop a physical activity mobile application (app) tailored to youth with MS and evaluate the usability of such an app. Features of the app will include the ability for users to directly monitor their physical activity behavior; theory-informed physical activity content and coaching features to help youth overcome barriers to activity; and social networking features to give youth with MS an opportunity to connect and support one another.
The study is poised to provide accessible and individually-tailored physical activity programming for youth with MS who face significant barriers to engaging in physical activity. It will also provide a platform for researchers to discover how to best promote PA and understand the role of physical activity on disease outcomes.
Comment
To successfully achieve the goal of translating research findings into innovative wellness solutions that will improve health and quality of life for people affected by MS, WRIG is founded on a keystone of active engagement of people affected by MS throughout the research process. By engaging members of the MS community, researchers will be better equipped to identify specific questions that are relevant to the community, people affected by MS will be empowered to actively contribute to research, and an immediate impact can be delivered that can be translated directly to people affected by MS in the clinic, at home, and/or in the community.