A group mediated cognitive behavioural intervention to improve mobility in individuals with multiple sclerosis: A pilot feasibility study


Group mediated cognitive behavioural interventions (GMCB-IV) have promoted exercise for asymptomatic and symptomatic individuals (SCI; CVD). We conducted a pilot GMCB-IV targeting balance and mobility exercise (BME) for inactive persons with multiple sclerosis (MS). Our prospective pre-post design utilized 8 weeks of intensive training and a 4-week follow-up. The intensive phase consisted of twice-weekly 60-minute BME sessions coupled with one 30-minute group cognitive-behavioural training session. Twelve individuals with EDSS scores between 1.5 and 6 participated. Functional mobility measures were from the short physical performance battery (timed up and go) and the In Chianti toolkit (i.e., 7m walk overcoming 2 obstacles (7m2), 7m walk picking up 3 objects (7m3), and 7m usual and brisk pace walks). Self-efficacy (SE) was assessed for community mobility (CME7), balance /mobility goals, and the MS-SE scale. Baseline measures were taken at onset and follow-up assessment was after 12 weeks.  Paired t-tests compared pre-post means on functional and social-cognitive outcomes. Functional mobility improved for all tasks, with positive trends or significant effects (p < .05; effect range:  d = -.95 [7m2] to d = -1.56 [7m3]).  SE for mobility also improved for both mobility and MS (i.e., trend or p < .05; effect range: d = 1.2 [CME] to 1.68 [MS-SE]). Participants demonstrated improved mobility function and correspondent SE. Results suggest preliminary feasibility of a mobility training GMCB-IV for people with MS.  Efficacy of this pilot is similar to GMCB-IV studies in chronic disease and physically disabled samples (Brawley, Flora, Locke, Gierc, 2012).

Acknowledgments: Grant from CAMECO Multiple Sclerosis Neuroscience Research Centre