Implications of the Intervention Program for Physical Activity
(IPPA) in the Perception of Illness and Wellbeing in People
with Multiple Sclerosis (MS)
Luísa Pedro
1
, José Pais-Ribeiro
2,3
and João Páscoa Pinheiro
4
1
ESTESL-IPL, Lisboa, Portugal
2
FPCE-UP, Porto, Portugal
3
UIPES, Lisboa, Portugal
4
FMUC/CHUC, Coimbra, Portugal
Keywords: Physical Activity, Wellbeing, Multiple Sclerosis.
Abstract: The aim of this study is to examine the implications of the IPPA in the perception of illness and wellbeing
in MS patients. Methods - This is a quasi experimental study non-randomized study with 24 MS patients
diagnosed at least 1 year before, and with an EDSS score of under 7. We used the IPPA in 3 groups of eight
people in 3 Portuguese hospitals (Lisbon, Coimbra, and Porto). The sessions were held once a week for 90
minutes, over a period of 7 weeks. The instruments used were: We asked the subjects the question “Please
classify the severity of your disease?” and used the Personal Wellbeing Scale (PWS) at the beginning (time
A) and end (time B) of the IPPA.
We used the SPSS version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the
variable analysis.
The intervention followed the recommendations of the Helsinki Declaration. Results – The results suggest
that there are differences between time A and B, the perception of illness decreased (p<0.08), while
wellbeing increased (p<0.01). Conclusions: The IPPA can play an important role in modifying the
perception of disease severity and personal wellbeing.
1 INTRODUCTION
Multiple Sclerosis (MS) is a chronic disease of the
central nervous system that affects more often young
adults in the prime of his career and personal
development, with no cure and unknown causes. The
most common signs and symptoms are fatigue,
muscle weakness, changes in sensation, ataxia,
changes in balance, gait difficulties, memory
difficulties, cognitive impairment and difficulties in
problem solving (Compston, Coles, 2008; Grima,
Torrance, Francis, Rice, Rosner, Lafortune, 2006)
MS is a relatively common neurological disorder
in which various impairments and disabilities impact
strongly on function and daily life activities.
The aim of this study is to examine the
implications of an Intervention Program of Physical
Activity (IPPA)
the perception of illness and
wellbeing in MS patients.
2 METHODS
This is a quasi experimental study, the hypothesis is:
people with MS that practice physical activity have a
better perception of the severity of disease; people
with MS that practice physical activity increase the
well being
The study
includes a consecutive sample of 27
MS patients, diagnosed at least one year, and with an
Expanded Disability Status Scale (EDSS) (Kurtzke,
1983) score under seven. The sample was divided in
three groups, each group including eight people,
collected sequentially in three Portuguese hospitals
(Lisbon, Coimbra, and Porto) with the collaboration
of their personal physician. The sessions were held
once a week for 90 minutes, over a period of seven
weeks.
The IPPA objective is to promote autonomous
physical activity visa a better well being. Each
session aimed: to stimulate group discussion about a
theme related to inability or limitation in physical
53
Pedro L., Pais-Ribeiro J. and Páscoa Pinheiro J..
Implications of the Intervention Program for Physical Activity (IPPA) in the Perception of Illness and Wellbeing in People with Multiple Sclerosis (MS).
DOI: 10.5220/0004615300530055
In Proceedings of the International Congress on Sports Science Research and Technology Support (icSPORTS-2013), pages 53-55
ISBN: 978-989-8565-79-2
Copyright
c
2013 SCITEPRESS (Science and Technology Publications, Lda.)
activity; to discuss strategies to minimize these
limitations; to define and learn appropriate physical
activities to implement between sessions.
We focus a set of exercises to be used in daily
life activities, according to studies developed with
MS patients (Howe and Gomperts, 2006; Khan et
al., 2007; Rietberg et al., 2005; Stuifbergen et al.,
2006; White and Dressendorfer , 2004).
The application of the program followed the self
regulation model (Maes and Karol, 2005). This
model includes three procedural phases: the first
phase, the individuals identify and define personal
goals they wish to achieve; the second phase they
implement strategies to achieve pre-set goals; the
third phase they assess if they reach the intended
objectives, as well as maintenance.
Table 1 is sketched the intervention program as
follows: the Therapist Objectives, the Activities to
Develop and Physical Activity.
Table 1: Intervention Program IPPA in MS.
Objectives
Therapist
Activities to
Develop
Physical
Activity
-to stimulate the
group towards
collaborative
interaction of all
participants.
- to Inform
about the
objectives of the
work that will
be developed
over the next
eight weeks,
once a week for
(90 min.)
-to explain the
international
recommendatio
ns.
-to plane the
activities for
between
sessions
- Each session
begins with a
discussion
between the
group members
about a topic
related to
physical
functional
limitations
(40min.).
-Approach the
strategies used
to cope with the
limitations
using the self-
regulatory
model.
- Promotion of
AR, a
biopsychosocial
perspective
-Strategies that
can be
implemented to
promote AR,
taking into
account the
personal goals
of each patient.
- Setting goals
to be met until
the next session
- Exercise
session (30min)
using the
particulars of
scientific
evidence.
-Moderate-
intensity aerobic
1.exercicios
2.treino
resistance with
low or moderate
intensity, first
the large muscle
groups after the
small groups.
3.exercicios
flexibility
moderate
- Program
consists of 4-8
different types
of exercises, 1-3
sets, increasing
gradually, with
rest periods.
- At the end
short relaxation
session (10min.)
The assessment of variables used one question for
disease severity, “Please classify the severity of your
disease?” with an answer in numerical scale between
“0” and “11” and the Personal Wellbeing Scale
(PWS) (Pais Ribeiro and Cummins, 2008), a one
dimensional scale including seven questions with a
classification between “0” and “100”, (internal
consistency of ???) to assess well being, at the
beginning (time A) and end (time B) of the IPPA.
Because we are using ordinal variables and the
sample is small, we used non parametric statistic to
compare initial and final results, named the
Wilcoxon test for paired samples. We used the
Statistical Package for the Social Sciences (SPSS)
version 20. The intervention followed the
recommendations of the Helsinki Declaration.
3 RESULTS
The age range of the subjects was between 20 and
58 years with a mean age of 44 years. 58.3 % were
women, 37.5 % were currently married, 67% were
retired and the mean level of education was 12.5
years.
Between time A and B, the perception of illness
decreased (p<0.08), while wellbeing increased
(p<0.01), confirming the hypothesis of the study.
Results suggests that an intervention program
that helps people to discuss their limitations, that
identify ways to surpass tem, and teach the way to
implement personal defined physical activities, can
be useful in the way they deal with everyday life,
and to feel improve perception of well being.
4 CONCLUSIONS
The IPPA can play an important role in modifying
the perception of disease severity and personal
wellbeing. Initial hypothesis where confirmed. We
think this program promotion and awareness of the
importance of physical activity, using the conceptual
model of self-regulation, can be very beneficial for
the prevention of disabilities you stay in people with
MS.
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ImplicationsoftheInterventionProgramforPhysicalActivity(IPPA)inthePerceptionofIllnessandWellbeinginPeople
withMultipleSclerosis(MS)
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