Implications of the Intervention Program for Physical Activity

(IPPA) in the Perception of Illness and Wellbeing in People

with Multiple Sclerosis (MS)

Luísa Pedro

, José Pais-Ribeiro

2,3

and João Páscoa Pinheiro

ESTESL-IPL, Lisboa, Portugal

FPCE-UP, Porto, Portugal

UIPES, Lisboa, Portugal

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

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

 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.

REFERENCES

Compston, A., Coles, A., 2008. Multiple Sclerosis. Lancet

372, 1502–1517.

icSPORTS2013-InternationalCongressonSportsScienceResearchandTechnologySupport

Grima, DT., Torrance, GW., Francis, G., Rice, G., Rosner,

A. J., Lafortune, L., 2006. Cost and health related

quality of life consequences of multiple sclerosis.

Multiple Sclerosis, 6, 91–98.

Howe, J., Gomperts M., 2006. Aerobic testing and

training for persons with multiple sclerosis: a review

with clinical recommendations. Physiotherapy

Canadian, 58, 259–270.

Khan F., Turner-Stokes L., Ng L., Kilpatrick T., 2007.

Multidisciplinary rehabilitation for adults with

multiple sclerosis. Cochrane Database System Review

2007, 2:CD006036.

Kurtzke, J. F., 1983. Rating neurologic impairment in

multiple sclerosis: an expanded disability status scale

(EDSS). Neurology, 33 (11), 1444–1452.

Maes S., Karoly P., 2005. Self-regulation assessment and

intervention in physical health and illness: a review.

Applied Psychology, 54, 267–99.

Pais Ribeiro, J., Cummins, R., 2008. O bem-estar pessoal:

estudo de validação da versão portuguesa da escala.

In: I.Leal, J.Pais-Ribeiro, I. Silva & S.Marques (Edts.).

Actas do 7º congresso nacional de psicologia da saúde

(pp. 505-508). Lisboa: ISPA

Rietberg, M. B., Brooks, D., Uitdehaag, B. M., &

Kwakkel, G., 2005. Exercise therapy for multiple

sclerosis. Cochrane Database System Review 1: 1–26

CD003980.

Stuifbergen, AK, Blozis, SA, Harrison, TC & Becker, H.

A., 2006. Exercise, functional limitations, and quality

of life: a longitudinal study of persons with multiple

sclerosis. Archives Physical Medicine Rehabilitation,

87, 935–943.

White L. J, Dressendorfer R. H., 2004. Exercise and

multiple sclerosis. Sports Medicine, 34, 1077–1100

ImplicationsoftheInterventionProgramforPhysicalActivity(IPPA)inthePerceptionofIllnessandWellbeinginPeople

withMultipleSclerosis(MS)