The development and testing of a novel intervention (Mii-vitaliSe) to support people with Multiple Sclerosis to be active - a pilot evaluation.

Abstract

Title: The development and testing of a novel intervention (Mii-vitaliSe) to support people with Multiple Sclerosis (MS) to be active - a pilot evaluation. Background: There are many benefits of physical activity for people with MS, but also barriers to participation. Active home gaming might help to maintain enthusiasm to exercise over the longer term. Pilot research in the USA suggested the Wii™ can be used safely at home by mobile people with MS. Aims: To develop and conduct preliminary testing of a home-based physiotherapist-supported Wii™ intervention (Mii-vitaliSe) for people with MS. Trial design: A mixed method study incorporating service user involvement throughout. Mii- vitaliSe (incorporates off-the-shelf Wii™ software, physiotherapist support and resource materials) was developed and piloted. Methods: A mixed methods wait-list parallel arm randomised controlled trial. Thirty ambulatory people with moderate MS were randomised to receive Mii-vitaliSe (incorporating off-the-shelf Wii™ software, physiotherapist support and resource materials) either immediately (for 12 months) or after a 6 month delay (for 6 months). Outcomes included assessments of balance, gait, mobility, hand dexterity, activity levels and adherence at baseline, 6 and 12 months. Interviews (n=25) sought participants’ experiences of taking part and physiotherapists’ (n=2) feedback. Results: Recruitment (31%), screening and data collection (97% complete data at six months) procedures worked well and participants found randomisation to a delayed group acceptable. Preliminary estimates of effect size were calculated for the outcome measures and the largest (d=0.41) positive effect found for the iTUG (instrumented Timed Up and Go). On average participants used the Wii™ twice a week for 30 minutes. Some continued to use the Wii™ for 12 months. Support and advice from the intervention resources were perceived to be helpful and a range of physical and psychological benefits reported. Conclusions: A novel intervention using the Wii™ has been developed and undergone feasibility testing. Mii-vitaliSe offers a way for people with MS to increase physical activity levels but requires further development and evaluation. Trial registration number: ISRCTN42534180 Funding: The study was funded by a project grant awarded by the UK Multiple Sclerosis Society (Reference number 933/10).