Treatment of symptoms in multiple sclerosis

Identifying physical activity information needs and preferred methods of delivery of people with multiple sclerosis

PURPOSE

The purpose of this study was to examine the preferred sources and methods for acquiring physical activity information of individuals with multiple sclerosis (MS) using the Comprehensive Model of Information Seeking. A secondary objective was to explore the barriers and facilitators to physical activity information seeking.

METHODS

Twenty-one participants diagnosed with MS participated in focus groups or telephone interviews.

RESULTS

A direct content analysis of the transcripts revealed that individuals appeared to generally prefer receiving physical activity information during period of relapse and remission. Participants also had positive beliefs toward physical activity and a clear preference for a time when physical activity messages would be relevant. Receiving physical activity information from credible sources such as the MS Society of Canada, healthcare professionals and peers with MS was also deemed important. The Internet was a preferred source to receive information due to its accessibility, but it often was considered to lack credibility. The lack of physical activity information specific to MS is the greatest barrier for individuals with MS to learn about physical activity.

CONCLUSIONS

Healthcare professionals, National MS Societies, and peers should work together to deliver specific and relevant physical activity messages the MS population.

IMPLICATIONS FOR REHABILITATION

People with MS want more physical activity information from credible sources. Multiple vehicles of physical activity information delivery (i.e. healthcare providers, peers, MS Society) should be utilized. Physical activity information should be tailored to the individual with MS.

Contribution of impaired mobility and general symptoms to the burden of multiple sclerosis

INTRODUCTION

Few studies have evaluated the contribution of individual symptoms and impairments to the burden of multiple sclerosis (MS). This article reviews the contribution of walking impairment, fatigue, spasticity, depression, and pain, to quality of life (QOL) of the patient and economic burden of MS.

METHODS

Studies for inclusion were chosen from the literature that reported on QOL and costs in patients with MS, identified through PubMed searches (main search terms: "multiple sclerosis" combined with "quality of life," "costs," or "burden"). Articles were selected based on whether the analyses included evaluation of symptoms and impairments as contributory factors to QOL or costs.

RESULTS

Impaired mobility was ranked to be of high concern, and was suggested to be an important contributory factor to QOL, having a greater impact on physical components than mental components. Fatigue was associated with QOL, with effects on both physical and mental components of QOL, independent of disability level. Depression was inversely associated with QOL. Spasticity may affect physical components of QOL, and daily activities may be impacted in as many as 44% of patients with MS. Pain, occurring in up to 86% of patients with MS, impacts daily function and QOL across the range of physical and mental domains. The contribution of these impairments and symptoms to the economic burden has been less well characterized, although the importance of mobility to employment and productivity has been suggested by several studies.

CONCLUSIONS

Evidence suggests that impaired mobility and symptoms such as fatigue, pain, depression, and spasticity are important contributory factors to the observed reduction in QOL, and in some cases, increased costs, associated with MS. There is a need for greater recognition of the presence and effects of these disabilities, and effective targeted treatment options for specific impairments, potentially resulting in improved QOL and reduced indirect costs.