Randomized controlled trial of an e-learning designed behavioral intervention for increasing physical activity behavior in multiple sclerosis

Robert W. Motl, Elizabeth A. Hubbard, Rachel E. Bollaert, Brynn C. Adamson, Dominique Kinnett-Hopkins, Julia M. Balto, Sarah K. Sommer, Lara A. Pilutti, Edward McAuley

Research output: Contribution to journalArticlepeer-review


Background: Internet-delivered, behavioral interventions represent a cost-effective, broadly disseminable approach for teaching persons with multiple sclerosis (MS) the theory-based skills, techniques, and strategies for changing physical activity. Objectives: This pilot, randomized controlled trial examined the efficacy of a newly developed Internet website based on e-learning approaches that delivered a theory-based behavior intervention for increasing physical activity and improving symptoms, walking impairment, and neurological disability. Methods: Participants with MS (N=47) were randomly assigned into behavioral intervention (n=23) or waitlist control (n=24) conditions delivered over a six-month period. Outcomes were administered before and after the six-month period using blinded assessors, and data were analyzed using analysis of covariance in SPSS. Results: There was a significant, positive intervention effect on self-reported physical activity (P=0.05, ηρ2=0.10), and non-significant improvement in objectively measured physical activity (P=0.24, ηρ2=0.04). There were significant, positive effects of the intervention on overall (P=0.018, η2=0.13) and physical impact of fatigue (P=0.003, ηρ2=0.20), self-reported walking impairment (P=0.047, ηρ2=0.10), and disability status (P=0.033, ηρ2=0.11). There were non-significant improvements in fatigue severity (P=0.10, ηρ2=0.06), depression (P=0.10, ηρ2=0.07) and anxiety (P=0.06, ηρ2=0.09) symptoms, and self-reported disability (P=0.10, ηρ2=0.07). Conclusions: We provide evidence for the efficacy of an Internet-based behavioral intervention with content delivered through interactive video courses grounded in e-learning principles for increasing physical activity and possibly improving secondary outcomes of fatigue, depression, anxiety, and walking impairment/disability in persons with MS.

Original languageEnglish (US)
JournalMultiple Sclerosis Journal - Experimental, Translational and Clinical
Issue number4
StatePublished - Oct 1 2017


  • Behavior change
  • E-learning
  • Multiple sclerosis
  • Physical activity
  • Theory

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience


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