Die Evaluation eines sportorientierten Schulungsprogramms zur Befähigung eines selbstregulierten Trainings für Menschen mit Multipler Sklerose

Zusammenfassung

Hintergrund Studien belegen einen positiven Nutzen von Sport auf Multiple Sklerose (MS). Eine 2014 für Personen mit Multipler Sklerose (PmMS) entwickelte sportorientierte Kompaktschulung (SpoKs) soll den Zugang zu selbstreguliertem sportlichen Training eröffnen. Sie bedient den Mangel an sportorientierten Schulungskonzepten zur Befähigung des selbstregulierten Trainings für MS und wurde bislang durch 3 aufeinanderfolgende Studien unterschiedlicher Designs und Probandenpools evaluiert.

Ziel In dieser Umsetzungsstudie soll der Einfluss der SpoKs (von Juni 2017 bis Mai 2019) auf die motorische Leistungsfähigkeit, Fatiguesymptomatik, Depressionsausprägung, Lebensqualität, Ausmaß der Selbstmanagementfähigkeit, Selbstwirksamkeit sportlicher Aktivität und Verständlichkeit aus Probandensicht erhoben werden. Die Daten sollen mit den bereits publizierten Studienergebnissen in Vergleich gesetzt und die Aussagekraft bisheriger Erkenntnisse soll durch Erhöhung der Probandenmenge verbessert werden. Zudem sollen zusätzliche Assessments das Wissen um die Auswirkung der SpoKs erweitern.

Methode Das Wochenend-Workshop-Design der SpoKs mit 2 Wochenendschulungen befähigte die Teilnehmenden (n=123) zum anschließenden selbstregulierten Training. Erhebungen fanden am ersten Schulungstag (T0) sowie nach einer Eigentrainingsphase von 12 Wochen (T1) statt. Inhalte der Erhebung waren das Functional Gait Assessment (FGA), der 6-Minuten-Walking-Test (6MWT), der 10-Meter-Walking-Test (10MWT), die Fatigue Scale für Motorik und Kognition (FSMC), die Selbstwirksamkeitsskala bei sportlicher Aktivität (SSA), die Messung der Lebensqualität (MusiQol), die MS-Selbstmanagement-Skala (MSSS), das Beck Depression Inventory (BDI-II) und der Evaluationsbogen zur Verständlichkeit von Patientenschulungen (COHEP).

Ergebnisse Es zeigte sich eine Verbesserung der motorischen Fähigkeiten: FGA=17,95% (p=,001); 6MWT=18,10% (p=,19); 10MWT=5,00% (p=,001) sowie des BDI-II um 21,70% (p=,08). Die MSSS (p=,98) und der FSMC (p=,72) zeigten keine Unterschiede. Reduzierte Werte zeigten die SSA (1,68%) und der MusiQol (2 Punkte).

Schlussfolgerung Die Ergebnisse dieser Studie konnten teils zur Bestätigung, aber auch zur kritischen Auseinandersetzung bereits erhobener Daten beitragen. Sie zeigten in Teilaspekten der Erhebung neue Erkenntnisse auf. Das Konzept der SpoKs zeigte positiven Nutzen für die PmMS und wurde von denselben ebenfalls positiv bewertet. Bisherige Ergebnisse sollten über Erhebungen großer Probandengruppen über Langzeiteffekte evaluiert und erweitert werden.

Abstract

Background Studies have shown a beneficial effect of sport and exercise training on multiple sclerosis (MS). A sports-oriented compact training course (SpoKs) developed for people with multiple sclerosis (pwMS) in 2014 aims at getting access to self-regulated athletic training. Furthermore, due to the lack of sports-oriented training concepts, it enables self-regulated training for persons suffering from this disease and has previously been evaluated in three different studies of various designs and subject pools.

Objective This feasibility study aims at assessing the impact of SpoKs (from June 2017 to May 2019) on motor performance, fatigue symptoms, depression expression, quality of life, extent of self-management ability and self-efficacy of sports activity. Data will be compared to previously published study results and the significance of previous findings shall be improved by an increase study sample. In addition, assessments that have been disregarded so far will be used to increase the knowledge about the impact of SpoKs.

Method The weekend workshop design of the SpoKs with two weekend training sessions empowered participants (n=123) for subsequent self-regulated training. Tests took place on the first day of training (T0), as well as after a self-training period of 12 weeks (T1). Contents of the test battery were the Functional Gait Assessment (FGA), the 6-Minute-Walking-Test (6MWT), the 10-Meter-Walking-Test (10MWT), the Fatigue Scale for Motor and Cognitive Activity (FSMC), the Self-Efficacy Scale for Sports Activity (SSA), the Quality of Life Measure (MusiQol), the MS Self-Management Scale (MSSS), the Beck Depression Inventory (BDI-II) and the Comprehensibility of Patient Education Evaluation Questionnaire (COHEP).

Results There was an improvement in motor skills (FGA = 17.95% (p=.001); 6MWT=18.10% (p=.19); 10MWT=5-00% (p=.001) and in the BDI-II 21.70% (p=.08). The MSSS (p=.98) and the FSMC (p=.72) showed no differences. A deterioration was shown in the SSA (1.68%) and the MusiQol (2 points).

Conclusion The results of this study could partly confirm previous results, but also contribute to the critical discussion of already collected data. The concept of SpoKs showed positive benefits for pwMS and was, additionally, positively evaluated by the participants themselves. Future studies with large sample sizes are needed to further evaluate current long-term effects of exercise-related patient training programs.

Schlüsselwörter

Patientenschulung - Multiple Sklerose - Sport - selbstreguliertes Training

Key words

patient education - multiple sclerosis - sport - self-regulated training

Publication History

Received: 22 September 2022

Accepted: 13 October 2022

Article published online:
18 September 2023

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