Sustained Benefits of a Multidomain Lifestyle Intervention in Multiple Sclerosis in the LIMS Study: A 24-Month Follow-Up.

چکیده اصلی

BACKGROUND AND OBJECTIVES: Multiple sclerosis (MS) often leads to physical, cognitive, and psychological impairments substantially affecting daily functioning and quality of life. Because current disease-modifying therapies do not fully prevent disease progression, interest has grown in the potential role of modifiable lifestyle factors. We evaluated (1) whether effects on patient-reported outcomes were sustained up to 24 months and (2) long-term changes in lifestyle behaviors after completion of the lifestyle in MS program. METHODS: People with MS participated in a 3-month multimodal lifestyle program (i.e., Mediterranean-style diet, physical activity, and sleep and stress), followed by a 21-month maintenance phase. Patient-reported outcomes were assessed 3 months before the intervention, at baseline, postintervention, and after 6, 12, 18, and 24 months. The primary outcome was MS-related impact on daily functioning (MS Impact Scale-29 [MSIS-29]). Secondary outcomes included quality of life, general health, and MS-related symptoms. Longitudinal changes were analyzed using piecewise mixed-effects models, and individual-level change was evaluated using proportions exceeding the smallest detectable change (SDC). RESULTS: In total, 659 participants were included (mean age 46 years, SD 11; 84% female). During the intervention phase, MSIS-29 physical and psychological scores significantly decreased by approximately 0.8 and 1.1 points per month, respectively, followed by attenuation during long-term follow-up. This was reflected by within-group changes of -2.7 (-3.7; -1.8) and -3.7 (-4.8; -1.6) points after the intervention and -0.8 (-1.7; 0.3) and -3.4 (-4.6; -2.3) point at month 24, remaining significantly improved or stable relative to baseline. Only a small proportion of participants exceeded the SDC for MSIS-29 (approximately 4%-7%). Trajectories were broadly similar across other patient-reported outcomes, with modest short-term improvements and subsequent stabilization. Most pronounced effects were found for dietary adherence and body mass index, which improved substantially during the intervention and remained partially sustained during follow-up. No significant changes were observed in physical activity adherence. DISCUSSION: In this large, real-world study, a digital multimodal lifestyle intervention was associated with modest, mainly short-term improvements in patient-reported outcomes and more pronounced individual-level changes in dietary behavior and body composition. These findings support a complementary role for lifestyle interventions in long-term MS management. TRIAL REGISTRATION INFORMATION: The study was registered at ClinicalTrials.gov (Identifier: NCT05402501; classic.clinicaltrials.gov/ct2/show/NCT05402501).

ترجمه فارسی چکیده

این مطالعه به بررسی پایداری اثرات یک برنامه سبک زندگی چندبعدی (شامل رژیم غذایی مدیترانه‌ای، فعالیت بدنی، خواب و استرس) بر نتایج گزارش‌شده توسط بیماران در بیماری ام‌اس (MS) طی ۲۴ ماه پس از پایان برنامه پرداخت است. در مجموع ۶۵۹ شرکت‌کننده (میانگین سن ۴۶ سال، ۸۴٪ زن) شرکت کردند. نمرات تأثیر ام‌اس بر عملکرد روزمره (MSIS-29) در فاز مداخله به طور معنی‌داری کاهش یافت و در پیگیری طولانی‌مدت به طور جزئی کاهش یافت. تغییرات در رژیم غذایی و شاخص توده بدنی به طور قابل توجهی بهبود یافت و در پیگیری تا ۲۴ ماه به طور بخشی حفظ شد. تغییرات در اطلاع‌رسانی درباره فعالیت بدنی معنی‌دار گزارش نشد.

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