1. Can Web-based Interventions Increase Physical Activity Levels in People with MS? A Systematic Review Protocol Rachel Dennett 1* Kim Algie 1 Elaine Coulter 2 Lorna Paul 2 Jennifer Freeman 1 1 Peninsula Allied Health Centre, Plymouth University, UK 2 School of Medicine, University of Glasgow, UK Background Objectives Methods Discussion People with Multiple Sclerosis (pwMS) are less physically active than even the general sedentary population 1. Evidence shows that exercise can improve weakness, fatigue, aerobic capacity and functional activity levels in pwMS 2 ; thereby minimising the complications associated with a sedentary lifestyle 3 Department of Health “Physical Activity Guidelines for Adults” 4 recommend 150 minutes of moderate intensity physical activity each week, as well as muscle strengthening activities at least 2 days/ week. They encourage “lifestyle activity” such as housework, gardening and employment as well as structured exercise programmes. These guidelines are based on evidence from the general population. MS-specific physical activity recommendations have recently been developed 2 :- Sustaining adequate levels of physical activity to maintain long term health benefits is a constant challenge for pwMS and clinicians involved in their care. Web based interventions have been trialled for the delivery of exercise programmes. This planned systematic review will investigate whether this approach increases physical activity levels in people with MS. (1) Klaren RE et al. Am J Prev Med Elsevier; 2014;47(5):613–6 : (2) Latimer-Cheung AE et al. Arch Phys Med Rehabil. 2013;94(9):1829–36 ; (3) Rietberg M et al. Cochrane database Syst Rev. 2011 : (4) Bull FC and the Expert Working Groups. Physical Activity Guidelines in the U.K.: Review and Recommendations. School of Sport, Exercise and Health Sciences, Loughborough University; 2010. y This systematic review will include quantitative and qualitative components. Inclusion criteria: studies that investigate the use of web-based interventions to increase physical activity in adults with MS. The interventions may be exercise or lifestyle activity based, or behaviour/ coaching in their approach but all must include a measure of physical activity. Exclusion criteria: studies that use the Internet to deliver virtual assessments, gaming interventions (e.g. Wii or Xbox); and those that do not report a measure of physical activity The Joanna Briggs Institute methodology will be used for this review process. The objectives of this systematic review are: Can web-based interventions enable people with MS to achieve the physical activity guidelines recommended for adults with MS in the short and long term? What are the experiences of people with MS using web-based interventions, in relation to helping improve and sustain physical activity levels in the short and long term. Physical activity recommendations for people with MS 2 30 minutes of moderate intensity aerobic activity 2 times a week AND Strength training exercises for major muscle groups 2 times a week Search strategy key words Web-based, internet-based, www, world wide web, telerehabilitation, Multiple Sclerosis, MS, neurological condition, neurolog*, physical activity, exercise, physical fitness, walking, motor activity, adherence, compliance, concordance, sustain*, behaviour change, behavio*, coaching, e-learning Discussion This systematic review will; Inform us about the current evidence regarding the effectiveness of web-based interventions in helping pwMS increase physical activity levels Ascertain if the physical activity levels reported are in line with current recommendations 2,4 Establish if the activity levels can be sustained in the long term Gain insight into the experience of pwMS in using web- based interventions in relation to improving and sustaining activity levels.