Time will be recorded for the full 30 s unless the participants loses balance before time runs out (eg, hops, drops their raised foot to the floor). Quality of life The unidimensional, 8-item Leeds Multiple Sclerosis Quality of Life Scale will be used as a disease-specific measure of overall QOL.32 An example item is: ‘I have felt happy about the future.’ certainly The scores range between 8 and 32, with lower scores representing better QOL. This scale has good internal consistency, test–retest reliability, evidence of score validity, and virtually
no floor or ceiling effects.32 As an additional MS-specific measure, the 29-item Multiple Sclerosis Impact Scale will be used to assess the physical (20 items) and
psychological components (9 items) of health-related QOL in persons with MS.33 An example item from the physical scale is: “In the past two weeks, how much have you been bothered by problems with balance?” An example item from the psychological scale is: “In the past two weeks, how much have you been bothered by feeling depressed?” Scores range between 0 and 100, with lower values representing greater health-related QOL. There is evidence for the reliability and validity of the MSIS-29 in samples of individuals with MS.52 Finally, the Satisfaction with Life Scale will be used as a global measure of QOL.34 This five-item, unidimensional scale asks participants to rate statements, such as ‘I am satisfied with my life,’ on a seven-point Likert scale. The scores can range
between 7 and 35, with higher scores representing higher QOL. This measure is commonly used in psychosocial research and has good internal consistency, test–retest reliability, and evidence of score validity.53 Qualitative inquiry As part of the mixed methods research design all participants will be asked to participate in a semistructured one-to-one qualitative interview. Interviews will be undertaken on the final day of testing by the same assessor who completed the quantitative assessments. A semistructured interview script will be followed Cilengitide to ensure consistency. Interviewers will receive training from an experienced qualitative researcher in MS. The interviews will establish data on three primary areas: (1) the participant’s views on one’s daily activity practices (eg, “To help me better understand, can you tell me what you think of as physical activity?”); (2) the perceived consequences from taking part in the study (eg, “Were there any problems or non-beneficial experiences you could tell me about from following the program?”) and (3) participants’ views on general participation in the study and future plans (eg, “Overall, thinking about the entire program, what factor do you think was the most important?”).