Impact of Walking Program on Individuals with Epilepsy

General Information

  • Title: The impact of a walking program on self-management, anxiety, stress, depression, quality of life, and seizure frequency in patients with epilepsy: A mixed methods approach using the COM-B behaviour change model
  • Authors: Esin Kavuran, Cemal Ozalp, Emrah Ay
  • Affiliations:
    • Department of Nursing Fundamentals, Nursing Faculty, Ataturk University, Erzurum, Turkey
    • Mus¸ Alparslan University, Malazgirt Vocational School, Department of Health Care Services, Mus¸, Turkey
  • Keywords: Anxiety, COM-B Model, Depression, Epilepsy, Quality of Life, Seizure Frequency, Self-Management, Stress, Walking Program
  • Date of Publication: 2025

Abstract

  • Objective: Investigate the effect of a walking program based on the COM-B Behaviour Change Model on self-management, anxiety, stress, depression, quality of life, and seizure frequency in individuals with epilepsy.
  • Methods:
    • Design: Prospective, parallel-group controlled experimental design with mixed methods.
    • Participants: 78 individuals with epilepsy (intervention group n=38, control group n=40) participated.
    • Intervention: Weekly walking program for 12 weeks, focusing on capability, opportunity, and motivation as per COM-B model.
    • Measurements: Scales for self-management, anxiety, stress, depression, quality of life, and seizure frequency through daily logs.
    • Qualitative Data: Semi-structured interviews with 10 participants to identify barriers to walking.
  • Results:
    • Intervention Group: Significant increases in self-management, significant decreases in anxiety, stress, and depression, improved quality of life, and reduced seizure frequency.
    • Control Group: No significant changes in these variables.
  • Conclusion: Walking program shows positive impact on epilepsy management, enhancing self-management and quality of life while potentially reducing seizure frequency.

Introduction

  • Epilepsy Overview:
    • A neurological disorder affecting approximately 65 million globally due to abnormal brain cell activity, leading to various types of seizures.
    • Psychological challenges include stress, anxiety, and depression resulting from seizure episodes.
    • Effective management comprises both seizure control and psychological/social support.
  • Role of Exercise:
    • Regular exercise may reduce epileptiform discharges and increase seizure threshold.
    • Engagement in physical activity correlates with improved overall well-being and reduction in subjective health problems (e.g., fatigue, sleep issues).
  • Challenges in Physical Activity:
    • Lower participation rates among people with epilepsy (PWE) due to barriers such as time constraints, transportation, and fear of seizures.
    • Avoidance behavior linked to anxiety about seizure triggers hinders engagement in exercise.
  • Walking as an Exercise:
    • Accessible, cost-free, and equipment-free, making it suitable for PWE.
    • Lower risk of injury compared to other forms of exercise.
    • Necessary consideration of individual preferences, health status, and co-morbidities when recommending activities.

COM-B Model of Behavior Change

  • Components of the COM-B Model:
    • Capability: Knowledge and skills needed to engage in physical activity.
    • Opportunity: External factors that allow physical activity.
    • Motivation: Internal processes that stimulate behavior.
  • Behavior Change Wheel (BCW):
    • Provides an eight-step process for designing behavior-change interventions based on the COM-B model.
    • Each step includes behavior analysis and strategies to influence behavior change.
  • Application:
    • The model facilitates the design of interventions to enhance self-management, reduce anxiety and depression, improve quality of life, and decrease seizure frequency in PWE.