Seizure free steps: A review of behaviour change techniques for physical activity in epilepsy.

Abstract

Introduction People with epilepsy (PWE) tend to be less physically active than the general population, primarily due to the belief that physical activity (PA) exacerbates seizure symptoms. However, recent research suggests that PA does not increase seizure frequency and may even reduce it, supporting the integration of PA into epilepsy management. Given the comorbidities and reduced quality of life associated with epilepsy, increasing PA may help mitigate risks such as cardiovascular disease and depression. Despite these benefits, promoting PA in PWE necessitates the use of complex behavior change techniques (BCTs)—defined as irreducible, replicable, and observable components of interventions designed to alter or redirect causal processes that regulate behavior—to address barriers such as overprotection. Aims and Methods This review aims to assess the BCTs utilized in PA interventions for individuals with epilepsy. Seventeen intervention studies on PWE were extracted from four systematic reviews identified through electronic databases. Studies were excluded if they did not include an intervention aimed at increasing physical activity or were not specific to epilepsy. Data were extracted regarding study characteristics, and the BCTs within the methodologies were coded using the Behaviour Change Taxonomy v1. Results and Discussion This review found that most studies did not report the effectiveness of their interventions but agreed that PA either had no impact on seizure frequency or, at best, reduced it. "Social support" and "instruction on how to perform behavior" were the most frequently used BCTs, which is a novel finding, as reviews of healthy populations typically identified other common techniques. Given the significant methodological heterogeneity across the studies, this review supports previous recommendations for the use of a unified language, such as the BCT taxonomy, in future research. Conclusion This review identifies novel BCTs more commonly employed to increase PA in the epileptic population compared to the general population, though further research is needed to determine their effectiveness. It also emphasizes the need for a standardized reporting framework, such as the Behaviour Change Taxonomy v1, in future interventional studies.