Skip to main content
SpringerLink
Log in

Sources of Variability in Physical Activity Among Inactive People with Multiple Sclerosis

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Purpose

Evidence supports that physical activity (PA) improves symptoms of multiple sclerosis (MS). Although application of principles from Social Cognitive Theory (SCT) may facilitate positive changes in PA behaviour among people with multiple sclerosis (pwMS), the constructs often explain limited variance in PA. This study investigated the extent to which MS symptoms, including fatigue, depression, and walking limitations combined with the SCT constructs, explained more variance in PA than SCT constructs alone among pwMS.

Method

Baseline data, including objectively assessed PA, exercise self-efficacy, goal setting, outcome expectations, 6-min walk test, fatigue and depression, from 65 participants of the Step It Up randomized controlled trial completed in Ireland (2016), were included. Multiple regression models quantified variance explained in PA and independent associations of (1) SCT constructs, (2) symptoms and (3) SCT constructs and symptoms.

Results

Model 1 included exercise self-efficacy, exercise goal setting and multidimensional outcomes expectations for exercise and explained ~14% of the variance in PA (R 2=0.144, p < 0.05). Model 2 included walking limitations, fatigue and depression and explained 20% of the variance in PA (R 2=0.196, p < 0.01). Model 3 combined models 1 and 2 and explained variance increased to ~29% (R 2=0.288; p<0.01). In Model 3, exercise self-efficacy (β=0.30, p < 0.05), walking limitations (β=0.32, p < 0.01), fatigue (β = −0.41, p < 0.01) and depression (β = 0.34, p < 0.05) were significantly and independently associated with PA.

Conclusion

Findings suggest that relevant MS symptoms improved by PA, including fatigue, depression and walking limitations, and SCT constructs together explained more variance in PA than SCT constructs alone, providing support for targeting both SCT constructs and these symptoms in the multifactorial promotion of PA among pwMS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Platta ME, et al. Effect of exercise training on fitness in multiple sclerosis: a meta-analysis. Arch Phys Med Rehabil. 2016;16(16):00091–5.

    Google Scholar 

  2. Motl RW, et al. Descriptive epidemiology of physical activity rates in multiple sclerosis. Acta Neurol Scand. 2015;131(6):422–5.

    Article  CAS  PubMed  Google Scholar 

  3. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.

    Article  CAS  PubMed  Google Scholar 

  4. Casey B, et al. Modifiable psychosocial constructs associated with physical activity behaviour in people with multiple sclerosis: a systematic review and meta-analysis. Mult Scler J. 2016;22(S3):29–30.

    Google Scholar 

  5. Uszynski MK, Casey B, Hayes S, Gallagher S, Purtill H, Motl RW, et al. Social cognitive theory correlates of physical activity in inactive adults with multiple sclerosis. Int J MS Care. 2017.

  6. Suh Y, et al. Social cognitive predictors of physical activity in relapsing-remitting multiple sclerosis. Int J Behav Med. 2014;21(6):891–8.

    Article  PubMed  Google Scholar 

  7. Streber R, Peters S, Pfeifer K. Systematic review of correlates and determinants of physical activity in persons with multiple sclerosis. Arch Phys Med Rehabil. 2016;97(4):633–45. e29

    Article  PubMed  Google Scholar 

  8. Motl RW, et al. Effects of change in fatigue and depression on physical activity over time in relapsing-remitting multiple sclerosis. Psychol Health Med. 2011;16(1):1–11.

    Article  PubMed  Google Scholar 

  9. Coote S, et al. A randomised controlled trial of an exercise plus behaviour change intervention in people with multiple sclerosis: the step it up study protocol. BMC Neurol. 2014;14(241):014–0241.

    Google Scholar 

  10. Coote S, O’Dwyer C. Comparative validity of accelerometer-based measures of physical activity for people with multiple sclerosis. Arch Phys Med Rehabil. 2012;93(11):2022–8.

    Article  PubMed  Google Scholar 

  11. Suh Y, et al. Pilot trial of a social cognitive theory-based physical activity intervention delivered by nonsupervised Technology in Persons with Multiple Sclerosis. J Phys Act Health. 2015;12(7):924–30.

    Article  PubMed  Google Scholar 

  12. Honarmand K, Feinstein A. Validation of the hospital anxiety and depression scale for use with multiple sclerosis patients. Mult Scler. 2009;15(12):1518–24.

    Article  PubMed  Google Scholar 

  13. Fry DK, Pfalzer LA. Reliability of four functional tests and rating of perceived exertion in persons with multiple sclerosis. Physiother Can. 2006;58(3):212–20.

    Article  Google Scholar 

  14. Rietberg M, Van Wegen E, Kwakkel G. Measuring fatigue in patients with multiple sclerosis: reproducibility, responsiveness and concurrent validity of three Dutch self-report questionnaires. Disabil Rehabil. 2010;32(22):1870–6.

    Article  CAS  PubMed  Google Scholar 

  15. Amtmann D, et al. Comparison of the psychometric properties of two fatigue scales in multiple sclerosis. Rehabil Psychol. 2012;57(2):159.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Suh Y, et al. Social cognitive correlates of physical activity: findings from a cross-sectional study of adults with relapsing-remitting multiple sclerosis. J Phys Act Health. 2011;8(5):626–35.

    Article  PubMed  Google Scholar 

  17. Dlugonski D, et al. Social cognitive correlates of physical activity in inactive adults with multiple sclerosis. Int J Rehabil Res. 2011;34(2):115–20.

    Article  PubMed  Google Scholar 

  18. Motl RW, McAuley E, Sandroff BM. Longitudinal change in physical activity and its correlates in relapsing-remitting multiple sclerosis. Phys Ther. 2013;93(8):1037–48.

    Article  PubMed  Google Scholar 

  19. Smith CM, Fitzgerald HJM, Whitehead L. How fatigue influences exercise participation in men with multiple sclerosis. Qual Health Res. 2015;25(2):179–88.

    Article  PubMed  Google Scholar 

  20. Heesen C, et al. Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable. Mult Scler. 2008;14(7):988–91.

    Article  CAS  PubMed  Google Scholar 

  21. Wood B, et al. Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis. Mult Scler. 2012:1352458512450351.

  22. Learmonth YC, Motl RW. Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences. Disabil Rehabil. 2016;38(13):1227–42.

    Article  PubMed  Google Scholar 

  23. Motl RW, et al. Symptoms, self-efficacy, and physical activity among individuals with multiple sclerosis. Res Nurs Health. 2006;29(6):597–606.

    Article  PubMed  Google Scholar 

  24. Kahraman T, et al. Determinants of physical activity in minimally impaired people with multiple sclerosis. Clin Neurol Neurosurg. 2015;138:20–4.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Therapies, Health Sciences Building, University of Limerick, Limerick, Ireland

    Marcin K. Uszynski, Blathin Casey, Sara Hayes & Susan Coote

  2. Multiple Sclerosis Society of Ireland, Western Regional Office, Galway, Ireland

    Marcin K. Uszynski

  3. Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland

    Matthew P. Herring

  4. Health Research Institute, University of Limerick, Limerick, Ireland

    Matthew P. Herring, Sara Hayes, Stephen Gallagher & Susan Coote

  5. Department of Psychology, University of Limerick, Limerick, Ireland

    Stephen Gallagher

  6. Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA

    Robert W. Motl

Authors
  1. Marcin K. Uszynski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew P. Herring
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Blathin Casey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sara Hayes
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stephen Gallagher
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robert W. Motl
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Susan Coote
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcin K. Uszynski.

Ethics declarations

Funding

This work is supported by the Irish Health Research Board, Health Research Award, grant number HRA_PHR/2013–264.

Conflict of Interest

No commercial party having a direct financial interest in the results of the research supporting this article or will be confer a benefit on the authors or on any organisation with which the authors are associated.

Ethical Approval

All procedures in this study were in accordance with ethical standards of the institutionaal and/or national research committee and with the 1964 Helsinki declaration and its later ammendments or comarable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Uszynski, M.K., Herring, M.P., Casey, B. et al. Sources of Variability in Physical Activity Among Inactive People with Multiple Sclerosis. Int.J. Behav. Med. 25, 259–264 (2018). https://doi.org/10.1007/s12529-017-9674-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-017-9674-z

Keywords

Search

Navigation