Skip to main content
SpringerLink
Log in

Current and Long-Term Physical Activity Among Adults with Multiple Sclerosis in the United States: COM-B Variables as Explanatory Factors

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

Abstract

Background

Physical activity is an evidence-based, safe second-line approach for improved multiple sclerosis (MS) symptoms and disease progression. This study examined the contributions of Capability-Opportunity-Motivation-Behavior (COM-B) factors for understanding engagement in current and long-term physical activity among persons with MS in the United States (U.S.).

Method

Adults with MS in the U.S. (N = 854) completed an online survey that included questions regarding demographic and clinical characteristics, COM-B constructs, Godin Leisure Time Exercise Questionnaire (GLTEQ), and Physical Activity Staging Questionnaire (PASQ). Participants were classified into groups based on the GLTEQ regarding current physical activity behavior and PASQ for long-term physical activity behavior. MANOVA and discriminant function analysis (DFA) identified COM-B constructs that differentiated physical activity groups.

Results

MANOVA analyses indicated that all COM-B constructs were significantly different for both GLTEQ current physical activity groups (Wilks’s λ = .5, F(44, 1432) = 14.8) and PASQ long-term physical activity groups (Wilks’s λ = .4, F(44, 1464) = 16.9) status except Information Provision. DFA analysis regarding GLTEQ identified a function including exclusively Capability and Motivation sources of behavior that differentiated current physical activity groups such as intention and self-efficacy. DFA for PASQ identified a different function of the Capability and Motivation sources of behavior that differentiated long-term physical activity groups; the primary differentiating variables were action control and intention.

Conclusion

Our results identify internal factors as the primary COM-B predictors of current and long-term physical activity among adults with MS in the U.S., and health promotion interventions may focus on assessing individual competencies and behavioral regulation for changing physical activity in MS.

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

Fig. 1

Similar content being viewed by others

References

  1. Wallin MT, Culpepper WJ, Campbell JD, et al. The prevalence of MS in the United States: a population-based estimate using health claims data. Neurology. 2019;92:e1029-1040.

    Article  Google Scholar 

  2. Compston A, Coles A. Multiple sclerosis. Lancet. 2008;372:1502–17.

    Article  CAS  Google Scholar 

  3. Motl RW, Sandroff BM, Kwakkel G, et al. Exercise in patients with multiple sclerosis. Lancet Neurol. 2017;16:848–56.

    Article  Google Scholar 

  4. Klaren RE, Motl RW, Dlugonski D, Sandroff BM, Pilutti LA. Objectively quantified physical activity in persons with multiple sclerosis. Arch Phys Med Rehabil. 2013;94:2342–8.

    Article  Google Scholar 

  5. Motl RW, Pekmezi D, Wingo BC. Promotion of physical activity and exercise in multiple sclerosis: importance of behavioral science and theory. Mult Scler J Exp Transl Clin. 2018;4:2055217318786745.

    PubMed  PubMed Central  Google Scholar 

  6. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42.

    Article  Google Scholar 

  7. Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.

    Article  Google Scholar 

  8. Riemann-Lorenz K, Motl RW, Casey B, Coote S, Daubmann A, Heesen C. Possible determinants of long-term adherence to physical activity in multiple sclerosis-theory-based development of a comprehensive questionnaire and results from a German survey study. Disabil Rehabil. 2020:1–14.

  9. Dalgas U, Hvid LG, Kwakkel G, Motl RW, de Groot V, Feys P, Op’t Eijnde B, Coote S, Beckerman H, Pfeifer K, Streber R. Moving exercise research in multiple sclerosis forward (the MoXFo initiative): Developing consensus statements for research. Mult Scler. 2020;12:1352458520910360.

  10. Riemann-Lorenz K, Wienert J, Streber R, Motl RW, Coote S, Heesen C. Long-term physical activity in people with multiple sclerosis: exploring expert views on facilitators and barriers. Disabil Rehabil. 2019:1–13.

  11. Gold SM, Heesen C, Schulz H, Guder U, Monch A, Gbadamosi J, et al. Disease specific quality of life instruments in multiple sclerosis: validation of the Hamburg Quality of Life Questionnaire in Multiple Sclerosis (HAQUAMS). Mult Scler. 2001;7:119–30.

    Article  CAS  Google Scholar 

  12. Sniehotta FF, Scholz U, Schwarzer R. Bridging the intention–behaviour gap: planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol Health. 2005;20:143–60.

    Article  Google Scholar 

  13. Sniehotta FF, Schwarzer R, Scholz U, Schüz B. Action planning and coping planning for long-term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005;35:565–76.

    Article  Google Scholar 

  14. Fuchs R, Göhner W, Mahler C, et al. Aufbau eines körperlich-aktiven Lebensstils im Kontext der medizinischen Rehabilitation: Ein motivational-volitionales Interventionskonzept (MoVo-LISA Projekt). Unveröffentlichter Endbericht Freiburg: Universität Freiburg; 2008.

    Google Scholar 

  15. Rose EA, Markland D, Parfitt G. The development and initial validation of the Exercise Causality Orientations Scale. J Sports Sci. 2001;19:445–62.

    Article  CAS  Google Scholar 

  16. Rovniak LS, Anderson ES, Winett RA, Stephens RS. Social cognitive determinants of physical activity in young adults: a prospective structural equation analysis. Ann Behav Med. 2002;24:149–56.

    Article  Google Scholar 

  17. Schwarzer R, Luszczynska A, Ziegelmann JP, Scholz U, Lippke S. Social-cognitive predictors of physical exercise adherence: three longitudinal studies in rehabilitation. Health Psychol. 2008;27(1s):S54-63.

    Article  Google Scholar 

  18. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60:631–7.

    Article  Google Scholar 

  19. McAuley E, Motl RW, White SM, Wojcicki TR. Validation of the multidimensional outcome expectations for exercise scale in ambulatory, symptom-free persons with multiple sclerosis. Arch Phys Med Rehabil. 2010;91:100–5.

    Article  Google Scholar 

  20. Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA). Rehabil Psychol. 2011;56:161–70.

    Article  Google Scholar 

  21. Herzberg PY, Glaesmer H, Hoyer J. Separating optimism and pessimism: a robust psychometric analysis of the Revised Life Orientation Test (LOT-R). Psychol Assess. 2006;18:433.

    Article  Google Scholar 

  22. Fuchs R, Fuchs R. Sportbezogene Konsequenzerfahrungen: Das Konstrukt und seine Messung. Freiburg: Universität Freiburg; 2013.

    Google Scholar 

  23. Godin G, Shephard R. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10:141–6.

    CAS  PubMed  Google Scholar 

  24. Motl RW, Bollaert RE, Sandroff BM. Validation of the Godin Leisure-Time Exercise Questionnaire classification coding system using accelerometry in multiple sclerosis. Rehabil Psychol. 2018;63:77.

    Article  Google Scholar 

  25. Nigg C, Hellsten L, Norman G, et al. Physical activity staging distribution: establishing a heuristic using multiple studies. Ann Behav Med. 2005;29(Suppl):35–45.

    Article  Google Scholar 

  26. Learmonth YC, Motl RW, Sandroff BM, Pula JH, Cadavid D. Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurol. 2013;13:37.

    Article  Google Scholar 

  27. Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics (6th edn, Vol. 5). Pearson: Boston;2007

  28. Comrey A, Lee H. Interpretation and application of factor analytic results. Comrey AL, Lee HB A first course in factor analysis. 1992;2.

    Google Scholar 

  29. Carey RN, Connell LE, Johnston M, et al. Behavior change techniques and their mechanisms of action: a synthesis of links described in published intervention literature. Ann Behav Med. 2019;53:693–707.

    PubMed  Google Scholar 

  30. Latimer-Cheung AE, Pilutti LA, Hicks AL, et al. Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil. 2013;94(1800–1828):e3.

    Google Scholar 

  31. Fasczewski KS, Gill DL, Rothberger SM. Physical activity motivation and benefits in people with multiple sclerosis. Disabil Rehabil. 2018;40:1517–23.

    Article  Google Scholar 

  32. Motl RW, McAuley E, DiStefano C. Is social desirability associated with self-reported physical activity? Prev Med. 2005;40:735–9.

    Article  Google Scholar 

  33. 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;38:1227–42.

    Article  Google Scholar 

Download references

Funding

This study was funded by the National Multiple Sclerosis Society (MB 0029).  

Author information

Authors and Affiliations

  1. Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, 35294, United States

    Stephanie L. Silveira & Robert W. Motl

  2. Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Karin Riemann-Lorenz & Christoph Heesen

  3. Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Christoph Heesen

Authors
  1. Stephanie L. Silveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karin Riemann-Lorenz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christoph Heesen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert W. Motl
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephanie L. Silveira.

Ethics declarations

Informed Consent

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

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silveira, S.L., Riemann-Lorenz, K., Heesen, C. et al. Current and Long-Term Physical Activity Among Adults with Multiple Sclerosis in the United States: COM-B Variables as Explanatory Factors. Int.J. Behav. Med. 28, 561–574 (2021). https://doi.org/10.1007/s12529-020-09946-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-020-09946-w

Keywords

Search

Navigation