Systematic Review of Correlates and Determinants of Physical Activity in Persons With Multiple Sclerosis

René Streber; Stefan Peters; Klaus Pfeifer

doi:10.1016/j.apmr.2015.11.020

Systematic Review of Correlates and Determinants of Physical Activity in Persons With Multiple Sclerosis

Arch Phys Med Rehabil. 2016 Apr;97(4):633-645.e29. doi: 10.1016/j.apmr.2015.11.020. Epub 2016 Jan 2.

Authors

René Streber¹, Stefan Peters², Klaus Pfeifer³

Affiliations

¹ Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
² Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany.
³ Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. Electronic address: Klaus.pfeifer@fau.de.

PMID: 26751247
DOI: 10.1016/j.apmr.2015.11.020

Abstract

Objective: To review the current evidence regarding correlates and determinants of physical activity (PA) in persons with multiple sclerosis (pwMS).

Data sources: PubMed and Scopus (1980 to January 2015) and reference lists of eligible studies.

Study selection: Eligible studies include adults with multiple sclerosis; have a cross-sectional or prospective observational design; or examine the effect of a theory-based intervention trial on PA, including a mediation analysis. Eligible studies also apply a quantitative assessment of PA and correlates or proposed mediators and are published in English or German language.

Data extraction: Two reviewers independently evaluated the risk of bias, extracted data, and categorized variables according to the International Classification of Functioning, Disability and Health.

Data synthesis: Consistency and the direction of associations were evaluated with a semiquantitative approach. Fifty-six publications with data from observational studies and 2 interventional studies provided evidence for 86 different variables. Consistent correlates of PA were the disability level, walking limitations in particular, PA-related self-efficacy, self-regulation constructs, employment status, and educational level. One interventional study provided evidence for a causal relation between self-regulation and PA. However, 59 of the 86 investigated variables in observational studies are based on 1 or 2 study findings, and most results stem from cross-sectional designs.

Conclusions: Beside the importance of the general disability level and walking limitations, the results highlight the importance of personal factors (eg, PA-related self-efficacy, self-regulatory constructs, sociodemographic factors). Limitations and implications of the current review are discussed. Research that is more rigorous is needed to better understand what affects PA in pwMS.

Keywords: Health behavior; Health promotion; Motor activity; Multiple sclerosis; Rehabilitation.

Publication types

Review
Systematic Review

MeSH terms

Adult
Cross-Sectional Studies
Disability Evaluation*
Educational Status
Employment
Exercise
Female
Humans
Male
Middle Aged
Mobility Limitation
Motor Activity*
Multiple Sclerosis / physiopathology*
Multiple Sclerosis / psychology
Observational Studies as Topic
Prospective Studies
Self Efficacy
Walking