Highlights
- •Physician referral enhances adherence to physical activity.
- •Higher exercise self-efficacy is associated with higher physical activity adherence.
- •Baseline fitness, function or EDSS score did not affect physical activity adherence.
Abstract
Background
Commitment and adherence to community-based physical activity can be a challenge for
clinical populations. The aim of this study was to explore the effectiveness of physician
referral on adherence to the Physical Activity Guidelines (PAGs) for adults with MS.
Methods
Ninety-one participants with MS (age: 47.9 ± 10.4 years, EDSS score: 3.5 ± 1.8) were
randomized into a direct referral to PAGs from a physician (REF) or control (CON)
group (given a print copy of PAGs). After 16 weeks participants were categorized as
either PAG “Adherers” (n = =30) or “Non-Adherers” (n = =49), based on achieving an adherence rate of ≥ 75%.
Results
Adherence to the PAGs was significantly higher in REF (68.0 ± 28.6%) compared with
CON (35.1 ± 35.0%) (p < 0.05). There were no differences in EDSS scores, time since diagnosis, fitness,
fatigue, mobility or QOL between those who adhered or did not adhere to the PAGs (p > 0.05), but greater self-efficacy for exercise at baseline was associated with higher
adherence (p < 0.0001).
Interpretation
Direct referral to physical activity from a physician is twice as effective as simply
providing information about physical activity for adherence to the PAG in people with
MS. As physical activity is recognized as an effective therapeutic option for adults
with MS it is important that physicians play a role in prescribing it to their patients.
Trial registration
ClinicalTrials.gov Identifier: NCT02100020
Keywords
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Article info
Publication history
Published online: October 22, 2019
Accepted:
October 10,
2019
Received in revised form:
September 3,
2019
Received:
June 11,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier B.V. All rights reserved.
