Highlights
- •Physical activity is associated with better quality of life even after adjusting for age, sex, and disability level.
- •Stronger associations observed with strenuous or moderate physical activity compared to mild.
- •Limited changes in physical activity were observed over the two years of follow-up.
Abstract
Background
Higher levels of total physical activity (PA) are associated with better health-related
quality of life (HRQOL) in individuals with multiple sclerosis (MS). The benefits
of PA across the activity continuum have not been well-studied. The goal of this study
was to compare the associations between total PA, strenuous PA, moderate PA, and mild
PA and HRQOL in a large cohort of individuals with MS using both generic and neurologic
disease-specific questionnaires. Longitudinal changes in PA and HRQOL over two years
were also examined
Methods
Subjects enrolled in SysteMS completed the Godin Leisure Time Exercise Questionnaire
(GLTEQ) to measure PA. Subjects also completed generic (SF-36) and neurologic disease-specific
(NeuroQoL) HRQOL measures. GLTEQ and HRQOL measures were administered at baseline
and 24 months. The associations between the GLTEQ total leisure activity (TLA), strenuous
PA, moderate PA and mild PA and scores on NeuroQoL and SF-36 were estimated using
Spearman's correlation coefficient and partial Spearman's correlation coefficient
adjusting for age, sex and Expanded Disability Status Scale (EDSS) measured by a provider.
To further investigate the associations between mild PA and HRQOL measures, the associations
between mild PA and HRQOL were estimated in participants who reported no moderate
or strenuous PA in the last week. The changes in GLTEQ TLA scores and each component
score were compared to the changes in NeuroQoL and SF-36 over 24 months using Spearman's
correlation coefficient and partial Spearman's correlation coefficient adjusting for
age, sex and EDSS.
Results
Statistically significant weak correlations were observed between GLTEQ TLA and NeuroQoL
and SF-36 domains, with higher levels of TLA being associated with better HRQOL outcomes.
After adjusting for age, sex and EDSS, all correlations were attenuated. Strenuous
and moderate levels of PA were similarly associated with many HRQOL outcomes, but
mild PA was only weakly correlated with NeuroQoL Lower Extremity Function. There was
limited change in PA over 24 months. In a subgroup of participants who reported mild
PA, but no moderate or strenuous PA, there were no significant associations with NeuroQoL
or SF-36 domains at baseline, but increases in mild PA over two years were moderately
associated with improvement on NeuroQoL Upper Extremity Function and SF-36 Mental
Health and Mental Component Summary.
Conclusion
There were weak associations between TLA and HRQOL across a wide range of HRQOL variables.
In addition, both strenuous PA and moderate PA were weakly associated with many HRQOL
outcomes, but mild PA was only associated with lower extremity function. Increases
in mild PA in a subgroup of individuals who reported no strenuous or moderate PA at
baseline were associated with improvements in HRQOL at 24 months. These findings suggest
that programs aimed at increasing PA across the activity continuum may lead to improvements
in multiple areas of HRQOL in individuals with MS.
Keywords
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Article info
Publication history
Published online: July 02, 2022
Accepted:
June 4,
2022
Received in revised form:
May 19,
2022
Received:
November 18,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
