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Habitual and Low-Intensity Physical Activity in People with Multiple Sclerosis

  • Hannah L. Gullo (a1), Anna L. Hatton (a1), Sally Bennett (a1), Jennifer Fleming (a2) and David H. K. Shum (a3)...


People with Multiple Sclerosis (MS) undertake insufficient physical activity based on current guidelines. Recent work points to the benefits of increasing the amount of time spent in all non-sedentary physical activity. The current study sought to explore the potential benefits to community participation, as well as examine factors predictive, of engagement in ‘habitual’ and/or low-intensity physical activity. Seventy-four people with MS were compared to 67 healthy controls using the Frenchay Activities Index (FAI). Findings revealed differences in habitual activity level (p < .001), and low-intensity physical activity (p < .001), with people with MS having a lower level of engagement than healthy people. After controlling for the impact of MS on mobility, years since symptom onset, physical fatigue and reduced positive affect were the most significant predictors of engagement in ‘at least weekly’ low-intensity physical activity. Higher frequency of low-intensity physical activity was significantly associated with greater home, social and occupational participation (all p < .05), and physical health status (p < .01), but not mental health status (p = .964) in people with MS. Results suggest that improving habitual activity level and engagement in low-intensity physical activity may be of benefit for people with MS.


Corresponding author

Address for correspondence: Dr Hannah L. Gullo, Phone: +61 7 3365 3004. E-mail:


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Australian Institute of Health and Welfare. (2004). Disability and its relationship to health conditions and other factors. Canberra.
Becker, H., & Stuifbergen, A. (2003). What makes it so hard? Barriers to health promotion experienced by people with multiple sclerosis and polio. Family and Community Health, 27 (1), 7585.
Beier, M., Bombardier, C.H., Hartoonian, N., Motl, R.W., & Kraft, G.H. (2014). Improved physical fitness correlates with improved cognition in multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 95 (7), 13281334. doi: 10.1016/j.apmr.2014.02.017.
Benedict, R.H., Wahlig, E., Bakshi, R., Fishman, I., Munschauer, F., Zivadinov, R., & Weinstock-Guttman, B. (2005). Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences, 231 (1–2), 2934.
Briken, S., Gold, S.M., Patra, S., Vettorazzi, E., Harbs, D., Tallner, A., . . . Heesen, C. (2014). Effects of exercise on fitness and cognition in progressive MS: A randomized, controlled pilot trial. Multiple Sclerosis, 20 (3), 382390. doi: 10.1177/1352458513507358.
Campbell, J.D., Ghushchyan, V., McQueen, B.R., Cahoon-Metzger, S., Livingston, T., Vollmer, T., . . . Nair, K. (2014). Burden of multiple sclerosis on direct, indirect costs and quality of life: National US estimates. Multiple Sclerosis and Related Disorders, 3 (2), 227236. doi: 10.1016/j.msard.2013.09.00.
Egerton, T., & Brauer, S. (2009). Temporal characteristics of habitual physical activity periods among older adults. Journal of Physical Activity and Health, 6 (5), 644650.
Ellis, T., & Motl, R.W. (2013). Physical activity behavior change in persons with neurologic disorders: Overview and examples from Parkinson disease and multiple sclerosis. Journal of Neurologic Physical Therapy, 37 (2), 8590. doi: 10.1097/NPT.0b013e31829157c0.
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39 (2), 175191.
Flachenecker, P., Kumpfel, T., Kallmann, B., Gottschalk, M., Grauer, O., Rieckmann, P., . . . Toyka, K.V. (2002). Fatigue in multiple sclerosis: A comparison of different rating scales and correlation to clinical parameters. Multiple Sclerosis, 8 (6), 523526.
Frau, J., Coghe, G., Lorefice, L., Fenu, G., Cadeddu, B., Marrosu, M.G., & Cocco, E. (2015). Attitude towards physical activity in patients with multiple slcerosis: A cohort study. Neurological Sciences, 36 (6), 889893. doi: 10.1007/s10072-015-2100-x.
Haskell, W.L., Lee, I.M, Pate, R.R, Powell, K.E., Blair, S.N., Franklin, B.A., . . . Bauman, A. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39 (8), 14231434.
Hirsh, A.T., Braden, A.L., Craggs, J.G., & Jensen, M.P. (2011). Psychometric properties of the community integration questionnaire in a heterogeneous sample of adults with physical disability. Archives of Physical Medicine and Rehabilitation, 92 (10), 16021610.
Hoyle, R.H., Harris, M.J., & Judd, C.M. (2002). Research methods in social relations. New York, NY: Wadsworth.
Kasser, S.L., Jacobs, J.V., Littenberg, B., Foley, J.T., Cardinal, B.J., & Maddalozzo, G.F. (2014). Exploring physical activity in women with multiple sclerosis: Associations with fear of falling and underlying impairments. American Journal of Physical Medicine Rehabilitation, 93 (6), 461469. doi: 10.1097/PHM.0000000000000049.
Kierkegaard, M., Einarsson, U., Gottberg, K., von, K.L., & Holmqvist, L.W. (2012). The relationship between walking, manual dexterity, cognition and activity/participation in persons with multiple sclerosis. Multiple Sclerosis, 18 (5), 639646. doi: 10.1177/1352458511426736.
Kohn, C.G., Coleman, C.I., Michael, W.C., Sidovar, M.F., & Sobieraj, D.M. (2014). Mobility, walking and physical activity in persons with multiple sclerosis. Current Medical Research and Opinion, 30 (9), 18571862.
Krupp, L.B., LaRocca, N.G., Muir-Nash, G., & Steinberg, G. (1989). The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46 (10), 11211123.
Marck, C.H., Hadgkiss, E.J., Weiland, T.J., van der Meer, D.M., Pereira, N.G., & Jelinek, G.A. (2014). Physical activity and associated levels of disability and quality of life in people with multiple sclerosis: a large international study. BMC Neurology, 14, 143.
Matsuda, P.N., Shumway-Cook, A., Ciol, M.A., Bombardier, C.H., & Kartin, D.A. (2012). Understanding falls in multiple sclerosis: Association of mobility status, concerns about falling, and accumulated impairments. Physical Therapy, 92 (3), 407415.
Matthews, C.E., Chen, K.Y., Freedson, P.S., Buchowski, M.S., Beech, B.M., Pate, R.R., & Troiano, R.P. (2008). Amount of time spent in sedentary behaviors in the United States 2003–2004. American Journal of Epidemiology, 167 (7), 875881.
Mostert, S., & Kesselring, J. (2002). Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Multiple Sclerosis, 8 (2), 161168.
Motl, R.W., Gappmaier, E., Nelson, K., & Benedict, R.H. (2011). Physical activity and cognitive function in multiple sclerosis. Journal of Sport and Exercise Psychology, 33 (5), 734741.
Motl, R.W., & McAuley, E. (2009). Symptom cluster as a predictor of physical activity in multiple sclerosis: Preliminary evidence. Journal of Pain and Symptom Management, 38 (2), 270280.
Motl, R.W., McAuley, E., Sandroff, B.M., & Hubbard, E.A. (2015). Descriptive epidemiology of physical activity rates in multiple sclerosis. Acta Neurologica Scandinavica, 131 (6), 422425.
Motl, R.W., McAuley, E., & Snook, E.M. (2005). Physical activity and multiple sclerosis: A meta-analysis. Multiple Sclerosis, 11 (4), 459463.
Motl, R.W., McAuley, E., Snook, E.M., & Gliottoni, R.C. (2009). Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support. Psychology, Health and Medicine, 14 (1), 111124.
Multiple Sclerosis Research Australia. (2011). The facts: MS matters. Multiple Sclerosis, 14.
Nelson, H.E., & Willison, J.R. (1991). The revised national adult reading test-test manual. Windsor, UK: NFER-Nelson.
Pallant, J.F., Misajon, R., Bennett, E., & Manderson, L. (2006). Measuring the impact and distress of health problems from the individual's perspective: Development of the perceived impact of problem profile (PIPP). Health and Quality of Life Outcomes, 4, 3648.
Petajan, J.H., Gappmaier, E., White, A.T., Spencer, M.K., Mino, L., & Hicks, R.W. (1996). Impact of aerobic training on fitness and quality of life in multiple sclerosis. Annals of Neurology, 39 (4), 432441.
Putnam, M., Geenen, S., Powers, L., Finney, S., & Dautel, P. (2003). Health and wellness: People with disabilities discuss barriers and facilitators to well-being. Journal of Rehabilitation, 69 (1), 3745.
Ritvo, P.G., Fischer, J.S., Miller, D.M., Andrews, H., Paty, D.W., & LaRocca, N.G. (1997). Multiple sclerosis quality of life inventory: A user's manual. (pp. 165). New York, NY: Multiple Sclerosis.
Ruuskanen, J.M., & Parkatti, T. (1994). Physical activity and related factors among nursing home residents. Journal of the American Geriatric Society, 42 (9), 987991
Salter, K., Foley, N., Jutai, J., Bayley, M., & Teasell, R. (2008). Assessment of community integration following traumatic brain injury. Brain Injury, 22 (11), 820835.
Sandroff, B.M., Dlugonski, D., Pilutti, L.A., Pula, J.H., Benedict, R.H., & Motl, R.W. (2014). Physical activity is associated with cognitive processing speed in persons with multiple sclerosis. Multiple Sclerosis and Related Disorders, 3 (1), 123128.
Sandroff, B.M., Klaren, R.E., & Motl, R.W. (2015). Relationships among physical inactivity, deconditioning, and walking impairment in persons with multiple sclerosis. Journal of Neurologic Physical Therapy, 39 (2), 103110. doi: 10.1097/NPT.0000000000000087.
Schuling, J., de Haan, R., Limburg, M., & Groenier, K.H. (1993). The frenchay activities index: Assessment of functional status in stroke patients. Stroke, 24 (8), 11731177.
Sherbourne, C.D., Hays, R.D., Ordway, L., DiMatteo, M.R., & Kravitz, R.L. (1992). Antecedents of adherence to medical recommendations: Results from the medical outcomes study. Journal of Behavioral Medicine, 15 (5), 447468.
Sosnoff, J.J., Sandroff, B.M., Pula, J.H., Morrison, S.M., & Motl, R.W. (2012). Falls and physical activity in persons with multiple sclerosis. Multiple Sclerosis International, 2012, 315620. doi: 10.1155/2012/315620
Stewart, A.L., Hays, R.D., & Ware, J.E. (1988). The MOS short-form general health survey: Reliability and validity in a patient population. Medical Care, 26 (7), 724735.
Stuifbergen, A.K. (1997). Physical activity and perceived health status in persons with multiple sclerosis. Journal of Neurosciences Nursing, 29 (4), 238243.
Stuifbergen, A.K., Blozis, S.A., Harrison, T.C., & Becker, H.A. (2006). Exercise, functional limitations, and quality of life: A longitudinal study of persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 87 (7), 935943.
Tabachnick, B.G., & Fidell, L.S. (2014). Using multivariate statistics (6th ed.). Harlow, UK: Pearson Education.
Veit, C., & Ware, J. (1983). The structure of psychological distress and well-being in general populations. Journal of Consulting and Clinical Psychology 51 (5), 730732.
Westerterp, K.R. (2001). Pattern and intensity of physical activity. Nature, 410 (6828), 539.
Willer, B., Rosenthal, M., Kreutzer, J.S., Gordon, W.A., & Rempel, R. (1993). Assessment of community integration following rehabilitation for traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (2), 7587.
Wood, B., van der Mei, I.A.F., Ponsonby, A., Pittas, F., Quinn, S., Dwyer, T., . . . Taylor, B.V. (2013). Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis. Multiple Sclerosis, 19 (2), 217–24.
Zhang, L., Abreu, B.C., Gonzales, V., Seale, G., Masel, B., & Ottenbacher, K.J. (2002). Comparison of the community integration questionnaire, the craig handicap assessment and reporting technique, and the disability rating scale in traumatic brain injury. Journal of Head Trauma Rehabilitation, 17 (6), 497509.


Habitual and Low-Intensity Physical Activity in People with Multiple Sclerosis

  • Hannah L. Gullo (a1), Anna L. Hatton (a1), Sally Bennett (a1), Jennifer Fleming (a2) and David H. K. Shum (a3)...


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