Advertisement

Quality of Life Research

, Volume 22, Issue 2, pp 253–261 | Cite as

Physical activity, self-efficacy, and health-related quality of life in persons with multiple sclerosis: analysis of associations between individual-level changes over one year

  • Robert W. Motl
  • Edward McAuley
  • Daniel Wynn
  • Brian Sandroff
  • Yoojin Suh
Article

Abstract

Background

Physical activity and self-efficacy represent behavioral and psychological factors, respectively, that are compromised in persons with multiple sclerosis (MS), but might be modifiable through intervention and result in better health-related quality of life (HRQOL).

Purpose

The present study adopted a panel research design and examined the associations between individual-level changes in physical activity, self-efficacy, and HRQOL over a one-year period in persons with MS.

Method

The sample consisted of 269 persons with relapsing–remitting MS who completed the Godin Leisure-Time Questionnaire (GLTEQ), Multiple Sclerosis Self-Efficacy (MSSE) Scale, and Multiple Sclerosis Quality of Life—29 (MSIS-29) Scale on two occasions that were separated by 1 year. The data were analyzed using panel analysis in Mplus 3.0.

Results

The initial panel analysis indicated that individual-level change in physical activity was associated with individual-level change in both physical and psychological HRQOL. The subsequent panel analysis indicated that (a) individual-level change in self-efficacy for functioning with MS was associated with individual-level change in physical HRQOL, whereas individual-level change in self-efficacy for control was associated with individual-level change in psychological HRQOL; (b) individual-level change in self-efficacy for functioning with MS, but not self-efficacy for control, mediated the association between individual-level change in physical activity and physical HRQOL; and (c) individual-level change in self-efficacy for controlling MS was the strongest predictor of individual-level change in HRQOL.

Conclusion

Physical activity and self-efficacy both might be important targets of subsequent behavioral and self-management interventions for improving the HRQOL of persons with MS, although self-efficacy is seemingly more important than physical activity.

Keywords

Multiple sclerosis Self-efficacy Physical activity 

Notes

Acknowledgment

This investigation was supported by a grant from the National Multiple Sclerosis Society (RG 3926A2/1).

References

  1. 1.
    Miller, A., & Dishon, S. (1006). Health-related quality of life in multiple sclerosis: The impact of disability, gender and employment status. Quality of Life Research, 15, 259–271.CrossRefGoogle Scholar
  2. 2.
    Wu, N., Minden, S. L., Hoaglin, D. C., Hadden, L., & Frankel, D. (2007). Quality of life in people with multiple sclerosis: Data from the Sonya Slifka longitudinal multiple sclerosis study. Journal of health and human services administration, 30, 233–267.PubMedGoogle Scholar
  3. 3.
    Naess, H., Beiske, A. G., & Myhr, K. M. (2008). Quality of life among young patients with ischaemic stroke compared with patients with multiple sclerosis. Acta Neurologica Scandinavica, 117, 181–185.PubMedCrossRefGoogle Scholar
  4. 4.
    Hincapie-Zapata, M. E., Suarez-Escudero, J. C., Pineda-Tamayo, R., & Anaya, J. M. (2009). Quality of life in multiple sclerosis and other chronic autoimmune and non-autoimmune diseases. Review of Neurology, 48, 225–230.Google Scholar
  5. 5.
    Benito-Leon, J., Morales, J. M., Rivera-Navarro, J., & Mitchell, A. J. (2003). A review about the impact of multiple sclerosis on health-related quality of life. Disability and Rehabilitation, 25, 1291–1303.PubMedCrossRefGoogle Scholar
  6. 6.
    Mitchell, A. J., Benito-León, J., González, J. M., & Rivera-Navarro, J. (2005). Quality of life and its assessment in multiple sclerosis: Integrating physical and psychological components of well-being. Lancet of Neurology, 4, 556–566.CrossRefGoogle Scholar
  7. 7.
    Sandroff, B. M., Dlugonski, D., Weikert, M., Suh, Y., Balantrapu, S., Motl, R. W. (2012). Physical activity and multiple sclerosis: New insights regarding inactivity. Acta Neurologica Scandinavica. doi:  10.1111/j.1600-0404.2011.01634.x
  8. 8.
    Motl, R. W. (2010). Physical activity and irreversible disability in multiple sclerosis. Exercise and Sport Sciences Reviews, 38, 186–191.PubMedCrossRefGoogle Scholar
  9. 9.
    Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behaviour, 31, 143–164.CrossRefGoogle Scholar
  10. 10.
    Motl, R. W., McAuley, E., Snook, E. M., & Gliottoni, R. C. (2008). Does the relationship between physical activity and quality of life differ based on generic versus disease-targeted instruments? Annals of Behavioral Medicine, 36, 93–99.PubMedCrossRefGoogle Scholar
  11. 11.
    Riazi, A., Thompson, A. J., & Hobart, J. C. (2004). Self-efficacy predicts self-reported health status in multiple sclerosis. Mult Sclerosis Journal, 10, 61–66.CrossRefGoogle Scholar
  12. 12.
    Schwartz, C. E., Coulthard-Morris, L., Zeng, Q., & Retzlaff, P. (1996). Measuring self-efficacy in people with multiple sclerosis: A validation study. Archives of Physical Medicine and Rehabilitation, 77, 394–398.PubMedCrossRefGoogle Scholar
  13. 13.
    Stroud, N. M., & Minahan, C. L. (2009). The impact of regular physical activity on fatigue, depression and quality of life in persons with multiple sclerosis. Health and Quality of Life Outcomes, 7, 68.PubMedCrossRefGoogle Scholar
  14. 14.
    Motl, R. W., & Snook, E. M. (2008). Physical activity, self-efficacy, and quality of life in multiple sclerosis. Annals of Behavioral Medicine, 35, 111–115.PubMedGoogle Scholar
  15. 15.
    McAuley, E., Konopack, J. F., Motl, R. W., Morris, K. S., Doerksen, S. E., & Rosengren, K. R. (2006). Physical activity and quality of life in older adults: Influence of health status and self-efficacy. Annals of Behavioral Medicine, 31, 99–103.PubMedCrossRefGoogle Scholar
  16. 16.
    McAuley, E., Doerksen, S. E., Morris, K. S., Motl, R. W., Hu, L., Wojcicki, T. R., et al. (2008). Pathways from physical activity to quality of life in older women. Annals of Behavioral Medicine, 36, 13–20.PubMedCrossRefGoogle Scholar
  17. 17.
    Kessler, R. C., & Greenberg, D. F. (1981). Linear panel analysis: Models of quantitative change. New York, NY: Academic Press, Inc.Google Scholar
  18. 18.
    Motl, R. W., McAuley, E., Wynn, D., Suh, Y., Weikert, M., & Dlugonski, D. (2010). Symptoms and physical activity among adults with relapsing-remitting multiple sclerosis? The Journal of Nervous and Mental Disease, 198, 213–219.PubMedCrossRefGoogle Scholar
  19. 19.
    Godin, G., & Shephard, R. J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Sciences, 10, 141–146.Google Scholar
  20. 20.
    Gosney, J. L., Scott, J. A., Snook, E. M., & Motl, R. W. (2007). Physical activity and multiple sclerosis: Validity of self-report and objective measures. Family & Community Health, 3, 144–150.CrossRefGoogle Scholar
  21. 21.
    Motl, R. W., McAuley, E., Snook, E. M., & Scott, J. A. (2006). Validity of physical activity measures in ambulatory individuals with multiple sclerosis. Disability and Rehabilitation, 28, 1151–1156.PubMedCrossRefGoogle Scholar
  22. 22.
    Weikert, M., Motl, R. W., Suh, Y., McAuley, E., & Wynn, D. (2010). Accelerometry in persons with multiple sclerosis: Measurement of physical activity or walking mobility? Journal of the Neurological Sciences, 290, 6–11.PubMedCrossRefGoogle Scholar
  23. 23.
    Hobart, J., Lamping, D., Fitzpatrick, R., Riazi, A., & Thompson, A. (2001). The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measures. Brain, 124, 962–973.PubMedCrossRefGoogle Scholar
  24. 24.
    Hadjimichael, O., Kerns, R. B., Rizzo, M. A., Cutter, G., & Vollmer, T. (2007). Persistent pain and uncomfortable sensations in persons with multiple sclerosis. Pain, 127, 35–41.PubMedCrossRefGoogle Scholar
  25. 25.
    Muthén, L. K., Muthén, B. O. (1998–2004). Mplus. Los Angeles: Author.Google Scholar
  26. 26.
    Bollen, K. A. (1989). Structural equations with latent variables. New York: John Wiley & Sons.Google Scholar
  27. 27.
    Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.CrossRefGoogle Scholar
  28. 28.
    Hugos, C. L., Copperman, L. F., Fuller, B. E., Yadav, V., Lovera, J., & Bourdette, D. N. (2010). Clinical trial of a formal group fatigue program in multiple sclerosis. Multiple Sclerosis, 16, 724–732.PubMedCrossRefGoogle Scholar
  29. 29.
    Mathiowetz, V. G., Matuska, K. M., Finlayson, M. L., Luo, P., & Chen, H. Y. (2007). One-year follow-up to a randomized controlled trial of an energy conservation course for persons with multiple sclerosis. International Journal of Rehabilitation Research, 30, 305–313.PubMedCrossRefGoogle Scholar
  30. 30.
    Finlayson, M. (2005). Pilot study of an energy conservation education program delivered by telephone conference call to people with multiple sclerosis. NeuroRehabilitation, 20, 267–277.PubMedGoogle Scholar
  31. 31.
    Stuifbergen, A. K., Blozis, S. A., Harrison, T. C., & Becker, H. A. (2005). Exercise, functional limitations, and quality of life: A longitudinal study of persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 87, 935–943.CrossRefGoogle Scholar
  32. 32.
    Costelloe, L., O’Rourke, K., Kearney, H., MvGuigan, C., Gribbin, L., Duggan, M., et al. (2007). The patient knows best: Significant change in the physical component of the Multiple Sclerosis Impact Scale (MSIS-29 physical). Journal of Neurology, Neurosurgery and Psychiatry, 78, 841–844.CrossRefGoogle Scholar
  33. 33.
    Bombardier, C. H., Cunniffe, M., Wadhwani, R., Gibbons, L. E., Blake, K. D., & Kraft, G. H. (2008). The efficacy of telephone counseling for health promotion in people with multiple sclerosis: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 89, 1849–1856.PubMedCrossRefGoogle Scholar
  34. 34.
    Motl, R. W., Dlugonski, D., Wójcicki, T. R., McAuley, E., & Mohr, D. C. (2011). Internet intervention for increasing physical activity in persons with multiple sclerosis. Multiple Sclerosis, 17, 116–128.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Robert W. Motl
    • 1
  • Edward McAuley
    • 1
  • Daniel Wynn
    • 2
  • Brian Sandroff
    • 1
  • Yoojin Suh
    • 1
  1. 1.Department of Kinesiology and Community HealthUniversity of IllinoisUrbanaUSA
  2. 2.Consultants in Neurology MS CenterNorthbrookUSA

Personalised recommendations