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Pathways between physical activity and quality of life in adults with multiple sclerosis.

OBJECTIVE
This prospective study examined symptoms of depression, fatigue, pain, self-efficacy, and social support as possible intermediaries in the pathway between changes in physical activity and quality of life (QOL) across a 6-month period in persons with multiple sclerosis (MS).


DESIGN AND MAIN OUTCOME MEASURES
Adults with a definite diagnosis of MS wore an accelerometer for 7 days and then completed a battery of questionnaires at baseline (n = 292) and 6-months follow-up (n = 276). The data were analyzed using panel analysis and covariance modeling in Mplus 3.0.


RESULTS
The initial analysis indicated that change in physical activity was associated with a statistically significant and small residual change in QOL (beta = .07). The subsequent analysis indicated that change in physical activity was associated with residual changes in fatigue (gamma = -.17), pain (gamma = -.13), social support (gamma = .07), and self-efficacy (gamma = .11), and, in turn, changes in fatigue (beta = -.13), pain (beta = -.09), social support (beta = .18), and self-efficacy (beta = .10) were associated with a residual change in QOL.


CONCLUSION
The observed pattern of relationships supports the possibility that physical activity is indirectly associated with improved QOL through pathways that include fatigue, pain, social support, and self-efficacy in individuals with MS.