Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 3 , Pages 420-428, March 2009

Exercise and Quality of Life Among People With Multiple Sclerosis: Looking Beyond Physical Functioning to Mental Health and Participation in Life

  • Aaron P. Turner, PhD

      Affiliations

    • Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA
    • Veterans Affairs Multiple Sclerosis Center of Excellence West, University of Washington, Seattle, WA
    • Veterans Affairs Center of Excellence in Substance Abuse Treatment and Education, University of Washington, Seattle, WA
    • Department of Rehabilitation Medicine, University of Washington, Seattle, WA
    • Corresponding Author InformationReprint requests to Aaron P. Turner, PhD, VA Puget Sound Health Care System, Rehabilitation Care Services, S-117, 1660 S Columbian Way, Seattle, WA, 98108
  • ,
  • Daniel R. Kivlahan, PhD

      Affiliations

    • Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA
    • Veterans Affairs Center of Excellence in Substance Abuse Treatment and Education, University of Washington, Seattle, WA
    • Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
  • ,
  • Jodie K. Haselkorn, MD, MPH

      Affiliations

    • Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA
    • Veterans Affairs Multiple Sclerosis Center of Excellence West, University of Washington, Seattle, WA
    • Department of Rehabilitation Medicine, University of Washington, Seattle, WA
    • Department of Epidemiology, University of Washington, Seattle, WA

Abstract 

Turner AP, Kivlahan DR, Haselkorn JK. Exercise and quality of life among people with multiple sclerosis: looking beyond physical functioning to mental health and participation in life.

Objective

To describe the prevalence of exercise in a national sample of veterans with multiple sclerosis (MS) and the association of exercise with quality of life, including physical health, mental health, and participation restriction.

Design

Cross-sectional cohort study linking computerized medical records to mailed survey data from 1999.

Setting

Veterans Health Administration.

Participants

Veterans with MS (N=2995; 86.5% men) who received services in the Veterans Health Administration and returned survey questionnaires.

Interventions

Not applicable.

Main Outcome Measures

Demographic information, Veteran RAND 36-Item Health Survey (VR-36), self-reported exercise frequency.

Results

Among all survey respondents with MS, only 28.6% (95% confidence interval, 26.9–30.2) endorsed any exercise. In adjusted logistic regression, exercise was associated with younger age, more education, living alone, lower levels of bodily pain, and higher body mass index. After adjusting for demographic variables and medical comorbidities, exercise was associated with better physical and mental health. People who exercised reported they had better social functioning and better role functioning (participation in life despite physical and emotional difficulties).

Conclusions

Exercise in veterans with MS is uncommon. In the context of chronic illness care, the identification of exercise patterns and promotion of physical activity may represent an important opportunity to improve mental health and quality of life among people with MS. Intervention should address factors associated with lower rates of exercise including age, education, and pain.

Key Words: Exercise, Health status, Mental health, Multiple sclerosis, Quality of life, Rehabilitation

List of Abbreviations: BMI, body mass index, CI, confidence interval, ICF, International Classification of Functioning, Disability and Health, LHS, Large Health Survey, MS, multiple sclerosis, OR, odds ratio, QOL, quality of life, SF-36, 36-Item Short Form Health Survey version 1.0, VA, Veterans Affairs, VR-36, Veteran RAND 36-Item Health Survey

 

 Supported by Department of Veterans Affairs Rehabilitation Research and Development Service Career Development Award (grant no. B4927W), Veterans Affairs Center of Excellence in Substance Abuse Treatment and Education, the Veterans Affairs Multiple Sclerosis Center of Excellence West, and the Veterans Affairs Office of Quality and Performance.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)01674-2

doi:10.1016/j.apmr.2008.09.558

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 3 , Pages 420-428, March 2009