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Systematic Review of Correlates and Determinants of Physical Activity in Persons With Multiple Sclerosis

  • René Streber
    Affiliations
    Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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  • Stefan Peters
    Affiliations
    Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany

    Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
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  • Klaus Pfeifer
    Correspondence
    Corresponding author Klaus Pfeifer, PhD, Institute of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstrasse 123b, 91058 Erlangen, Germany.
    Affiliations
    Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
    Search for articles by this author
Published:January 02, 2016DOI:https://doi.org/10.1016/j.apmr.2015.11.020

      Abstract

      Objective

      To review the current evidence regarding correlates and determinants of physical activity (PA) in persons with multiple sclerosis (pwMS).

      Data Sources

      PubMed and Scopus (1980 to January 2015) and reference lists of eligible studies.

      Study Selection

      Eligible studies include adults with multiple sclerosis; have a cross-sectional or prospective observational design; or examine the effect of a theory-based intervention trial on PA, including a mediation analysis. Eligible studies also apply a quantitative assessment of PA and correlates or proposed mediators and are published in English or German language.

      Data Extraction

      Two reviewers independently evaluated the risk of bias, extracted data, and categorized variables according to the International Classification of Functioning, Disability and Health.

      Data Synthesis

      Consistency and the direction of associations were evaluated with a semiquantitative approach. Fifty-six publications with data from observational studies and 2 interventional studies provided evidence for 86 different variables. Consistent correlates of PA were the disability level, walking limitations in particular, PA-related self-efficacy, self-regulation constructs, employment status, and educational level. One interventional study provided evidence for a causal relation between self-regulation and PA. However, 59 of the 86 investigated variables in observational studies are based on 1 or 2 study findings, and most results stem from cross-sectional designs.

      Conclusions

      Beside the importance of the general disability level and walking limitations, the results highlight the importance of personal factors (eg, PA-related self-efficacy, self-regulatory constructs, sociodemographic factors). Limitations and implications of the current review are discussed. Research that is more rigorous is needed to better understand what affects PA in pwMS.

      Keywords

      List of abbreviations:

      ICF (International Classification of Functioning, Disability and Health), MS (multiple sclerosis), PA (physical activity), pwMS (persons with multiple sclerosis), RoB (risk of bias), RRMS (relapsing-remitting multiple sclerosis)
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