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BMC Neurology
Published in: BMC Neurology 1/2014

Open Access 01-12-2014 | Research article

Physical activity in subjects with multiple sclerosis with focus on gender differences: a survey

Authors: Elisabeth Anens, Margareta Emtner, Lena Zetterberg, Karin Hellström

Published in: BMC Neurology | Issue 1/2014

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Abstract

Background

There is increasing research that examines gender-issues in multiple sclerosis (MS), but little focus has been placed on gender-issues regarding physical activity. The aim of the present study was to describe levels of physical activity, self-efficacy for physical activity, fall-related self-efficacy, social support for physical activity, fatigue levels and the impact of MS on daily life, in addition to investigating gender differences.

Methods

The sample for this cross-sectional cohort study consisted of 287 (84 men; 29.3%) adults with MS recruited from the Swedish Multiple Sclerosis Registry. A questionnaire was sent to the subjects consisting of the self-administrated measurements: Physical Activity Disability Survey – Revised, Exercise Self-Efficacy Scale, Falls- Efficacy Scale (Swedish version), Social Influences on Physical Activity, Fatigue Severity Scale and Multiple Sclerosis Impact Scale. Response rate was 58.2%.

Results

Men were less physically active, had lower self-efficacy for physical activity and lower fall-related self-efficacy than women. This was explained by men being more physically affected by the disease. Men also received less social support for physical activity from family members. The level of fatigue and psychological consequences of the disease were similar between the genders in the total sample, but subgroups of women with moderate MS and relapsing remitting MS experienced more fatigue than men.

Conclusions

Men were less physically active, probably a result of being more physically affected by the disease. Men being more physically affected explained most of the gender differences found in this study. However, the number of men in the subgroup analyses was small and more research is needed. A gender perspective should be considered in strategies for promoting physical activity in subjects with MS, e.g. men may need more support to be physically active.
Literature
1.
Koutsouraki E, Costa V, Baloyannis S: Epidemiology of multiple sclerosis in Europe: a review. Int Rev Psychiatry. 2010, 22 (1): 2-13. 10.3109/09540261003589216.CrossRefPubMed
2.
Ahlgren C, Oden A, Lycke J: High nationwide prevalence of multiple sclerosis in Sweden. Mult Scler. 2011, 17 (8): 901-908. 10.1177/1352458511403794.CrossRefPubMed
3.
Brain WR: Brain’s Clinical Neurology. 1978, Oxford: Oxford Univ Press, 5
4.
Martino G, Adorini L, Rieckmann P, Hillert J, Kallmann B, Comi G, Filippi M: Inflammation in multiple sclerosis: the good, the bad, and the complex. Lancet Neurol. 2002, 1 (8): 499-509. 10.1016/S1474-4422(02)00223-5.CrossRefPubMed
5.
Motl RW, Fernhall B, McAuley E, Cutter G: Physical activity and self-reported cardiovascular comorbidities in persons with multiple sclerosis: evidence from a cross-sectional analysis. Neuroepidemiology. 2011, 36 (3): 183-191. 10.1159/000327749.CrossRefPubMedPubMedCentral
6.
Marrie R, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T: Comorbidity, socioeconomic status and multiple sclerosis. Mult Scler. 2008, 14 (8): 1091-1098. 10.1177/1352458508092263.CrossRefPubMed
7.
Shephard RJ, Balady GJ: Exercise as cardiovascular therapy. Circulation. 1999, 99 (7): 963-972. 10.1161/01.CIR.99.7.963.CrossRefPubMed
8.
Motl RW, McAuley E, Snook EM: Physical activity and multiple sclerosis: a meta-analysis. Mult Scler. 2005, 11 (4): 459-463. 10.1191/1352458505ms1188oa.CrossRefPubMed
9.
Sandroff BM, Dlugonski D, Weikert M, Suh Y, Balantrapu S, Motl RW: Physical activity and multiple sclerosis: new insights regarding inactivity. Acta Neurol Scand. 2012, 126 (4): 256-262.CrossRefPubMed
10.
Motl RW, Goldman M: Physical inactivity, neurological disability, and cardiorespiratory fitness in multiple sclerosis. Acta Neurol Scand. 2011, 123 (2): 98-104.CrossRefPubMedPubMedCentral
11.
Beckerman H, de Groot V, Scholten MA, Kempen JC, Lankhorst GJ: Physical activity behavior of people with multiple sclerosis: understanding how they can become more physically active. Phys Ther. 2010, 90 (7): 1001-1013. 10.2522/ptj.20090345.CrossRefPubMed
12.
Romberg A, Virtanen A, Aunola S, Karppi SL, Karanko H, Ruutiainen J: Exercise capacity, disability and leisure physical activity of subjects with multiple sclerosis. Mult Scler. 2004, 10 (2): 212-218. 10.1191/1352458504ms1001oa.CrossRefPubMed
13.
Henriksson J, Sundberg CJ: 1. Genereal Effects of Physical Activity. InPhysical Activity in the Prevention and Treatment of Disease, ProfessionalAssociations for Physical Activity, Sweden and Swedish National Institute ofPublic Health. Stockholm: Elanders; 2010:11–40.
14.
15.
Bize R, Johnson JA, Plotnikoff RC: Physical activity level and health-related quality of life in the general adult population: a systematic review. Prev Med. 2007, 45 (6): 401-415. 10.1016/j.ypmed.2007.07.017.CrossRefPubMed
16.
Einarsson U, Hillert J: 35. Multiple Sclerosis. In Physical Activity in thePrevention and Treatment of Disease, Professional Associations for PhysicalActivity, Sweden and Swedish National Institute of Public Health. Edited bySundberg CJ. Stockholm: Elanders; 2010:464–480
17.
Rietberg MB, Brooks D, Uitdehaag BMJ, Kwakkel G: Exercise therapy for multiple sclerosis (Review). Cochrane Database Syst Rev. 2009, 4
18.
Cakt BD, Nacir B, Genc H, Saracoglu M, Karagoz A, Erdem HR, Ergun U: Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study. Am J Phys Med Rehabil. 2010, 89 (6): 446-457. 10.1097/PHM.0b013e3181d3e71f.CrossRefPubMed
19.
Snook EM, Motl RW: Effect of exercise training on walking mobility in multiple sclerosis: a meta-analysis. Neurorehabil Neural Repair. 2009, 23 (2): 108-116.CrossRefPubMed
20.
Motl RW, Gosney JL: Effect of exercise training on quality of life in multiple sclerosis: a meta-analysis. Mult Scler. 2008, 14 (1): 129-135. 10.1177/1352458507080464.CrossRefPubMed
21.
Sherwood NE, Jeffery RW: The behavioral determinants of exercise: implications for physical activity interventions. Annu Rev Nutr. 2000, 20: 21-44. 10.1146/annurev.nutr.20.1.21.CrossRefPubMed
22.
Lee LL, Arthur A, Avis M: Using self-efficacy theory to develop interventions that help older people overcome psychological barriers to physical activity: a discussion paper. Int J Nurs Stud. 2008, 45 (11): 1690-1699. 10.1016/j.ijnurstu.2008.02.012.CrossRefPubMed
23.
Stroud N, Minahan C, Sabapathy S: The perceived benefits and barriers to exercise participation in persons with multiple sclerosis. Disabil Rehabil. 2009, 31 (26): 2216-2222. 10.3109/09638280902980928.CrossRefPubMed
24.
Motl RW, McAuley E, Doerksen S, Hu L, Morris KS: Preliminary evidence that self-efficacy predicts physical activity in multiple sclerosis. Int J Rehabil Res. 2009, 32 (3): 260-263. 10.1097/MRR.0b013e328325a5ed.CrossRefPubMed
25.
Kayes NM, McPherson KM, Schluter P, Taylor D, Leete M, Kolt GS: Exploring the facilitators and barriers to engagement in physical activity for people with multiple sclerosis. Disabil Rehabil. 2011, 33 (12): 1043-1053. 10.3109/09638288.2010.520801.CrossRefPubMed
26.
Dlugonski D, Wojcicki TR, McAuley E, Motl RW: Social cognitive correlates of physical activity in inactive adults with multiple sclerosis. Int J Rehabil Res. 2011, 34 (2): 115-120. 10.1097/MRR.0b013e328342ddc0.CrossRefPubMed
27.
Bandura A: Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977, 84 (2): 191-215.CrossRefPubMed
28.
Bandura A: Social Foundations of Thought and Action: A Social Cognitive Theory. 1986, Englewood Cliffs, NJ: Prentice Hall
29.
Tinetti ME, Richman D, Powell L: Falls efficacy as a measure of fear of falling. J Gerontol. 1990, 45 (6): 239-243. 10.1093/geronj/45.6.P239.CrossRef
30.
Nilsagard Y, Lundholm C, Denison E, Gunnarsson LG: Predicting accidental falls in people with multiple sclerosis – a longitudinal study. Clin Rehabil. 2009, 23 (3): 259-269. 10.1177/0269215508095087.CrossRefPubMed
31.
Peterson EW, Cho CC, Finlayson ML: Fear of falling and associated activity curtailment among middle aged and older adults with multiple sclerosis. Mult Scler. 2007, 13 (9): 1168-1175. 10.1177/1352458507079260.CrossRefPubMed
32.
Matsuda PN, Shumway-Cook A, Ciol MA, Bombardier CH, Kartin DA: Understanding falls in multiple sclerosis: association of mobility status, concerns about falling, and accumulated impairments. Phys Ther. 2012, 92 (3): 407-415. 10.2522/ptj.20100380.CrossRefPubMed
33.
Merkelbach S, Schulz H, Kolmel HW, Gora G, Klingelhofer J, Dachsel R, Hoffman F, Polzer U: Fatigue, sleepiness, and physical activity in patients with multiple sclerosis. J Neurol. 2011, 258 (1): 74-79. 10.1007/s00415-010-5684-3.CrossRefPubMed
34.
Plow MA, Resnik L, Allen SM: Exploring physical activity behaviour of persons with multiple sclerosis: a qualitative pilot study. Disabil Rehabil. 2009, 31 (20): 1652-1665. 10.1080/09638280902738375.CrossRefPubMedPubMedCentral
35.
Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW: Correlates of physical activity: why are some people physically active and others not?. Lancet. 2012, 380 (9838): 258-271. 10.1016/S0140-6736(12)60735-1.CrossRefPubMed
36.
Pan SY, Cameron C, Desmeules M, Morrison H, Craig CL, Jiang X: Individual, social, environmental, and physical environmental correlates with physical activity among Canadians: a cross-sectional study. BMC Public Health. 2009, 9: 21-10.1186/1471-2458-9-21.CrossRefPubMedPubMedCentral
37.
Sjogren K, Stjernberg L: A gender perspective on factors that influence outdoor recreational physical activity among the elderly. BMC Geriatr. 2010, 10: 34-10.1186/1471-2318-10-34.CrossRefPubMedPubMedCentral
38.
Kim HK, Kim MJ, Park CG, Kim HO: Gender differences in physical activity and its determinants in rural adults in Korea. J Clin Nurs. 2010, 19 (5–6): 876-883.CrossRefPubMed
39.
Jobin C, Larochelle C, Parpal H, Coyle PK, Duquette P: Gender issues in multiple sclerosis: an update. Womens Health (Lond Engl). 2010, 6 (6): 797-820. 10.2217/whe.10.69.CrossRef
40.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB: Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000, 25 (24): 3186-3191. 10.1097/00007632-200012150-00014.CrossRef
41.
Hilton A, Skrutkowski M: Translating instruments into other languages: development and testing processes. Cancer Nurs. 2002, 25 (1): 1-7. 10.1097/00002820-200202000-00001.CrossRefPubMed
42.
Kayes NM, Schluter PJ, McPherson KM, Taylor D, Kolt GS: The Physical Activity and Disability Survey – Revised (PADS-R): an evaluation of a measure of physical activity in people with chronic neurological conditions. Clin Rehabil. 2009, 23 (6): 534-543. 10.1177/0269215508101750.CrossRefPubMed
43.
Rimmer JH, Riley BB, Rubin SS: A new measure for assessing the physical activity behaviors of persons with disabilities and chronic health conditions: the Physical Activity and Disability Survey. Am J Health Promot. 2001, 16 (1): 34-42. 10.4278/0890-1171-16.1.34.CrossRefPubMed
44.
Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A: The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure. Brain. 2001, 124 (Pt 5): 962-973.CrossRefPubMed
45.
Riazi A, Hobart JC, Lamping DL, Fitzpatrick R, Thompson AJ: Multiple Sclerosis Impact Scale (MSIS-29): reliability and validity in hospital based samples. J Neurol Neurosurg Psychiatry. 2002, 73 (6): 701-704. 10.1136/jnnp.73.6.701.CrossRefPubMedPubMedCentral
46.
Forbes A, While A, Mathes L, Griffiths P: Health problems and health-related quality of life in people with multiple sclerosis. Clin Rehabil. 2006, 20 (1): 67-78. 10.1191/0269215506cr880oa.CrossRefPubMed
47.
Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD: The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989, 46 (10): 1121-1123. 10.1001/archneur.1989.00520460115022.CrossRefPubMed
48.
Mattsson M, Moller B, Lundberg I, Gard G, Bostrom C: Reliability and validity of the Fatigue Severity Scale in Swedish for patients with systemic lupus erythematosus. Scand J Rheumatol. 2008, 37 (4): 269-277. 10.1080/03009740801914868.CrossRefPubMed
49.
Valko PO, Bassetti CL, Bloch KE, Held U, Baumann CR: Validation of the fatigue severity scale in a Swiss cohort. Sleep. 2008, 31 (11): 1601-1607.PubMedPubMedCentral
50.
Kroll T, Kehn M, Ho PS, Groah S: The SCI Exercise Self-Efficacy Scale (ESES): development and psychometric properties. Int J Behav Nutr Phys Act. 2007, 4: 34-10.1186/1479-5868-4-34.CrossRefPubMedPubMedCentral
51.
Hellstrom K, Lindmark B: Fear of falling in patients with stroke: a reliability study. Clin Rehabil. 1999, 13 (6): 509-517. 10.1191/026921599677784567.CrossRefPubMed
52.
Hellstrom K, Lindmark B, Fugl-Meyer A: The Falls-Efficacy Scale, Swedish version: does it reflect clinically meaningful changes after stroke?. Disabil Rehabil. 2002, 24 (9): 471-481. 10.1080/09638280110105259.CrossRefPubMed
53.
Chogahara M: A multidimensional scale for assessing positive and negative social influences on physical activity in older adults. J Gerontol B Psychol Sci Soc Sci. 1999, 54 (6): S356-S367.CrossRefPubMed
54.
Driver SJ: Psychometric properties and analysis of the physical activity Social Influence Scale for adults with traumatic brain injuries. Adapt Phys Activ Q. 2007, 24 (2): 160-177.PubMed
55.
Vandervelde L, Van den Bergh PY, Goemans N, Thonnard JL: ACTIVLIM: a Rasch-built measure of activity limitations in children and adults with neuromuscular disorders. Neuromuscul Disord. 2007, 17 (6): 459-469. 10.1016/j.nmd.2007.02.013.CrossRefPubMed
56.
Vandervelde L, Van den Bergh PY, Goemans N, Thonnard JL: Activity limitations in patients with neuromuscular disorders: a responsiveness study of the ACTIVLIM questionnaire. Neuromuscul Disord. 2009, 19 (2): 99-103. 10.1016/j.nmd.2008.11.004.CrossRefPubMed
57.
Groll DL, To T, Bombardier C, Wright JG: The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol. 2005, 58 (6): 595-602. 10.1016/j.jclinepi.2004.10.018.CrossRefPubMed
58.
59.
Abel T, Graf N, Niemann S: Gender bias in the assessment of physical activity in population studies. Soz Praventivmed. 2001, 46 (4): 268-272. 10.1007/BF01593182.CrossRefPubMed
60.
Kayes NM, McPherson KM, Taylor D, Schluter PJ, Wilson BJ, Kolt GS: The Physical Activity and Disability Survey (PADS): reliability, validity and acceptability in people with multiple sclerosis. Clin Rehabil. 2007, 21 (7): 628-639. 10.1177/0269215507075516.CrossRefPubMed
61.
Hadjimichael O, Vollmer T, Oleen-Burkey M: Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey. Health Qual Life Outcomes. 2008, 6: 100-10.1186/1477-7525-6-100.CrossRefPubMedPubMedCentral
62.
Mollaoglu M, Ustun E: Fatigue in multiple sclerosis patients. J Clin Nurs. 2009, 18 (9): 1231-1238. 10.1111/j.1365-2702.2008.02733.x.CrossRefPubMed
63.
Asch DA, Jedrziewski MK, Christakis NA: Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997, 50 (10): 1129-1136. 10.1016/S0895-4356(97)00126-1.CrossRefPubMed
64.
Suh Y, Weikert M, Dlugonski D, Balantrapu S, Motl RW: Social cognitive variables as correlates of physical activity in persons with multiple sclerosis: findings from a longitudinal, observational study. Behav Med. 2011, 37 (3): 87-94. 10.1080/08964289.2011.603768.CrossRefPubMed
65.
Hing CB, Smith TO, Hooper L, Song F, Donell ST: A review of how to conduct a surgical survey using a questionnaire. Knee. 2011, 18 (4): 209-213. 10.1016/j.knee.2010.10.003.CrossRefPubMed
66.
Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT: Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012, 380 (9838): 219-229. 10.1016/S0140-6736(12)61031-9.CrossRefPubMedPubMedCentral
Metadata
Title
Physical activity in subjects with multiple sclerosis with focus on gender differences: a survey
Authors
Elisabeth Anens
Margareta Emtner
Lena Zetterberg
Karin Hellström
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2014
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-14-47

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