Systematic review of correlates and determinants of physical activity in persons with multiple sclerosis

Publication date: Available online 2 January 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): René Streber, Stefan Peters, Klaus Pfeifer
ObjectiveTo review the current evidence regarding correlates and determinants of physical activity (PA) in persons with multiple sclerosis (pwMS).Data SourcesPubmed and Scopus (1980 to January 2015) and reference lists of eligible studies.Study SelectionEligible studies (i) include adults with MS, (ii) have a cross-sectional or prospective observational design or (iii) examine the effect of a theory-based intervention trial on PA including a mediation analysis, (iv) apply a quantitative assessment of PA and correlates or proposed mediators and (v) are published in English or German.Data ExtractionTwo reviewers independently evaluated the risk of bias, extracted data and categorized variables according to the International Classification of Functioning, Disability and Health (ICF).Data SynthesisConsistency and the direction of associations were evaluated with a semi-quantitative approach. Fifty-six publications with data from observational studies and two interventional studies provided evidence for 86 different variables. Consistent correlates of PA were the disability level, walking limitations in particular, PA-related self-efficacy and self-regulation constructs as well as employment status and educational level. One interventional study provided evidence for a causal relationship between self-regulation and PA. However, 59 of 86 of all investigated variables in observational studies are based on one or two study findings, and the majority of results stem from cross-sectional designs.ConclusionsBeside the importance of the general disability level and walking limitations, the results highlight the importance of personal factors, such as PA-related self-efficacy, self-regulatory constructs and 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.



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