Predictors of Adherence to Exercise Goals in Patients with Multiple Sclerosis.
|Title||Predictors of Adherence to Exercise Goals in Patients with Multiple Sclerosis.|
|Publication Type||Journal Article|
|Authors||Cline MJ, LaRotonda CJ, Wadhwani R, Bombardier CH, Ehde DM, Kraft GH, Bowen JD|
|Journal||International Journal of MS Care|
Background: Exercise is important in managing multiple sclerosis (MS) symptoms. However, little is known about factors that contribute to adherence to exercise regimens. Methods: Sequential MS patients (N = 119) who were ambulatory without aid were eligible for inclusion. Participants were randomly assigned to receive motivational exercise counseling and exercise goal setting or to a usual care condition. Baseline characteristics were assessed to determine factors that might potentially influence adherence with exercise goals. Subjects were evaluated for fatigue (modified Fatigue Impact Scale), pain (Brief Pain Inventory), depression (Center for Epidemiologic Studies Depression Scale), disability (MS Functional Composite), and Motivational Readiness to Exercise Scale. Results: Of 49 evaluable subjects in the exercise condition, 81.2% were women, 98% white, 83.7% had relapsing MS, mean age was 51.5 ± 10.2 years, and mean time since diagnosis was 10.7 ± 6.7 years. Mean timed 25-foot walk was 5.00 ± 1.34 seconds. Mean baseline exercise was 71.5 ± 68.0 min/week. Exercise goals averaged 158.0 ± 96.4 min/week. Actual exercise was 209.3 ± 186.9 at 2 weeks and 301.1 ± 355.2 min/week. At 2 months, exercise goals were met by 2.2%, exceeded by 60.0%, and not met by 37.8%. Actual exercise at 2 months was not statistically correlated with prestudy exercise behavior (P = .650, R = 0.068), fatigue (P = .690, R = 0.060), depression (P = .324, R = 0.150), pain (P = .518, R = 0.125), 25-foot timed gait (P = .635, R = 0.068), marital status (P = .741, R = 0.049), education (P = .981, R = 0.005), or employment (P = .162, R = 0.207). Conclusions: Motivational counseling successfully engages MS patients in exercise programs over a 2-month period. Baseline patient characteristics are not strongly associated with the success of participation in exercise. Patients can successfully exercise despite disability, fatigue, depression, pain, or prior exercise activity.