Predictors of exercise participation are different depending on ambulatory status among older people with multiple sclerosis
A peer-reviewed article of this Preprint also exists.
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Abstract
Background: Exercise at moderate intensity may confer neuroprotective benefits in multiple sclerosis (MS), however it has been reported that people with MS (PwMS) exercise less than national guideline recommendations. We aimed to determine predictors of moderate to vigorous exercise among a sample of older Canadians with MS who were divided into ambulatory (less disabled) and non-ambulatory (more disabled) groups. Methods: We analysed data collected as part of a national survey of health, lifestyle and aging with MS. Participants (n=743) were Canadians over 55 years of age with MS for 20 or more years. We identified ‘a priori’ variables (demographic, personal, socioeconomic, physical health, exercise history and health care support) that may predict exercise at moderate to vigorous intensity (>6.75 metabolic equivalent hours/week). Predictive variables were entered into stepwise logistic regression, adding and deleting correlated variables until best fit was achieved for each of the two groups (ambulatory and non-ambulatory). Results: Seventy-seven percent (77%) of participants in the ambulatory group (n=351) and 35% of the non-ambulatory group (n=392) were classified as exercisers. In the ambulatory group, exercise predictors included degree of disability (OR 1.95, 95%CI 1.18-3.25), depressive symptoms (OR 0.51, 95%CI 0.29-0.89) and perseverance (OR 1.8, 95%CI 1.04-3.10). In the non-ambulatory group, exercise predictors included degree of disability (OR 5.3, 95%CI 3.22-8.71) and perseverance (OR 2.1, 95%CI 1.27-3.54). It was also notable that the factors, age, gender, years with MS, co-morbid conditions, social support, health care support and financial status were not predictive of exercise. Conclusions: This is the first examination of exercise and exercise predictors among older, more disabled PwMS. Disability and perseverance are major predictors of exercise participation (at moderate to vigorous levels) in both ambulatory and non-ambulatory groups. Presence of depressive symptoms was only predictive in the ambulatory group. Our results suggest that more exercise options must be developed for people with greater disability. Perseverance and depression are both characteristics that are modifiable and are potential targets for exercise adherence interventions.
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2015. Predictors of exercise participation are different depending on ambulatory status among older people with multiple sclerosis. PeerJ PrePrints 3:e786v1 https://doi.org/10.7287/peerj.preprints.786v1note This preprint is not peer-reviewed. You may wish to reference the subsequent peer-reviewed version of this article.
Author comment
This paper has been submitted to PeerJ for review. The Health Lifestyle and Aging with MS Canadian Consortium comprises the following individuals: John D. Fisk PhD, A. Dessa Sadovnick PhD, Paul O’Connor, MD, FRCPC, Sarah A. Morrow, MD, FRCPC, Luanne M. Metz MD, FRCPC, Penelope Smyth MD, FRCPC, Nancy Mayo, PhD, Ruth Ann Marrie, MD, PhD, Penelope W. Alderdice PhD, Mark Stefanelli MD FRCPC, Marshall Godwin, MD
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Competing Interests
Dr. Michelle Ploughman was supported by a Canadian Institutes for Health Research (Institute of Aging) Postdoctoral Fellowship. Her research was supported by the Newfoundland and Labrador Centre for Applied Health Research, Health Care Foundation, and Physiotherapy Foundation of Canada. She is also an academic editor of PeerJ.
Chelsea Harris, Elizabeth Wallack, Olivia Drodge, Serge Beaulieu, Stephen Hogan, Dr. Penelope Alderdice, Dr. A. Dessa Sadovnick, Dr. Luanne M. Metz, and Dr. Nancy Mayo have no disclosures or conflicts of interest to report.
Dr. John Fisk is the Director of the endMS Atlantic Regional Research and Training Centre, which is funded by the Multiple Sclerosis Society of Canada. He receives research funding from the Canadian Institutes of Health Research (CIHR) and in the past has received grants, honoraria and consultation fees from Astra- Zeneca, Bayer, Biogen-Idec Canada, Heron Evidence Development Limited, Hoffmann-La Roche, MAPI Research Trust, Novartis, Sanofi-Aventis, Serono Canada, and QualityMetric Inc.
Dr. Paul O'Connor has received consulting fees and/or research support for MS trials from Actelion, Bayer, Biogen Idec, BioMS, Cognosci, Daiichi Sankyo, EMD Serono, Genentech, Genmab, Novartis, Roche, Sanofi Aventis, Teva and Warburg Pincus.
Dr. Sarah Morrow has received research support from Biogen Idec and Novartis Canada, and received support for speaking engagement and advisory panels for Bayer, Biogen Idec, EMDSerono and Teva Neurosciences and Novartis Canada.
Dr. Penelope Smyth has served on scientific advisory boards for Novartis an EMD Serono. She has received funding for travel to pharmaceutically sponsored events by EMD Serono. She has received honoraria for speaking, facilitating and chairing from Novartis and EMD Serono as well as from the MS Society of Canada. She has received academic research support for medical education research from the Arnold P. Gold Foundation, and the Teaching and Learning Enhancement Fund from the University of Alberta.
Dr. Ruth Ann Marrie receives research funding from: Canadian Institutes of Health Research, Multiple Sclerosis Society of Canada, Multiple Sclerosis Scientific Research Foundation, Rx & D Health Research Foundation, and has conducted clinical trials funded by Sanofi-Aventis.
Dr. Katherine Knox received grant funding from Saskatoon City Hospital Foundation and MS Society of Canada, educational CME event grant funding from Bayer HealthCare Pharmaceuticals, honoraria /travel grant from Biogen and Teva. She was a member of the CIHR and MS Society of Canada Scientific Expert Working Group on CCSVI and MS.
Dr. Mark Stefanelli has served on advisory boards for Biogen Idec and Novartis and has been provided speaker/travel support by Teva Neuroscience. His research was supported by Genzyme and Biogen.
Dr. Marshall Godwin’s research is funded by the Canadian Institutes of Health Research, Public Health Agency of Canada, Health Canada, and Newfoundland and Labrador Centre for Applied Health Research. He reports no conflicts of interest.
Author Contributions
Michelle Ploughman conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper.
Chelsea Harris conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper, ethics applications, recruitment, data entry, data cleaning.
Elizabeth M Wallack conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper.
Olivia Drodge conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper.
Serge Beaulieu performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, development of database management system.
Stephen Hogan performed the experiments, contributed reagents/materials/analysis tools, ethics applications, recruitment, data entry, data cleaning.
Human Ethics
The following information was supplied relating to ethical approvals (i.e., approving body and any reference numbers):
Health Lifestyle and Aging with MS Study
Ethics boards -
Human Investigation Committee, Memorial University and Patient Research Ethics Committee, Eastern Health Authority, St. John’s NL Canada HIC#10.06 -
Capital Health Research Ethics Board, Halifax NS Canada -
McGill University Health Centre and Montreal General Hospital Research Ethics Office, Montreal QC Canada -
Health Sciences Research Ethics Board, University of Western Ontario, London ON Canada -
Research Ethics Board, St. Michael’s Hospital, Toronto ON Canada -
Research Ethics Board. Bannatyne campus, University of Manitoba, Winnipeg MB Canada -
Behavioural Research Ethics Board, University of Saskatchewan, Saskatoon SK Canada -
Health Research Ethics Board, University of Alberta, Alberta Health Services, Edmonton AB, Canada -
Behavioural Research Ethics Board, University of British Columbia, Vancouver BC, Canada
Funding
This study was funded by a Canadian Institutes of Health Research (CIHR) Post-doctoral Fellowship for M.P., a Newfoundland and Labrador Centre for Applied Health Research, Healthy Aging Research Program Project Grant, the Health Care Foundation (Eastern Health Authority) Research Project Grant, and the Physiotherapy Foundation of Canada Alberta Research Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
