Mobility, walking and physical activity in persons with multiple sclerosis

Abstract

Objective:

The effect of differing levels of mobility and walking disability on level of physical activity (PA) performed in persons with multiple sclerosis (PwMS) is unknown. We aimed to quantify the association between mobility and walking impairment and PA levels in PwMS.

Methods:

We assessed mobility and walking impairment in >3000 North American Research Committee on Multiple Sclerosis registrants using the Patient Determined Disease Steps scale (score of 0–2 = no, 3–6 = moderate, ≥7 = severe impairment) and 12-Item Multiple Sclerosis Walking Scale (MSWS-12) score (divided into quartiles, score of 0–25 = least walking impairment, 76–100 = most). Level of PA performance (metabolic equivalent [MET] minutes/week) was estimated using the Godin Leisure-Time Exercise Questionnaire. Multivariable regression and general linear models were used to assess the impact of walking and mobility impairment on PA levels.

Results:

Moderate and severe mobility impairment was associated with performance of 183 and 319 fewer MET minutes/week and a 65% and 90% reduced odds of performing ≥500 MET minutes/week of PA compared to no impairment (mean ± SD: 447 ± 413 MET minutes/week) (p < 0.05 for all). Compared to the first quartile of MSWS-12 score (mean ± SD: 475 ± 401), the second, third and fourth quartiles were associated with performance of 127, 216 and 268 fewer MET minutes/week and 51%, 71% and 77% reduced odds of achieving ≥ 500 MET minutes/week of PA (p < 0.05 for each). Limitations of our study include possible recall bias, use of a patient-reported rather than objective outcome and assumptions made when calculating MET minutes.

Conclusion:

Mobility and walking impairment are associated with less physical activity in PwMS.

Keywords::

• Exercise
• Mobility
• Motor activity
• Multiple sclerosis
• Physical activity
• Walking

Transparency

Declaration of funding

This work was supported by Acorda Therapeutics Inc., Ardsley, NY, USA. The publication of these study results was not contingent on the sponsor’s approval or censorship of the manuscript.

Declaration of financial/other relationships

M.F.S. has disclosed that he is a paid employee and stockholder of Acorda Therapeutics Inc., Ardsley, NY, USA. C.I.C. has disclosed that he has received research funding from Acorda Therapeutics Inc., Ardsley, NY, USA. C.G.K., C.M.W. and D.M.S. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.