title: Exercise and quality of life among people with multiple sclerosis: looking beyond physical functioning to mental health and participation in life.
abstract: OBJECTIVE
  To describe the prevalence of exercise in a national sample of veterans with multiple sclerosis (MS) and the association of exercise with quality of life, including physical health, mental health, and participation restriction.
  
  
  METHODS
  Cross-sectional cohort study linking computerized medical records to mailed survey data from 1999.
  
  
  METHODS
  Veterans Health Administration.
  
  
  METHODS
  Veterans with MS (N=2995; 86.5% men) who received services in the Veterans Health Administration and returned survey questionnaires.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Demographic information, Veteran RAND 36-Item Health Survey (VR-36), self-reported exercise frequency.
  
  
  RESULTS
  Among all survey respondents with MS, only 28.6% (95% confidence interval, 26.9-30.2) endorsed any exercise. In adjusted logistic regression, exercise was associated with younger age, more education, living alone, lower levels of bodily pain, and higher body mass index. After adjusting for demographic variables and medical comorbidities, exercise was associated with better physical and mental health. People who exercised reported they had better social functioning and better role functioning (participation in life despite physical and emotional difficulties).
  
  
  CONCLUSIONS
  Exercise in veterans with MS is uncommon. In the context of chronic illness care, the identification of exercise patterns and promotion of physical activity may represent an important opportunity to improve mental health and quality of life among people with MS. Intervention should address factors associated with lower rates of exercise including age, education, and pain.
authors.affiliation: Veterans Affairs Puget Sound Health Care System, Rehabilitation Care Services, University of Washington, Seattle, WA 98108, USA. Aaron.Turner@va.gov
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kivlahan
authors.forename: Jodie K
authors.initials: JK
authors.lastname: Haselkorn
mesh_terms: D000203:Activities of Daily Living; D015897:Comorbidity; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000534:rehabilitation*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology; D010147:Pain Measurement; D011159:Population Surveillance; D011788:Quality of Life; D012919:Social Behavior; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*