title: Pathways between physical activity and quality of life in adults with multiple sclerosis.
abstract: OBJECTIVE
  This prospective study examined symptoms of depression, fatigue, pain, self-efficacy, and social support as possible intermediaries in the pathway between changes in physical activity and quality of life (QOL) across a 6-month period in persons with multiple sclerosis (MS).
  
  
  METHODS
  Adults with a definite diagnosis of MS wore an accelerometer for 7 days and then completed a battery of questionnaires at baseline (n = 292) and 6-months follow-up (n = 276). The data were analyzed using panel analysis and covariance modeling in Mplus 3.0.
  
  
  RESULTS
  The initial analysis indicated that change in physical activity was associated with a statistically significant and small residual change in QOL (beta = .07). The subsequent analysis indicated that change in physical activity was associated with residual changes in fatigue (gamma = -.17), pain (gamma = -.13), social support (gamma = .07), and self-efficacy (gamma = .11), and, in turn, changes in fatigue (beta = -.13), pain (beta = -.09), social support (beta = .18), and self-efficacy (beta = .10) were associated with a residual change in QOL.
  
  
  CONCLUSIONS
  The observed pattern of relationships supports the possibility that physical activity is indirectly associated with improved QOL through pathways that include fatigue, pain, social support, and self-efficacy in individuals with MS.
authors.affiliation: Department of Kinesiology and Community Health.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Motl
authors.affiliation: Department of Kinesiology and Community Health.
authors.forename: Edward
authors.initials: E
authors.lastname: McAuley
mesh_terms: D000328:Adult; D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D009103:Multiple Sclerosis; D011788:Quality of Life; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult