Transitional shifts in exercise behavior among women with multiple sclerosis.
BACKGROUND
While physical activity is recommended to reduce symptomology associated with multiple sclerosis (MS) little has been done to explore the potential usefulness of theoretical models of exercise behavior change in individuals with MS. Based on the success of the transtheoretical model of exercise behavior change (TTM) in the general population and early promising results in those with MS, the TTM was tested in a sample of women with MS over a 1-year period, to examine its usefulness and the effect of TTM constructs on MS-related symptoms.


METHODS
This was a longitudinal study conducted over a 1-year period. Ambulatory women (N=86) with MS completed questionnaires assessing exercise behavior, TTM constructs, MS-related quality of life, pain, and fatigue at baseline and after 1 year. After categorization into transitional shift patterns reflecting naturally occurring exercise behavior change over the year, a series of mixed-design analyses of variance were conducted to examine TTM predictions and the relationship of the transitional shift patterns to MS-related quality of life, pain, and fatigue.


RESULTS
Significant interactions between transitional shift patterns and time (P < .05) indicated that changes in behavioral and cognitive processes of change and in self-efficacy were consistent with TTM predictions. Significant differences (P < .05) between the transitional shift groups in pain and fatigue in expected directions were also found.


CONCLUSIONS
Results supported the TTM proposed relationships, indicating the model's potential for motivating individuals with MS to increase their physical activity. Findings also support the notion that physical activity is useful in reducing MS-related symptoms and that lifestyle types of physical activity may be as useful as structured exercise in bringing about these outcomes.
School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182-7251, USA. slevy@mail.sdsu.edu
Susan S
SS
Levy
Kin-Kit
KK
Li
Bradley J
BJ
Cardinal
Gianni F
GF
Maddalozzo
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005221:Fatigue / Q000209:etiology; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D020377:Self Efficacy; D011795:Surveys and Questionnaires