title: Physical activity, self-efficacy, and health-related quality of life in persons with multiple sclerosis: analysis of associations between individual-level changes over one year.
abstract: BACKGROUND
  Physical activity and self-efficacy represent behavioral and psychological factors, respectively, that are compromised in persons with multiple sclerosis (MS), but might be modifiable through intervention and result in better health-related quality of life (HRQOL).
  
  
  OBJECTIVE
  The present study adopted a panel research design and examined the associations between individual-level changes in physical activity, self-efficacy, and HRQOL over a one-year period in persons with MS.
  
  
  METHODS
  The sample consisted of 269 persons with relapsing-remitting MS who completed the Godin Leisure-Time Questionnaire (GLTEQ), Multiple Sclerosis Self-Efficacy (MSSE) Scale, and Multiple Sclerosis Quality of Life-29 (MSIS-29) Scale on two occasions that were separated by 1 year. The data were analyzed using panel analysis in Mplus 3.0.
  
  
  RESULTS
  The initial panel analysis indicated that individual-level change in physical activity was associated with individual-level change in both physical and psychological HRQOL. The subsequent panel analysis indicated that (a) individual-level change in self-efficacy for functioning with MS was associated with individual-level change in physical HRQOL, whereas individual-level change in self-efficacy for control was associated with individual-level change in psychological HRQOL; (b) individual-level change in self-efficacy for functioning with MS, but not self-efficacy for control, mediated the association between individual-level change in physical activity and physical HRQOL; and (c) individual-level change in self-efficacy for controlling MS was the strongest predictor of individual-level change in HRQOL.
  
  
  CONCLUSIONS
  Physical activity and self-efficacy both might be important targets of subsequent behavioral and self-management interventions for improving the HRQOL of persons with MS, although self-efficacy is seemingly more important than physical activity.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois, 233 Freer Hall, Urbana, IL 61801, USA. robmotl@illinois.edu
authors.forename: Robert W
authors.initials: RW
authors.lastname: Motl
authors.forename: Edward
authors.initials: E
authors.lastname: McAuley
authors.forename: Daniel
authors.initials: D
authors.lastname: Wynn
authors.forename: Brian
authors.initials: B
authors.lastname: Sandroff
authors.forename: Yoojin
authors.initials: Y
authors.lastname: Suh
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009043:Motor Activity; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors