title: 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.
  
  
  CONCLUSIONS
  Mobility and walking impairment are associated with less physical activity in PwMS.
authors.affiliation: Department of Pharmacy Practice, University of Connecticut School of Pharmacy , Storrs, CT , USA.
authors.forename: Christine G
authors.initials: CG
authors.lastname: Kohn
authors.forename: Craig I
authors.initials: CI
authors.lastname: Coleman
authors.forename: C
authors.initials: C
authors.lastname: Michael White
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Sidovar
authors.forename: Diana M
authors.initials: DM
authors.lastname: Sobieraj
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D015444:Exercise; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000523:psychology; D015999:Multivariate Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016138:Walking
keywords: Exercise; Mobility; Motor activity; Multiple sclerosis; Physical activity; Walking