title: Changes of Motivational Variables in Patients with Multiple Sclerosis in an Exercise Intervention: Associations between Physical Performance and Motivational Determinants.
abstract: OBJECTIVE
  This study examines the effects of a standardized fitness training on motivational factors such as the intention to be physically active, self-efficacy, perceived barriers, counterstrategies, and exercise specific social support in patients with progressive Multiple Sclerosis (MS) and the relation of these factors to physical performance.
  
  
  METHODS
  Moderately disabled patients with secondary or primary progressive MS (Expanded Disability Status Scale of 4-6) were randomized to a training group or a waitlist control group. Patients completed on average 20 sessions of training tailored to their individual fitness at baseline over a course of 8-12 weeks. Motivational variables (stage of change according to the transtheoretical model (TTM), self-efficacy, perceived barriers, counterstrategies, and exercise specific social support) were assessed via questionnaires at baseline and follow-up.
  
  
  RESULTS
  Forty patients completed the trial. We found significant effects on stages of change (p = .016) and self-efficacy (p = .014) and a trend in counterstrategies (p = .08). Significant correlations between change of physical performance during the exercise training and change in the TTM, perceived barriers, and counterstrategies were detected.
  
  
  CONCLUSIONS
  This study indicates that tailored individual endurance training could stabilize self-efficacy and increase exercise motivation in patients with progressive MS. Motivational variables were related to the physical performance.
authors.affiliation: Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W26, 20246 Hamburg, Germany ; Competence Center for Sports and Exercise Medicine (Athleticum), University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Geertz
authors.affiliation: Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W26, 20246 Hamburg, Germany ; Competence Center for Sports and Exercise Medicine (Athleticum), University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Anna-Sophie
authors.initials: AS
authors.lastname: Dechow
authors.affiliation: Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W26, 20246 Hamburg, Germany ; Competence Center for Sports and Exercise Medicine (Athleticum), University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Patra
authors.affiliation: Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany ; Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Heesen
authors.affiliation: Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Gold
authors.affiliation: Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W26, 20246 Hamburg, Germany ; Competence Center for Sports and Exercise Medicine (Athleticum), University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Schulz
mesh_terms: D000328:Adult; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D009103:Multiple Sclerosis / Q000628:therapy*; D020377:Self Efficacy; D011795:Surveys and Questionnaires