title: Exploring factors related to physical activity in cervical dystonia.
abstract: BACKGROUND
  People with disabilities have reported worse health status than people without disabilities and receiving fewer preventive health services such as counseling around exercise habits. This is noteworthy considering the negative consequences associated with physical inactivity. No research has been conducted on physical activity in cervical dystonia (CD), despite its possible major impact on self-perceived health and disability. Considering the favorable consequences associated with physical activity it is important to know how to promote physical activity behavior in CD. Knowledge of variables important for such behavior in CD is therefore crucial. The aim of this study was to explore factors related to physical activity in individuals with cervical dystonia.
  
  
  METHODS
  Subjects included in this cross-sectional study were individuals diagnosed with CD and enrolled at neurology clinics (n = 369). Data was collected using one surface mailed self-reported questionnaire. Physical activity was the primary outcome variable, measured with the Physical Activity Disability Survey. Secondary outcome variables were: impact of dystonia measured with the Cervical Dystonia Impact Scale; fatigue measured with the Fatigue Severity Scale; confidence when carrying out physical activity measured with the Exercise Self-Efficacy Scale; confidence in performing daily activities without falling measured with the Falls Efficacy Scale; enjoyment of activity measured with Enjoyment of Physical Activity Scale, and social influences on physical activity measured with Social Influences on Physical Activity in addition to demographic characteristics such as age, education level and employment status.
  
  
  RESULTS
  The questionnaire was completed by 173 individuals (47% response rate). The multivariate association between related variables and physical activity showed that employment, self-efficacy for physical activity, education level and consequences for daily activities explained 51% of the variance in physical activity (Adj R 0.51, F (5, 162) = 35.611, p = 0.000). Employment and self-efficacy for physical activity contributed most strongly to the association with physical activity.
  
  
  CONCLUSIONS
  Considering the favorable consequences associated with physical activity it could be important to support the individuals with CD to remain in work and self-efficacy to physical activity as employment and self-efficacy had significant influence on physical activity level. Future research is needed to evaluate causal effects of physical activity on consequences related to CD.
authors.affiliation: Department of Neuroscience, Section of Physiotherapy, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden. Lena.Zetterberg@neuro.uu.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Zetterberg
authors.affiliation: Department of Neuroscience, Section of Physiotherapy, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden. Charlotte.Urell@neuro.uu.se.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Urell
authors.affiliation: Department of Neuroscience, Section of Physiotherapy, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden. Elisabeth.Anens@neuro.uu.se.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Anens
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D020377:Self Efficacy; D014103:Torticollis / Q000503:physiopathology* / Q000523:psychology