title: Systematic Review of Correlates and Determinants of Physical Activity in Persons With Multiple Sclerosis.
abstract: OBJECTIVE
  To review the current evidence regarding correlates and determinants of physical activity (PA) in persons with multiple sclerosis (pwMS).
  
  
  METHODS
  PubMed and Scopus (1980 to January 2015) and reference lists of eligible studies.
  
  
  METHODS
  Eligible studies include adults with multiple sclerosis; have a cross-sectional or prospective observational design; or examine the effect of a theory-based intervention trial on PA, including a mediation analysis. Eligible studies also apply a quantitative assessment of PA and correlates or proposed mediators and are published in English or German language.
  
  
  METHODS
  Two reviewers independently evaluated the risk of bias, extracted data, and categorized variables according to the International Classification of Functioning, Disability and Health.
  
  
  RESULTS
  Consistency and the direction of associations were evaluated with a semiquantitative approach. Fifty-six publications with data from observational studies and 2 interventional studies provided evidence for 86 different variables. Consistent correlates of PA were the disability level, walking limitations in particular, PA-related self-efficacy, self-regulation constructs, employment status, and educational level. One interventional study provided evidence for a causal relation between self-regulation and PA. However, 59 of the 86 investigated variables in observational studies are based on 1 or 2 study findings, and most results stem from cross-sectional designs.
  
  
  CONCLUSIONS
  Beside the importance of the general disability level and walking limitations, the results highlight the importance of personal factors (eg, PA-related self-efficacy, self-regulatory constructs, sociodemographic factors). Limitations and implications of the current review are discussed. Research that is more rigorous is needed to better understand what affects PA in pwMS.
authors.affiliation: Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: René
authors.initials: R
authors.lastname: Streber
authors.affiliation: Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Peters
authors.affiliation: Institute of Sport Science and Sport, Division Exercise and Health, Department Psychology and Sport Science, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. Electronic address: Klaus.pfeifer@fau.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Pfeifer
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004522:Educational Status; D004651:Employment; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009043:Motor Activity; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000523:psychology; D064887:Observational Studies as Topic; D011446:Prospective Studies; D020377:Self Efficacy; D016138:Walking
keywords: Health behavior; Health promotion; Motor activity; Multiple sclerosis; Rehabilitation