title: Subjective and objective assessment of physical activity in multiple sclerosis and their relation to health-related quality of life.
abstract: BACKGROUND
  Physical activity (PA) is frequently restricted in people with multiple sclerosis (PwMS) and aiming to enhance PA is considered beneficial in this population. We here aimed to explore two standard methods (subjective plus objective) to assess PA reduction in PwMS and to describe the relation of PA to health-related quality of life (hrQoL).
  
  
  METHODS
  PA was objectively measured over a 7-day period in 26 PwMS (EDSS 1.5-6.0) and 30 matched healthy controls (HC) using SenseWear mini® armband (SWAmini) and reported as step count, mean total and activity related energy expenditure (EE) as well as time spent in PA of different intensities. Measures of EE were also derived from self-assessment with IPAQ (International Physical Activity Questionnaire) long version, which additionally yielded information on the context of PA and a classification into subjects' PA levels. To explore the convergence between both types of assessment, IPAQ categories (low, moderate, high) were related to selected PA parameters from objective assessment using ANOVA. Group differences and associated effect sizes for all PA parameters as well as their relation to clinical and hrQoL measures were determined.
  
  
  RESULTS
  Both, SWAmini and IPAQ assessment, captured differences in PA between PwMS and HC. IPAQ categories fit well with common cut-offs for step count (p = 0.002) and mean METs (p = 0.004) to determine PA levels with objective devices. Correlations between specifically matched pairs of IPAQ and SWAmini parameters ranged between r .288 and r .507. Concerning hrQoL, the lower limb mobility subscore was related to four PA measures, while a relation with patients' report of general contentment was only seen for one.
  
  
  CONCLUSIONS
  Both methods of assessment seem applicable in PwMS and able to describe reductions in daily PA at group level. Whether they can be used to track individual effects of interventions to enhance PA levels needs further exploration. The relation of PA measures with hrQoL seen with lower limb mobility suggests lower limb function not only as a major target for intervention to increase PA but also as a possible surrogate for PA changes.
authors.affiliation: NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Theresa
authors.initials: T
authors.lastname: Krüger
authors.affiliation: NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.|Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Janina R
authors.initials: JR
authors.lastname: Behrens
authors.affiliation: NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Anuschka
authors.initials: A
authors.lastname: Grobelny
authors.affiliation: Motognosis UG, Schönhauser Allee 177, 10119, Berlin, Germany.
authors.forename: Karen
authors.initials: K
authors.lastname: Otte
authors.affiliation: Motognosis UG, Schönhauser Allee 177, 10119, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Mansow-Model
authors.affiliation: Motognosis UG, Schönhauser Allee 177, 10119, Berlin, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Kayser
authors.affiliation: NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.|Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Bellmann-Strobl
authors.affiliation: NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.|Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Alexander U
authors.initials: AU
authors.lastname: Brandt
authors.affiliation: NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.|Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.|Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany.
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
authors.affiliation: NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. Tanja.schmitz-huebsch@charite.de.
authors.forename: Tanja
authors.initials: T
authors.lastname: Schmitz-Hübsch
mesh_terms: D061725:Accelerometry; D000328:Adult; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D009103:Multiple Sclerosis / Q000503:physiopathology*; D011788:Quality of Life; D057566:Self Report
keywords: Accelerometry; IPAQ; Multiple sclerosis; Physical activity; Quality of life