RehabMove 2018: LONGITUDINAL ASSOCIATIONS BETWEEN ACTIVITY PACING, FATIGUE, AND PHYSICAL ACTIVITY IN ADULTS WITH MULTIPLE SCLEROSIS

PURPOSE: The purpose of this study was to evaluate how activity pacing relates to physical activity and
health-related quality of life over a one year period in a sample of adults with multiple sclerosis.
METHODS: 68 adults with multiple sclerosis (mean age= 42 ± 11 years) filled in questionnaires on their
active engagement in pacing decisions and perceived difficulty in preventing overactivity (5-point Activity
Pacing and 2-point Risk of Overactivity Questionnaire), fatigue (7-point Fatigue Severity Scale), physical
activity (adapted Short Questionnaire to Assess Health-Enhancing Physical Activity) and health-related
quality of life (RAND-12 Health Survey) post rehabilitation and at one year follow up, as part of the
Rehabilitation, Sports and Active lifestyle study (a nationwide multi-centre program aimed at stimulating
and promoting an active lifestyle in rehabilitation in the Netherlands). Multilevel modelling was used to
analyse the associations between activity pacing, fatigue, physical activity and health-related quality of life.
RESULTS: No associations were found between activity pacing and physical activity (β = -0.21; p > 0.05),
and between activity pacing and health-related quality of life (β = -0.10; p > 0.05) at long-term. Fatigue was
negatively related to health-related quality of life (β = -0.35; p < 0.001). Perceived risk of overactivity
moderated the association between fatigue and health-related quality of life (β = -0.13; p = 0.039).
CONCLUSIONS: These findings suggest that persons who experience decreases in health-related quality
of life with increased fatigue, are more likely to be engaging in ‘overactive’ behaviour. The lack of
associations between activity pacing and physical activity, and between activity pacing and health-related
quality of life suggests there is no clear strategy among persons with MS that is successful in improving
physical activity and quality of life either in short or long-term when no interventions are introduced.