Learning Objective #1: Describe the relationship between changes in exercise and functional limitations over time in persons with MS

Learning Objective #2: Describe the relationship between exercise and quality of life over time in persons with MS

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During the last decade substantial progress has been made in defining the pathologic changes of multiple sclerosis (MS) and developing disease-modifying medications. However, little is known about the natural history of MS and specifically how functional limitations change over time, what factors influence the rate of change and the resulting impact on quality of life. The purpose of this study was to explore the trajectories of functional limitations, health behaviors (exercise) and perceived quality of life over a seven-year time period.

A sample of 621 persons with MS enrolled in the longitudinal study and completed an annual questionnaire battery with instruments measuring demographic and illness characteristics, health-related attitudes and behaviors, and quality of life. At the start of the longitudinal study participants ranged in age from 21 to 81 (mean 50.44). The majority were female (83%), white/non Hispanic (93%), and married (73%). Most (85%) had completed high school and only 25 % were currently employed full-time.

A multivariate latent curve model was estimated in which self-reports of functional limitations, exercise behaviors and quality of life scores were considered simultaneously to study the correlations between characteristics of change between the variables. Covariates (age, gender and years since diagnosis) were included in the model to study potential moderating effects of these variables on the correlations between change features in the repeated measures. Change in functional limitation scores were negatively correlated with change in exercise behaviors and quality of life scores (r = -.43 and r = -.66, respectively). Change in exercise behaviors and quality of life scores were positively correlated (r = .45). Longitudinal studies of functional limitations, disability, and quality of life offer an opportunity to gain critical information about the challenges that persons with MS face over time and identify potential moderators of the course of the disease-related limitations.