Diet, Physical Activity, and Stress Among Wheelchair Users With Multiple Sclerosis: Examining Individual and Co-Occurring Behavioral Risk Factors.
Stephanie L Silveira, Brenda Jeng, Gary Cutter and 1 others
PMID 36649911WHAT IT FOUND
Wheelchair users with MS who had two or three behavioral risk factors reported worse depression, anxiety, sleep quality, and health-related quality of life than those with zero or one.
Insufficient physical activity was the most common single risk factor, present alone in 28% of participants.
Key findings
01Participants with 2 or 3 behavioral risk factors had worse depression, anxiety, sleep quality, physical HRQOL, and psychological HRQOL than those with 0 or 1.
02The most common pattern of risk factors was insufficient physical activity alone (28%), followed by insufficient physical activity combined with high stress (22%), and all three risk factors together (21%).
03Number of behavioral risk factors showed moderate correlations with depression (r=.36), anxiety (r=.43), physical HRQOL (r=.30), and psychological HRQOL (r=.47).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The cross-sectional design means the study cannot determine whether behavioral risk factors cause worse symptoms or if worse symptoms lead to poorer health behaviors. Physical activity was measured by self-report rather than objective devices, which may introduce bias. Participants were recruited via online registries, requiring internet access and technological skills, which may limit generalizability to those with more severe disability or lower socioeconomic status. Cognitive functioning was not assessed, which could affect the validity of self-reported dietary and symptom data. The study took place during the height of the COVID-19 pandemic, which may have influenced engagement in health behaviors and stress levels. The sample size was 123, and the study describes associations rather than testing an intervention.
Declared interests
The paper is supported by the National Institutes of Health (Extramural) and Non-U.S. Government research support. Specific author conflicts of interest are not detailed in the provided text.
The easy way to misread this
Do not assume that improving diet, activity, or stress will directly reduce symptoms. This study shows an association between having more risk factors and reporting worse symptoms, but it did not test an intervention and cannot prove that changing these behaviors causes improvement.