Current and Long-Term Physical Activity Among Adults with Multiple Sclerosis in the United States: COM-B Variables as Explanatory Factors

Stephanie L Silveira; Karin Riemann-Lorenz; Christoph Heesen; Robert W Motl

doi:10.1007/s12529-020-09946-w

Current and Long-Term Physical Activity Among Adults with Multiple Sclerosis in the United States: COM-B Variables as Explanatory Factors

Int J Behav Med. 2021 Oct;28(5):561-574. doi: 10.1007/s12529-020-09946-w. Epub 2021 Jan 8.

Authors

Stephanie L Silveira¹, Karin Riemann-Lorenz², Christoph Heesen^{2

3}, Robert W Motl⁴

Affiliations

¹ Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, 35294, United States. ssilveira@uab.edu.
² Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴ Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, 35294, United States.

PMID: 33420718
DOI: 10.1007/s12529-020-09946-w

Abstract

Background: Physical activity is an evidence-based, safe second-line approach for improved multiple sclerosis (MS) symptoms and disease progression. This study examined the contributions of Capability-Opportunity-Motivation-Behavior (COM-B) factors for understanding engagement in current and long-term physical activity among persons with MS in the United States (U.S.).

Method: Adults with MS in the U.S. (N = 854) completed an online survey that included questions regarding demographic and clinical characteristics, COM-B constructs, Godin Leisure Time Exercise Questionnaire (GLTEQ), and Physical Activity Staging Questionnaire (PASQ). Participants were classified into groups based on the GLTEQ regarding current physical activity behavior and PASQ for long-term physical activity behavior. MANOVA and discriminant function analysis (DFA) identified COM-B constructs that differentiated physical activity groups.

Results: MANOVA analyses indicated that all COM-B constructs were significantly different for both GLTEQ current physical activity groups (Wilks's λ = .5, F(44, 1432) = 14.8) and PASQ long-term physical activity groups (Wilks's λ = .4, F(44, 1464) = 16.9) status except Information Provision. DFA analysis regarding GLTEQ identified a function including exclusively Capability and Motivation sources of behavior that differentiated current physical activity groups such as intention and self-efficacy. DFA for PASQ identified a different function of the Capability and Motivation sources of behavior that differentiated long-term physical activity groups; the primary differentiating variables were action control and intention.

Conclusion: Our results identify internal factors as the primary COM-B predictors of current and long-term physical activity among adults with MS in the U.S., and health promotion interventions may focus on assessing individual competencies and behavioral regulation for changing physical activity in MS.

Keywords: Behavior change; Capability-opportunity-motivation-behavior (COM-B) model; Multiple sclerosis; Physical activity.