Pilot study exploring quality of life and barriers to leisure-time physical activity in persons with moderate to severe multiple sclerosis

Elizabeth A. Vanner, M.S., Pamela Block, Ph.D., Christopher C. Christodoulou, Ph.D., Beverly P. Horowitz, Ph.D., Lauren B. Krupp, M.D.

Disability and Health JournalJanuary 2008 Volume 1, Issue 1, Pages 58–65
DOI: http://dx.doi.org/10.1016/j.dhjo.2007.11.001



We sought to assess how impairment (physiological/psychological) and disability (social/environmental) are associated with physical and leisure/recreation activity levels and quality of life (QOL) in people with moderate/severe multiple sclerosis (MS). We conducted a cross-sectional survey at the MS Comprehensive Care Center, Stony Brook University Hospital, Stony Brook, NY, of a convenience sample of 43 people (50 eligible) with MS and Expanded Disability Status Scale scores of 6.0 to 8.0. The main outcome measures were QOL measured by MSQOL-54, physical activity measured by Physical Activity Disability Scale, and leisure/recreation activity measured by Nottingham Leisure Questionnaire. We analyzed the canonical correlations among physical and leisure/recreation activity levels and (1) impairment and (2) QOL.


Higher levels of physical and leisure/recreation activity were associated with lower levels of apathy and depression and higher levels of cognition, self-efficacy, and QOL (physical and mental). Major barriers reported included fatigue, lack of motivation, and cost.


Impairments and social/environmental disabilities create barriers to physical and leisure/recreation activity. Additional research is needed to determine, for people with MS, what supports might increase participation in physical and leisure/recreation activities and whether this increase yields improved QOL.