Self-reported depression and physical activity in adults with mobility impairments



Rosenberg DE, Bombardier CH, Artherholt S, Jensen MP, Motl RW.  Group Health Research Institute, Seattle, WA 98101, USA.  Arch Phys Med Rehabil. 2013 Apr;94(4):731-6. doi: 10.1016/j.apmr.2012.11.014. Epub 2012 Nov 16.

OBJECTIVE: To test hypothesized associations between depression and physical activity among adults with multiple sclerosis (MS), spinal cord injury (SCI), muscular dystrophy (MD), and postpolio syndrome (PPS).

DESIGN: Cross-sectional survey.

SETTING: Survey responses collected from individuals in the Washington state area (participants with SCI) and across the United States (participants with MS, MD, and PPS).

PARTICIPANTS: Convenience sample of participants were surveyed (N=1676; MD, n=321; PPS, n=388; MS, n=556; SCI, n=411).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: The Patient Health Questionnaire-9 (PHQ-9) assessing depressive symptoms and the International Physical Activity Questionnaire (IPAQ) and Godin Leisure Time Exercise Questionnaire (GLTEQ) assessing physical activity.

RESULTS: The average age was 56 years, 64% were women, 92% were white, 86% had a high school degree or higher, and 56% walked with an assistive device or had limited self-mobility. The IPAQ and GLTEQ explained a small but statistically significant and unique amount of the variance in PHQ-9 scores in all diagnostic groups, with no significant differences in the relation by condition, age, or mobility status (IPAQ R(2)=.004; GLTEQ R(2)=.02; both P<.02).

CONCLUSIONS: Both physical activity measures demonstrated a small but statistically significant association with depression in all 4 diagnostic groups. Research is needed to determine longitudinal relations and whether physical activity interventions could promote improved mood in adults with physical disabilities.

CONCLUSIONS: The ED visit rate was much higher than those reported in other studies. Better education on self-management of chronic conditions, depression screening by primary care physicians and ED, and depression treatment that includes symptom management and problem-solving skills may be important to reduce ED visits among medically ill, low-income homebound adults.