Objectively assessed physical activity in the context of pacing behaviour in adults with multiple sclerosis

Background: Activity pacing has the potential to change physical activity (PA) behaviour, and reduce the high prevalence of physical inactivity in people with multiple sclerosis (MS). However, little is known about the association between PA behaviour and naturalistic pacing in this population. Purpose: To explore association between PA behaviour and naturalistic pacing in adults with MS. Methods: 21 people with MS (mean age= 59 ± 9 years) wore an accelerometer that measured free-living PA behaviour for 7 days and filled in questionnaires on their activity pacing, fatigue, and health-related quality of life (HRQoL). PA behaviour was assessed by examining activity level and activity variability (an index of activity pattern). Associations between the variables were examined using hierarchical regression. Results: Activity level, activity variability, engagement in pacing, fatigue and HRQoL were 241.07 (144.68), 3.96 ± .72, 3.25 ± .74, 4.75 ± 1.62 and 42.66 ± 8.13 respectively. Lower activity level was negatively associated with higher engagement in pacing (β= -.438, t= -2.66, p= .024), whereas there was no association between activity variability and engagement in pacing (β= -.225, t= -.96, p= .361). Conclusion: The negative association between activity level and activity pacing suggests that those with lower activity levels could be inappropriately using activity pacing as a reactionary response to their symptoms. As PA can help to prevent physical deconditioning and improve MS symptoms, further research into activity pacing as a potential strategy for increasing PA levels in people with MS is warranted. Funding: None.