Objectively-assessed physical activity and self-reported activity pacing in adults with multiple sclerosis: A pilot study

Objective: To examine the association between self-reported activity pacing (a strategy to manage fatigue symptoms) and objectively-measured physical activity behaviours in adults with multiple sclerosis. Design: Single cross-sectional study Setting: Multiple sclerosis rehabilitation centre in Colchester, United Kingdom. Subjects: Twenty-one adults (59 +/- 9 years) with multiple sclerosis. Main measures: Physical activity behaviours (activity level: activity counts per minute; activity variability: highest activity counts per minute each day divided by activity counts per minute on that day) were measured with accelerometers. Self-reported activity pacing (Activity Pacing and Risk of Overactivity Questionnaire), fatigue severity (Fatigue Severity Scale) and health-related quality of life (RAND-12-Item Short-Form Health Survey) were measured. Scatter plots were used to explore associations between measures. Results: Activity level was 258 +/- 133 counts per minutes, activity variability was 4 +/- 1, self-reported activity pacing was 3 +/- 1, fatigue severity was 5 +/- 2 and health-related quality of life was 43 +/- 8. Increased self-reported activity pacing was associated with lower activity levels and less variability in daily activities. Conclusion: This investigation suggests that people with multiple sclerosis who have low physical activity levels could be inappropriately using activity pacing as a reactionary response to their multiple sclerosis symptoms.