What characteristics are associated with meeting the Canadian physical activity guidelines for people with multiple sclerosis? A retrospective chart review.

Meeting multiple sclerosis-specific physical activity guidelines (PAGs) has been associated with numerous benefits in people with multiple sclerosis (PwMS). However, the characteristics of PwMS predictive of meeting PAGs are unknown. This study aimed to examine which sociodemographic and clinical characteristics are associated with meeting the Canadian MS PAGs. A retrospective chart review of all PwMS referred to physiatry at the largest Canadian tertiary MS clinic between December 2021-December 2023 (n=455) was conducted. Physical activity, sociodemographic, and clinical characteristics were collected. Physical activity levels were categorized into one of three groups: no activity, some activity but not meeting PAGs, and meeting PAGs. Physical activity was further categorized by type of activity (aerobic and strength training). Associations between characteristics and physical activity levels were examined using multinomial logistic regression. PwMS who did not drive (OR=0.53, 95%CI=0.29-0.97) and were non-ambulatory (OR=0.34, 95%CI 0.11-0.99) were significantly less likely to meet PAGs. Higher Expanded Disability Status Scale (OR=0.80, 95% CI=0.70-0.91), gait aid use (OR=0.55, 95%CI=0.34-0.88), incoordination (OR= 0.52, 95% CI=0.33-0.82), progressive MS phenotype (OR=0.60, 95% CI=0.37-0.95), and smoking (OR=0.31, 95% CI=0.13-0.76) were associated with lower odds of doing any aerobic activity. Those with cognitive symptoms (OR=1.93, 95%CI=1.22-3.04) and greater muscle strength (OR=1.04, 95% CI=1.01-1.07) were more likely to do aerobic activity. Only employment status was associated with strength training, with those employed more likely to do some strength training (OR=1.73, 95% CI=1.04-2.89). Physical disability, cognitive symptoms, adverse health behaviours may drive which type and amount of activity a PwMS participates in.