Do levels of physical activity differ by anxiety and depressive symptom status in persons with multiple sclerosis?

Physical inactivity, anxiety, and depression are prevalent among persons with multiple sclerosis (MS). Anxiety and depressive symptoms impact a range of outcomes and may be differentially associated with levels of physical activity in MS. This study examined the independent and combined effects of anxiety and depressive symptom status on device-measured physical activity levels in persons with MS. This study was a secondary analysis of data from two combined studies of 440 persons with MS who completed the Hospital Anxiety and Depression Scale (HADS) and wore an accelerometer for 7 days as a measure of physical activity. The participants were divided into four subgroups of elevated and non-elevated anxiety and depressive symptom status. We examined the effects of anxiety and depressive symptoms on physical activity using 2-way analysis of covariance controlling for demographic and clinical covariates that differed among symptoms groups. There were statistically significant interactions for anxiety and depressive symptoms on light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and daily step count, after controlling for covariates. The subgroup with elevated anxiety and non-elevated depression had significantly higher levels of LPA, MVPA, and daily steps than the other three symptom subgroups. Persons with MS who have elevated anxiety and non-elevated depression had higher levels of physical activity than the other three symptom subgroups, and this may be explained by the action dispositions as theorized within the circumplex model of mood and emotion. • Physical inactivity is prevalent in people with multiple sclerosis (MS) • Anxiety and depressive symptoms may impact physical activity in MS • We report interaction effects of anxiety and depressive symptoms on physical activity • Results were conceptualized within the circumplex model of affect