Department of Rehabilitation and Movement Science, University of Vermont, Burlington, USA.
Department of Pharmacy and Health Sciences, Wayne State University, Detroit, USA.
Mult Scler Relat Disord. 2024 Oct;90:105835. doi: 10.1016/j.msard.2024.105835. Epub 2024 Aug 23.
This study aimed to explore the patterns of association between dual-tasking, cognition, ambulation disability, fatigue, and self-efficacy and their pathways in predicting social participation in persons with multiple sclerosis (MS).
Adults with MS (n = 1162) completed an online survey. Social participation was assessed by the Quality of Life in Neurological Disorders. The Dual-task Impact on Daily-Living Activities Questionnaire, Multiple Sclerosis Walking Scale-12v2, and Modified Fatigue Impact Scale measured dual-tasking, ambulation, and fatigue, respectively. Fall Efficacy Scale-International and Self-Efficacy for Community Mobility were assessed and modeled as a latent variable for efficacy.
The correlation matrix showed significant associations of social participation with dual-tasking, cognition, ambulation, efficacy, and fatigue (all p < 0.001) and interrelationships among the independent variables (p < 0.05). The final model showed excellent global model fit (CFI = 0.99, TLI = 0.96), with all variables significantly predicting social participation either directly or indirectly. Efficacy significantly mediated the effects of dual-tasking (β=-0.32, p < 0.001) and ambulation disability (β=-0.42, p < 0.001) on social participation.
This study indicated that dual-tasking, ambulation disability, fatigue, and efficacy play important roles in social participation in persons with MS. The findings can help provide insight into factors that may underpin social participation and offer targets for interventions in persons with MS.
本研究旨在探索双重任务、认知、步行障碍、疲劳和自我效能感之间的关联模式，以及它们在预测多发性硬化症（MS）患者社会参与方面的预测途径。
1162 名成年 MS 患者完成了在线调查。社会参与由神经障碍生活质量问卷评估。双重任务对日常生活活动的影响问卷、多发性硬化症行走量表-12v2 和改良疲劳影响量表分别评估双重任务、行走和疲劳。跌倒效能感量表-国际版和社区移动自我效能感作为效能的潜在变量进行评估和建模。
相关矩阵显示，社会参与与双重任务、认知、步行、效能和疲劳均呈显著相关（均 p < 0.001），且独立变量之间存在相互关系（p < 0.05）。最终模型显示出极好的总体模型拟合度（CFI = 0.99，TLI = 0.96），所有变量均直接或间接显著预测社会参与。效能显著中介了双重任务（β=-0.32，p < 0.001）和步行障碍（β=-0.42，p < 0.001）对社会参与的影响。
本研究表明，双重任务、步行障碍、疲劳和效能在 MS 患者的社会参与中起着重要作用。这些发现可以帮助深入了解支持社会参与的因素，并为 MS 患者的干预措施提供目标。
