Implementing physical activity vital sign as a self-reported measure of physical activity in patients with multiple sclerosis in a clinical setting

PM R. 2023 Mar 17. doi: 10.1002/pmrj.12971. Online ahead of print.


Introduction: Routinely assessing exercise levels during clinical visits may be a starting point for clinicians to support physical activity in persons with multiple sclerosis (MS).

Objective: To evaluate the feasibility and findings of routinely implementing a self-reported physical activity vital sign during clinical visits.

Design: Retrospective database review.

Setting: Outpatient academic MS center.

Patients: All adult patients of our MS center with confirmed MS presenting for an in-person or telemedicine clinic visit with a physician or nurse practitioner.

Interventions: None.

Main measure(s): A standard physical activity vital sign representing minutes per week of moderate-to-vigorous exercise was collected. Percentage of persons with MS with a recorded physical activity vital sign was retrospectively evaluated along with demographic characteristics and key findings.

Results: Ninety-three percent of patients with MS at our center had a physical activity vital sign recorded in at least one visit, and 86% at the most recent visit. Of 1560 patients with a recorded physical activity vital sign, 24.3% of patients were consistently active (≥150 min/week of exercise), 20.8% were consistently inactive (0 min/week), and the remaining 54.9% were inconsistently active. The physical activity vital sign was inversely associated with BMI (p < .001) and 25-foot walk test times (p < .001), but not associated with biological sex or age.

Conclusions: Approximately a quarter of patients with MS with a documented physical activity vital sign met national aerobic exercise guidelines of 150 min/week per the U.S. Department of Health and Human Services. Routine implementation of the physical activity vital sign at our MS center was feasible and helped identify inactive patients who may benefit from physical activity counseling.