Factors associated with community integration in people with multiple sclerosis with mild and moderate levels of disability: a cross-sectional study

Abstract

Background/Aims Multiple sclerosis could lead to limitations in daily activities and restrictions in community integration and participation. The aim of this study was to investigate variables associated with community integration and participation in people with multiple sclerosis and mild or moderate levels of disability. Methods A convenience sample of 326 patients with mild and moderate levels of disability as a result of multiple sclerosis participated in this cross-sectional study. An assessor who was blinded to the study's aims measured demographic information and clinical characteristics through a set of assessment tools, including body appreciation scale, modified Barthel Index, Lawton Instrumental Activities of Daily Living Scale, modified Fatigue Impact Scale, visual analogue scale of pain and a community integration questionnaire. These questionnaires were administered in a random order. Results Multiple linear regression analysis revealed a significant association between community integration and participation with instrumental activities of daily living (P<0.001), fatigue (P=0.004), disease duration (P<0.001), body image (P<0.001), basic activities of daily living (P=0.015) and pain (P=0.017) in patients with a mild level of disability caused by multiple sclerosis. In participants with moderate levels of disability, basic activities of daily living (P<0.001), instrumental activities of daily living (P<0.001) and disease duration (P=0.021) were significantly associated with community integration. Conclusions Instrumental activities of daily living are the strongest variable associated with community integration in people with multiple sclerosis with a mild level of disability, and basic activities of daily living are the strongest variable associated with community integration in people with multiple sclerosis and a moderate level of disability. Implications for practice Rehabilitation professionals should be aware of the significant variables associated with community integration and participation for individuals with multiple sclerosis who have mild or moderate levels of disability. They should and consider targeting these areas when designing a valuable and effective rehabilitation programme.