Exercise, Diet, and Stress Management as Mediators Between Functional Disability and Health-Related Quality of Life in Multiple Sclerosis

The main objective of this study was to examine the mediational and moderational effect of exercise, diet, and stress management on the relationship between functional disability and health-related quality of life. Quantitative descriptive research design using multiple regression and correlation techniques was used. Participants were 215 individuals with multiple sclerosis (MS). Outcome measure used was health-related quality of life as measured by the Medical Outcomes Study (MOS) Short-Form Health Survey (SF-12v2). Functional disability and health-promoting behaviors including exercise, diet, and stress management were found to be associated with health-related quality of life. Exercise and stress management (but not diet) were partial mediators between functional disability and health-related quality of life. Exercise was found to be a moderator between functional disability and health-related quality of life. Exercise had a stronger effect on health-related quality of life for individuals with lower functional disability than people with higher functional disability. Health-promoting behaviors are important for health-related quality of life, and health-related quality of life in turn is related to better employment outcomes. Health-promoting behaviors can also mediate the relationship between functional disability and health-related quality of life. Rehabilitation counselors should consider including health promotion interventions in vocational rehabilitation services for individuals with MS.