Stages of Change, Self-Efficacy, and Processes of Change of Exercise Behavior in Adults with Myotonic Dystrophy: A Pilot Study



Poster Number: 200


Nicole White, DPT, U of R School of Medicine and Dentistry Neurology, Jeanne Dekdebrun, University of Rochester, Shree Pandya, DPT, University of Rochester, Katy Eichinger, PT, PhD, University of Rochester

Background/Purpose: Exercise studies in adults with Myotonic Dystrophy (DM) have documented improvements in strength, aerobic capacity, and mobility as well as decreased fatigue and daytime sleepiness. However, adherence and long-term engagement in physical activity (PA) and exercise are often limited. Therefore, the purpose of this study is to better understand factors that influence participation in PA and exercise programs, using the transtheoretical model (TTM).
Methods: Adults with DM, 18 years or older, who attended the 2014 DM Conference in Washington, DC on September 12-13 were invited to participate. Surveys included a clinical profile and stages of change (SOC), self-efficacy (SE), and processes of change (POC) questionnaires. Surveys were anonymously completed and returned to designated areas. Participants were divided into active and inactive based on SOC responses and compared using independent sample t-tests. Number of patient reported symptoms, SE, cognitive and behavioral POC were entered into a regression model to examine the relationship to SOC.
Results: 30 participants (63% female) with DM (80% DM-Type 1) participated. There was a significant difference in SE; t(26)=2.8; p=0.009, for active and inactive participants (mean difference=3.81, standard deviation (SD)=1.36). A significant difference was also seen in POC; t(27)=3.3; p=0.003, between active and inactive participants (mean difference=28.17, SD=8.55). The model explains 64% of the variability in SOC with behavioral POC having a significant effect on SOC; t(16)=3.83, p<0.001. Conclusions: SE is one’s confidence to participate in PA and POC are strategies used to progress through SOC; both were found to be significantly different between active and inactive participants. A study with a larger sample size is necessary to confirm our results; however, our finding of behavioral POC having the greatest contribution to SOC may be useful in developing targeted interventions to increase adherence and improve long-term engagement in PA and exercise programs by individuals with DM.