Contribution of dual-tasking to social participation in persons with multiple sclerosis: A structural equation modeling approach

Abstract

IntroductionThis 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). MethodsAdults 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. ResultsThe 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. ConclusionThis 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.