Capability–Opportunity–Motivation–Behavior (COM-B) Correlates of Physical Activity in People with Multiple Sclerosis Who Have Analogue Generalized Anxiety Disorder

RESEARCH

Published: 05 November 2026

Abstract

Background

Generalized anxiety disorder (GAD) is prevalent, yet poorly managed among people with multiple sclerosis (MS). Physical activity (PA) may be a potential lifestyle, behavioral approach for managing GAD in MS. As a foundational step in developing PA behavior change interventions, this study applied the Capability–Opportunity–Motivation–Behavior (COM-B) model for explaining PA behavior in people with MS who have analogue GAD (AGAD).

Methods

Participants (N = 320) prescreened for AGAD completed online surveys regarding PA (Godin Leisure Time Exercise Questionnaire (GLTEQ), Physical Activity Staging Questionnaire (PASQ)) and COM-B constructs. Participants were categorized into current PA groups based on GLTEQ scores, and long-term PA groups based on PASQ scores. Multivariate analysis of variance and discriminant function analysis (DFA) identified COM-B constructs that differentiated PA groups.

Results

All COM-B constructs significantly differed among current and long-term PA groups. DFA identified Action Control, Intention, Self-efficacies (Action, Maintenance, Recovery), Action and Coping Planning, and Goal Setting as primary constructs differentiating PA groups.

Conclusion

This study identified factors within the Capability and Motivation domains of the COM-B model as primary correlates of PA in persons with MS and AGAD. Such results might guide the development of behavior change interventions for increasing PA and perhaps treating GAD in MS.

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