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32 lower on the MSSS compared with those with no PA (moderate exercise, = .003; rigorous exercise, = .001), and PA correlated significantly with MSSS outcomes ( = 0.452, .001). Educational level and PA are significantly associated with reduced MSSS, and both contribute to a less severe MS clinical course. Current MS management protocols should consider lifestyle changes to improve the quality of life of patients with MS. Educational level and PA are significantly associated with reduced MSSS, and both contribute to a less severe MS c