Facilitators and barriers to engagement in physical activity for people with multiple sclerosis: a qualitative investigation

Abstract

For people with MS, the decision to engage in physical activity (or not) is complex, fluid and individual; made more complex by the unpredictable nature of MS. Rehabilitation professionals attempting to engage people with MS in a physical activity programme should consider adopting an individualised approach to barrier management which takes into account personal beliefs and perceptions regarding physical activity engagement.

Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences

“…The mean age of participants ranged between 39.2 and 64.5 years (Overall Mean ¼ 46.6, SD ¼ 10.8). Participants' race was only reported in five studies [24,26,29,30,34]; 63 participants were Caucasian and two were Māori. The depth of clinical demographic data varied amongst studies ( Table 1).…”

“…Some of the consequences of physical activity and exercise perceived by those with MS mimic the quantitative evidence (e.g. improved aerobic capacity [23][24][25][26][27], balance [27][28][29], depression [26][27][28], muscular strength [26][27][28]30,31] and quality of life [25,26,28,[32][33][34][35]). Yet, qualitative inquiry provides an opportunity for extending our knowledge of the consequences of physical activity and exercise beyond the limitations of items on numerical scales and focal scientific outcomes by telling us, in the person's own words, about the range of perceived consequences.…”

“…Thirteen of these studies used only face-to-face interview methodology [24][25][26]28,[30][31][32][33][34]54,69,70,72], one used faceto-face and telephone interviews [27], one used only telephone interviews [23], and four used focus groups [29,35,68,71]. Interpretative phenomenological analysis [23,31,33,34,70] and more general inductive analytical approaches [24][25][26][27][28][29][30]32,54,68,69] were used in most studies. The remaining three studies used deductive analytical approaches, specifically thematic content analysis [35,71] and phenomenology [72].…”

“…Yet, the uniqueness of qualitative inquiry is that much richer and more detailed accounts of these perceived determinants can be identified beyond that identified in quantitative methods. One example of this richness comes from a study that focused on factors influencing the decision to participate in physical activity and exercise in persons with MS [24]. For example, related to the built environment, good public access allowed those with MS to more easily access physical activity sites.…”

Bridging the gap between goal intentions and actions: a systematic review in patient populations

“…Therefore, as part of our on-going research in the evaluation of innovative strategies to enhance patient engagement in their rehabilitation [39][40][41][42][43] we were interested in exploring the extent to which implementation intentions in the specific form of an if-then plan had been tried and tested in patient populations. The aim of this systematic review was to evaluate the evidence for the effectiveness of if-then implementation intentions (hereafter called if-then plans for brevity) when used as a sole intervention or as part of treatment or therapy (including strategies to promote healthy behaviour) in adult patient populations.…”