Group-based, individualized exercises can provide perceived bodily changes and strengthen aspects of self in individuals with MS: a qualitative interview study

ABSTRACT

Background: Group-based physiotherapy is effective for individuals with MS; nevertheless individualization within groups is questioned and little is known regarding individuals´ experiences with individualization in small groups.

Objective: We aimed to explore the short- and long-term experiences of individuals with MS participating in a 6-week, group-based, individualized physiotherapy-intervention.

Methods: Within a randomized controlled trial (RCT), 25 in-depth interviews with a strategic sample of 13 people (9 women; age 25–79 years old; European Disability Status Scale (EDSS) 1–6.5) were conducted at weeks 7 and 30 using systematic text condensation, with dynamic systems theory and phenomenology as analytical frameworks.

Results: The main categories were: 1) movement control, orientation and insights: Bodily improvements were associated with targeted exercises, specific adjustments by the physiotherapist, emotional engagement and re-access to activities; and 2) the individual within the group: Equal distributions of one-to-one interactions and attention were important for experiencing success. Less attention and improvements turned attention toward own disability. Physical changes felt particularly emotional short term, implying that individuals’ feelings of ownership and control of body and movement, new views of themselves and changed affordances in daily life were involved.

Conclusion: Equally distributed attention and engagement, targeted exercises and hands-on adjustments resulting in visible and perceived bodily changes were experienced as key factors of individualization in small groups.

KEYWORDS:

• Multiple sclerosis
• group-based
• physiotherapy
• core stability
• balance

Acknowledgments

We would like to thank the individuals with MS who participated in this study, the contributing physiotherapists and the administrations of the participating municipalities. We also express our appreciation to the Department of Physiotherapy at the Nordland Hospital Trust. The study was financed by the Northern Norway Regional Health Authority.

The current workplace of the last author Britt Normann is Nord University, Faculty of Nursing and Health Sciences, Bodø, Norway.

Disclosure Statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Helse Nord RHF [1240].