“Can I exercise? Would it help? Would it not?”: exploring the experiences of people with relapsing remitting multiple sclerosis engaging with physical activity during a relapse: a qualitative study

Abstract

Purpose

Physical activity (PA) has been found to be beneficial for people with multiple sclerosis (pwMS) outside of the relapse period. However, little is known about how people experience PA during a relapse. This study investigates the experiences of pwMS engaging with PA during a relapse.

Materials and methods

The study followed an interpretivist approach, adopting a qualitative exploratory design. Semi-structured interviews were conducted with a purposive sample of 15 adults following a recent relapse. Transcripts were analysed in NVivo using framework analysis.

Results

The experiences of participants were synthesised in three overarching themes: “on the road to recovery”, “getting active but fearing repercussions”, and “self-directed versus guided recovery”. Barriers to PA included: feeling unwell, physical limitations, concerns about causing deterioration, worries that others would recognise their disability, and lack of professional support. Facilitators included: awareness of the benefits of PA, access to exercise resources, individualised advice and support from practitioners, and PA pitched at the right level.

Conclusions

Relapses can disrupt normal PA routines, making it challenging to return to PA. This article makes recommendations for supporting people to undertake PA, the timing and form of support, along with suggestions for further research exploring the safety of PA during a relapse.

Implications for rehabilitation

• People with RRMS find it difficult to be physically active during a relapse.

• There are complex personal, social and environmental reasons why people find it hard to engage with physical activity (PA).

• Improved timely advice and customised support during a relapse can help reduce fears and enhance confidence with returning to PA.

• Physical activity recommendations should be tailored to individual’s abilities to make them achievable, giving a sense of accomplishment and boosting motivation.

Keywords:

• Multiple sclerosis
• relapse
• exacerbation
• physical activity
• exercise

Acknowledgements

The authors would like to thank all the participants who gave their time to help with this study.

Author contributions

All authors were involved in the study’s design. HW conceptualised the study, collected and analysed the data and drafted the article. KC assisted with recruitment of participants. CM and YK advised on data analysis and interpretation. CM, YK, and KC critically revised the drafted article. All authors approved the final submitted article.

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

This study was undertaken as part of the MRes Clinical Research at City, University of London for which HW was funded by North Central London Health Education England. This work was supported in part by a grant towards transcription costs from the London Association of Physiotherapists in Neurology (ACPIN).