Long-term physical activity in people with multiple sclerosis: exploring expert views on facilitators and barriers

Abstract

Purpose: To explore the views of experts on facilitators and barriers of long-term physical activity among people with multiple sclerosis living in different European countries.

Methods: We conducted semi-structured telephone or face to face interviews with twelve multiple sclerosis and physical activity experts (scientists, practitioners, patient representatives) from five European countries. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis.

Results: We identified 20 themes and categorized them into environmental and personal factors. The most frequently mentioned and intensively discussed themes were environmental factors. The themes were structured according to possible intervention level: organizational, interpersonal and intrapersonal level themes. Themes at the organizational level comprised availability, access and quality of exercise/physical activity options; health system characteristics like services and organization, health professionals and information provision. The interpersonal level comprised social support and peer support. Disease related factors were the most frequently mentioned intrapersonal level theme. In our study, more codes were obtained for environmental factors than for personal factors.

Conclusions: The results suggested that environmental factors may need to be addressed in particular to increase long-term physical activity adherence. This study will inform the design of a survey questionnaire assessing possible barriers and facilitators among people with multiple sclerosis.

Implications for rehabilitation

• Long-term physical activity among people with multiple sclerosis is subject to a number of modifiable determinants: personal and environmental factors.

• Multiple sclerosis exercise experts emphasized the importance of environmental factors on the organizational and interpersonal level.

• Future physical activity interventions should be guided by a social-ecological perspective.

• Addressing environmental and personal factors simultaneously to reach optimal long-term outcomes should be considered in future interventions.

Keywords:

• Physical activity
• multiple sclerosis
• expert interviews
• environmental factors
• personal factors

Acknowledgements

This work was part of the RIMS AD@MS initiative (Bruce J, Dalgas U, Feys P, Finlayson M, Hamalainen P, Heesen C, Köpke S, Kos D, Matthews V, Moss-Morris R, Motl R, Sastre-Garriga J, Solari A) to study adherence to pharmacological and non-pharmacological interventions in MS. AD@MS was financially supported by Novartis Pharma. The authors would like to thank Yvonne Bulmers for translations and her language revision of the manuscript. We would also like to thank all interview participants for sharing their experiences and their time and efforts. Additionally, we would like to thank Sascha Köpke, Jana Pöttgen and Anne Rahn from the Heesen work group for fruitful discussions about the project.

Disclosure statement

No potential conflict of interest was reported by the authors.