The Embodied and Situated Nature of Moods

In search of the pleasure of moving through bodily re-explorations and interactions with the surroundings: a qualitative study on changed perceptions of physical activity in people with mild multiple sclerosis

INTRODUCTION

Reduced physical activity (PA) among people with multiple sclerosis (pwMS) with low disability is a significant concern. Developing healthcare to promote PA requires a comprehensive understanding of pwMS's perspectives.

PURPOSE

To explore how pwMS with mild disability perceive PA and the impact of individual, professional, social, and environmental aspects on their PA engagement.

METHODS

Qualitative, in-depth interviews with 27 pwMS (21 women, 6 men; aged 31-66; EDSS ≤ 3.5) were analyzed via systematic text condensation and informed by enactive theory.

RESULTS

Three categories were formed: Perception Shifts after Diagnosis: Participants adapted their perceptions to PA throughout their disease journey. Initial uncertainty concerning bodily capacities, prospects and safety reduced PA. Moving "correctly" during activities was emphasized to facilitate PA levels. Affective Experiences Drive Behavior: Pleasure associated with movement was a highlighted motivator, however, some experienced PA less rewarding after diagnosis. Discomfort and fear were barriers to PA engagement. The Surroundings Influence Perceptions: Participants sought social interactions and outdoor-environments to improve PA. Healthcare professionals were trusted to provide possibilities for PA, but early-stage and tailored follow-up was often lacking.

CONCLUSION

This study illuminates changed PA perceptions after MS diagnosis and how affect, shaped by personal, interpersonal, and environmental aspects, drive PA engagement. Moreover, it calls for early follow-up and the implementation of tailored healthcare throughout the disease course to promote PA engagement. Considering these findings, we have put forth a model aimed at fostering a nuanced comprehension of PA in pwMS with mild disabilities. Further development and exploration of this model is needed.

The meaningfulness of exploring one's own limits through interactions and enjoyment in outdoor high-intensity physiotherapy for people with multiple sclerosis: a qualitative study

Background and purpose

Physical activity (PA) is often reduced in people with MS (pwMS), even when disability is low. Understanding the perspectives of pwMS on interventions aiming to improve PA is important to inform the development of such services. The aim of this study was to explore the experiences of pwMS participating in an outdoor, high-intensity and balance exercise group intervention.

Methods

This qualitative study was nested within an RCT exploring a novel intervention integrating sensorimotor exercises with high-intensity intervals of running/walking. Individual, in-depth interviews with the intervention group (n = 15; 12 women, 3 men; age 38-66; EDSS score 0-3.5) were conducted postintervention (mean days = 14), analyzed using a phenomenological-inspired approach with systematic text condensation, and interpreted based on enactive theory.

Results

Four categories were generated: (1) Exploration of one's own physical abilities: Challenging one's own limits was perceived by all participants to improve movement performance and/or intensity level. Such bodily changes engendered strong positive feelings. Some negative consequences of high-intensity training were described, increasing a feeling of loss. (2) New insights and beliefs: Participants experienced enhanced beliefs in their own capabilities, which they integrated in activities outside the intervention. (3) An engaging environment: The group setting was perceived as supportive, and the outdoor environment was perceived as stimulating activity. (4) Professional leadership, tailoring and co-creation of enjoyment: Physiotherapist-led, individualized interactions were regarded as necessary to safely revisit prior activities, such as running. Co-creating enjoyment facilitated high-intensity training and intervention adherence.

Discussion

High-intensity training combined with detailed exercises in a physiotherapy outdoor group was perceived to create meaningful bodily changes and enhance PA and prospects for both PA and life. Importantly, however, some negative experiences were also reported from the high-intensity training. Enactive theory allowed for the illumination of new perspectives: the importance of embodiment for self-efficacy and of tailored physiotherapy and an outdoor-group environment for exploring one's own limits to physical capabilities. These aspects should inform future exercise interventions in pwMS with low disability.

"Bringing new life in": Hope as a know-how of not knowing

We offer a theoretical and empirical exploration of parental or guardian hope through an enactive, ecological, and reflective lifeworld research framework. We examine hoping as a practice, or know-how, by exploring the shape of interviewees' lives as they prepare for lives to come. We pursue hoping as a necessarily shared practice-a social agency-rather than an individual emotion. One main argument is that hoping operates as a kind of languaging. An enactive-ecological approach shifts scholarly conversations around hope, in part by including voices of non-scholars and considering lifeworld factors like class privilege. We aim to identify particular impediments to or facilitators of hope, which may be thought of as classes of restrictive and generative thought-shapers, respectively. Results from our qualitative study indicate that uncertainty is deeply salient to hoping, not only because hope as a concept entails epistemic limits, but more vitally because not knowing, when done skillfully and when supported through education and some degree of socio-economic security, leaves room for others to reframe utterances, and so for the family or community to resist linguistic enclosure.

Qigong Training Positively Impacts Both Posture and Mood in Breast Cancer Survivors With Persistent Post-surgical Pain: Support for an Embodied Cognition Paradigm

Theories of embodied cognition hypothesize interdependencies between psychological well-being and physical posture. The purpose of this study was to assess the feasibility of objectively measuring posture, and to explore the relationship between posture and affect and other patient centered outcomes in breast cancer survivors (BCS) with persistent postsurgical pain (PPSP) over a 12-week course of therapeutic Qigong mind-body training. Twenty-one BCS with PPSP attended group Qigong training. Clinical outcomes were pain, fatigue, self-esteem, anxiety, depression, stress and exercise self-efficacy. Posture outcomes were vertical spine and vertical head angles in the sagittal plane, measured with a 3D motion capture system in three conditions: eyes open (EO), eyes open relaxed (EOR) and eyes closed (EC). Assessments were made before and after the Qigong training. The association between categorical variables (angle and mood) was measured by Cramer's V. In the EO condition, most participants who improved in fatigue and anxiety scales also had better vertical head values. For the EOR condition, a moderate correlation was observed between changes in vertical head angle and changes in fatigue scale. In the EC condition, most of the participants who improved in measures of fatigue also improved vertical head angle. Additionally, pain severity decreased while vertical spine angle improved. These preliminary findings support that emotion and other patient centered outcomes should be considered within an embodied framework, and that Qigong may be a promising intervention for addressing biopsychosocially complex interventions such as PPSP in BCSs.

Deontological Feeling: The Tranquil, the Familiar and the Body

This paper contributes to filling a lacuna in recent research on common normative backgrounds. On the one hand, discussions of common normative backgrounds tend to underexpose the role the feeling body plays in relation to the agent’s recognition of deontic powers (obligations, compelling reasons or rights). On the other hand, discussions of bodily background orientations and their role in the agent’s sensitivity to practical significance tend to underexpose the recognition of deontic power. In this paper, I argue that bodily background orientations can contribute to an agent’s sensitivity to deontic power. Developing further on Ratcliffe’s conceptualization of existential feelings, I propose that a person’s bodily background orientation implies responsiveness to an ethically significant kind of affordance. In order to flesh out this theoretical claim, I draw on empirical material concerning a specific existential orientation labelled as “quietism.” Reconstructing its central patterns, I explicate the bodily dimension involved in the quietist orientation as well as the way in which it shapes the responsiveness to felt demands in terms of preserving tranquillity and protecting the familiar. Finally, I discuss the broader theoretical implications of my claim and suggest to categorize ethically relevant bodily background orientations such as the one implicated in the quietist orientation as deontological feelings.