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Roikjær SG, Skou ST, Walløe S, Tang LH, Beck M, Simonÿ C, Asgari N. Experiences of integrating and sustaining physical activity in life with multiple sclerosis, Alzheimer's disease, and ischaemic heart disease: a scoping review. Disabil Rehabil 2024; 46:2979-2988. [PMID: 37584422 DOI: 10.1080/09638288.2023.2244424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 07/03/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE The effects of physical activity on health are well-established for chronic diseases such as multiple sclerosis (MS), Alzheimer's disease (AD), and ischaemic heart disease (IHD). However, sustaining physical activity in everyday life is difficult. Lifeworld knowledge can help qualify interventions aimed at resolving this public health issue, but there is a gap in regard to synthesized research on peoples' experiences with integrating and sustaining physical activity. Hence, the purpose of this review is to explore and present the available evidence on experiences with integrating and sustaining physical activity in a lived life with MS, AD, and IHD. METHODS We conducted a scoping review with qualitative analysis and narrative syntheses in accordance with PRISMA-ScR. Based on SPIDER we ran a systematic search in Cinahl, Embase, Medline, and PsychInfo for primary qualitative research papers published until December 2022. RESULTS 43 papers were included. A thematic content analysis found that individuals who have MS, AD or IHD find integrating and sustaining physical activity in everyday life meaningful on several levels: Physical activity can facilitate meaningful movement with outcomes of physical, psychosocial, and existential importance. CONCLUSION The research literature presents a meaning to physical activity that extends the idea of physical fitness to one of existential movement and personal growth. In addition, our review finds that people are more likely to integrate and sustain physical activity if they feel acknowledged, supported and believe that physical activity has a meaningful purpose reflecting their sense of self. Taking a more person-centred approach in rehabilitative care might help qualify the content of physical activity in terms of integration into everyday life, but more research is needed on how to implement a person-centred approach in practice.
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Affiliation(s)
- Stine G Roikjær
- Department of Neurology Næstved, Slagelse and Ringsted Hospitals, CNF, the Center for Neurological Research, Slagelse, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy Næstved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy Næstved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sisse Walløe
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy Næstved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
- The Research Unit OPEN, Open Patient data Explorative Network, University of Southern Denmark, Odense, Denmark
| | - Lars H Tang
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy Næstved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Malene Beck
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Charlotte Simonÿ
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy Næstved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Nasrin Asgari
- Department of Neurology Næstved, Slagelse and Ringsted Hospitals, CNF, the Center for Neurological Research, Slagelse, Denmark
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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Huynh TLT, Neal WN, Barstow EA, Motl RW. Physical Activity in Individuals Newly Diagnosed With Multiple Sclerosis Through the Lens of the COM-B Model. Int J MS Care 2024; 26:49-56. [PMID: 38482516 PMCID: PMC10930808 DOI: 10.7224/1537-2073.2022-095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Physical activity (PA) is a promising intervention for disease modification and symptom management in multiple sclerosis (MS); however, there is a lack of research focusing on PA behavior change interventions for persons newly diagnosed with MS. Such PA behavior change interventions should be developed based on a strong empirical foundation of understanding the behavior and its determinants (ie, what to target for changes to occur). To that end, this qualitative study examined factors explaining PA in persons newly diagnosed with MS and identified potential targets for future behavior change intervention development based on the Capability-Opportunity-Motivation-Behavior (COM-B) model. METHODS Twenty individuals diagnosed with MS within the past 2 years underwent one-on-one semistructured interviews using questions developed based on the COM-B model. Data were analyzed using reflective thematic analysis, and the identified themes were then mapped with the COM-B model. RESULTS Factors explaining PA in the study sample were identified across the COM-B components. The typical factors include knowledge and skills to sufficiently engage in PA with appropriate approaches, ability to adapt and navigate through new environmental and social difficulties after diagnosis, and motivation resulting from a combination of factors, such as outcome expectation, belief of capabilities, role/identity, reinforcement, and emotions. CONCLUSIONS The COM-B model was applied successfully in this study to understand PA behavior and identify potential targets for behavior change in individuals newly diagnosed with MS. Future behavior change interventions should consider addressing these factors to generate effective PA behavior change in this population.
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Affiliation(s)
- Trinh L. T. Huynh
- From the Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA (TLTH, RWM)
| | - Whitney N. Neal
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA (WNN)
| | - Elizabeth A. Barstow
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA (EAB)
| | - Robert W. Motl
- From the Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA (TLTH, RWM)
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Garg H, Rutherfurd C, Labrum J, Hawley B, Gard E, Davis J. Feasibility, Outcomes, and Perceptions of a Virtual Group Exercise Program in Multiple Sclerosis. J Neurol Phys Ther 2024; 48:54-63. [PMID: 37563754 DOI: 10.1097/npt.0000000000000450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
BACKGROUND AND PURPOSE Individuals with multiple sclerosis (MS) frequently report low physical activity and psychosocial support due to concerns with transportation, time, finances, access to services, and lack of caregiver support. These barriers can be addressed by online group interventions; however, utility of such programs in individuals with MS has not been examined yet. The purpose of this retrospective study was, therefore, to ( a ) investigate the feasibility, safety, and outcomes of a virtual group exercise program in individuals with MS, and ( b ) explore the participant perceptions after the program. METHODS Retrospective data from the medical records of 17 individuals with MS (mean [SD] age = 53.5 [12.3] years, body mass index = 28.2 [7.2]) who completed the virtual 13-week group exercise program, pre- and posttraining functional status questionnaires, and the end-of-program feedback were extracted. The exercise program included aerobic, resistance, balance, and flexibility training components recommended for people with MS. Feasibility, safety, outcomes, and participant perceptions were determined by adherence to the prescribed daily exercise dosage, number of adverse events, within-group differences in self-reported functional status, and thematic analysis of the participant feedback, respectively. RESULTS Participants were adherent (79%), reported minimal adverse effects, and demonstrated significant changes ( P < 0.05) in functional status posttraining. Several themes on the perceived barriers, facilitators, and suggestions for improvement were identified. DISCUSSION AND CONCLUSIONS A virtual 13-week group exercise program can be feasible, safe, effective, and well received by individuals with MS. Future research should investigate the dose-response effectiveness of telehealth and compare various telehealth models of exercise training using large randomized controlled trials.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A434 , which demonstrates an overview of the study).
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Affiliation(s)
- Hina Garg
- Department of Physical Therapy (H.G.), Rocky Mountain University of Health Professions, Provo, Utah; Easterseals Massachusetts (C.R.), Worcester; Rocky Mountain University Foundation Community Rehabilitation Clinic (J.L., B.H.), Provo, Utah; and Rocky Mountain University of Health Professions (E.G., J.D.), Provo, Utah
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4
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Manche S, Probst Y. Exploring the socio-ecological factors impacting lifestyle management of multiple sclerosis: A scoping review. Mult Scler Relat Disord 2023; 79:104958. [PMID: 37708822 DOI: 10.1016/j.msard.2023.104958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/01/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic, autoimmune, neurodegenerative disorder affecting over 2.9 million people worldwide. First line care revolves around disease modifying therapy and supporting people living with MS to manage their disease. Early management often sees lifestyle modification as people living with MS try to gain a sense of control. Lifestyle management is an evolving area of care with variable strength of evidence for different lifestyle factors. OBJECTIVE To explore factors that impact on the self-management of MS with a socio-ecological focus. METHODS A scoping review following the Joanna Briggs Institute guidelines for a systematic search was conducted across six databases with 9241 articles identified and 51 included in the review. The results were analysed in conjunction with the socio-ecological model considering the categories: individual, interpersonal, organisational, community, and public policy. RESULTS A map of health behaviour (lifestyle) factors extending across all levels of the socio-ecological model revealed a complex web of pathways to behavioural patterns impacting MS self-management. Factors followed a cascading effect towards either of two key principles: (1) self-identity or (2) accessibility. These principles in-turn impact on an individual's self-efficacy, and hence, effectiveness of MS self-management strategies. CONCLUSIONS MS care is highly individualised to the personal context and circumstances of the individual, with consideration towards suitable management strategies required. Healthcare professionals must consider these lifestyle influences and coordinate an approach to assisting people living with MS to self-manage their disease in relation to their personal circumstances. Person-centred care addressing both barriers and motivators to health behaviour changes is key to effective MS self-management.
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Affiliation(s)
- Sarah Manche
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
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Adamson B, Wyatt N, Key L, Boone C, Motl RW. Results of the MOVE MS Program: A Feasibility Study on Group Exercise for Individuals with Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6567. [PMID: 37623153 PMCID: PMC10454660 DOI: 10.3390/ijerph20166567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
Exercise improves a wide range of symptoms experienced by those living with multiple sclerosis (MS) and may foster community and a positive sense of disability identity. However, exercise rates remain low. Sustained exercise participation has the greatest likelihood of improving symptoms and requires a theory-based approach accounting for the barriers faced by people with MS that impede exercise participation long-term. MOVE MS is a once weekly group exercise program based on Social Cognitive Theory supporting long-term exercise participation through peer instruction, behavior change education, multiple exercise modalities, and seated instruction. This feasibility study evaluated MOVE MS with a 7-month trial. The primary scientific outcome was exercise participation and the secondary outcomes were MS symptoms/impact, self-efficacy, depression, anxiety, disability identity, and quality of life, among others. We further conducted semi-structured formative interviews post-intervention. Thirty-three participants began the program. The onset of COVID-19 necessitated a shift toward online delivery. Seventeen participants completed the program. There were non-significant improvements in exercise participation (Godin Leisure-Time Exercise Questionnaire, baseline mean = 14.2 (SD = 11.8), post-intervention mean = 16.6 (SD = 11.2), F-value = 0.53 (Partial Eta2 = 0.08), and several secondary outcomes (including the MS Impact Scale, MS Walking Scale, and the Leeds MS Quality of Life Scale). Sixteen participants were interviewed, and analysis yielded five themes on program components and feedback. MOVE MS-delivered in-person or online-may be a feasible option for long-term exercise programming for people with MS.
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Affiliation(s)
- Brynn Adamson
- Department of Health Sciences, University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80907, USA
| | - Nic Wyatt
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 506 S. Wright St., Urbana, IL 61801, USA
| | - Latashia Key
- Department of Recreation, Sport, and Tourism, University of Illinois at Urbana-Champaign, 506 S. Wright St., Urbana, IL 61801, USA
| | - Carrena Boone
- Department of Health Sciences, University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80907, USA
| | - Robert W. Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1200 West Harrison St., Chicago, IL 60607, USA
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Russell N, Gallagher S, Msetfi RM, Hayes S, Motl RW, Coote S. Experiences of people with multiple sclerosis participating in a social cognitive behavior change physical activity intervention. Physiother Theory Pract 2022; 39:954-962. [PMID: 35094662 DOI: 10.1080/09593985.2022.2030828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Understanding the experiences of people with MS taking part in physical activity interventions is critical to inform future interventions. AIM The aim was to gain insight into the experiences of people with MS taking part in a behavior change group physical activity intervention with a novel social cognitive theory component. METHODS A qualitative semi-structured interview format was utilized. Questions focussed on expectations, views and beliefs at being involved in the study, beliefs on physical activity, and subjective evaluation of the trial content and delivery. Seventeen people were interviewed and data were analyzed using thematic analysis. RESULTS Three themes were generated: psychological and social factors, intervention processes, and MS identity. The acceptance of MS as an identity acted as an initial barrier to exercise, with a more positive, exercise-enabling identity post-intervention. Psychological factors such as self-efficacy and anxiety, as well as social factors such as social support, were found to play an important role in how participants experienced the program. Similarly, intervention processes included support for group-based activities and structure of exercise classes, and were also inter-linked to the other themes. CONCLUSION It appears that group-based exercise interventions are acceptable and feasible for people with MS. The qualitative findings support previously reported quantitative findings that the Step it Up intervention is effective at promoting physical activity and improving psychological outcomes.
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Affiliation(s)
- Niall Russell
- Centre for Social Issues, Department of Psychology, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Centre for Social Issues, Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Rachel M. Msetfi
- Centre for Social Issues, Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Sara Hayes
- Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Clinical Therapies, University of Limerick, Ireland
| | - Robert W. Motl
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Susan Coote
- Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Clinical Therapies, University of Limerick, Ireland
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7
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Richardson EV, Barstow E, Fifolt M, Motl RW. Evaluation of a Conceptual Model Regarding Exercise Promotion Through the Patient-Provider Interaction in Multiple Sclerosis: Health Care Provider Perspectives. QUALITATIVE HEALTH RESEARCH 2020; 30:1262-1274. [PMID: 30584791 DOI: 10.1177/1049732318819453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Nearly 80% of persons with multiple sclerosis (MS) do not engage in sufficient amounts of exercise for managing symptoms and improving quality of life. We have addressed this problem by developing a systematic line of qualitative research targeting the patient-provider interaction for promotion of exercise within comprehensive MS care. This research resulted in a conceptual model that guides health care providers in promoting exercise among persons with MS. The current study involves a final evaluation of the model based on semistructured interviews with 28 MS health care providers. Providers perceived that the model was a strong conceptualization of practice that reflected the MS illness course and supported exercise behavior change, but more steps were required to translate the model from concept into practice, including improved clarity of the model, and the development of practice models. The evaluation yielded a final conceptual model for exercise promotion in MS through the patient-provider interaction.
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Affiliation(s)
| | | | - Matthew Fifolt
- The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert W Motl
- The University of Alabama at Birmingham, Birmingham, Alabama, USA
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8
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Lahelle AF, Øberg GK, Normann B. Group dynamics in a group-based, individualized physiotherapy intervention for people with multiple sclerosis: A qualitative study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 25:e1829. [PMID: 31883187 DOI: 10.1002/pri.1829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/22/2019] [Accepted: 12/13/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Group-based physiotherapy is a common and beneficial intervention for people with multiple sclerosis (MS). Most group interventions are not individually adapted to each participant's needs. Evidence on how individualization and group elements can be combined in a clinical setting is lacking. The objective of this study is to expand the knowledge base in neurological physiotherapy by investigating the nature of group dynamics in a group-based, individualized intervention for people with MS. METHODS This qualitative study included 13 nonparticipatory video observations (14 hr 38 min) of GroupCoreDIST exercise sessions complemented by 13 interviews (12 hr 37 min) with physiotherapists (PTs). The purposively sampled participants included 40 patients with MS (expanded disability scale of 1.0-6.5) and six PTs with expertise in neurological physiotherapy. Data were analysed using systematic text condensation in an enactive theoretical framework. RESULTS Two main categories emerged from the material. (a) Individual systems affect group dynamics: Individual perceptions of success through adapted and embodied approaches positively affected the dynamics of the group. (b) Disease and exercise peer support: Social support was a substantial product of dynamic group processes and was enhanced through the PTs' strategic focus on experience sharing. CONCLUSION The results revealed that group dynamics benefit from individualization and the PTs' focus on experience sharing. These findings are contrary to the prevailing view that individualization and group-based interventions are mutually exclusive and thus should be considered in group-based interventions for people with MS.
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Affiliation(s)
- Andreas Falck Lahelle
- Department of Health and Care Sciences, University of Tromsø, The Artic University of Norway, Tromsø, Norway
| | - Gunn Kristin Øberg
- Department of Health and Care Sciences, University of Tromsø, The Artic University of Norway, Tromsø, Norway
| | - Britt Normann
- The Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Department of Physiotherapy, Nordland Hospital Trust, Bodø, Norway
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Claesson IM, Ståhle A, Johansson S. Being limited by Parkinson’s disease and struggling to keep up exercising; is the group the glue? Disabil Rehabil 2019; 42:1270-1274. [DOI: 10.1080/09638288.2018.1522552] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ingrid M. Claesson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Sophiahemmet, Neurocampus, Stockholm, Sweden
| | - Agneta Ståhle
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Function Area Occupational therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
| | - Sverker Johansson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Function Area Occupational therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
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10
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Shirazipour CH, Evans MB, Leo J, Lithopoulos A, Martin Ginis KA, Latimer-Cheung AE. Program conditions that foster quality physical activity participation experiences for people with a physical disability: a systematic review. Disabil Rehabil 2018; 42:147-155. [DOI: 10.1080/09638288.2018.1494215] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - M. Blair Evans
- Kinesiology Department, Pennsylvania State University, University Park, PA, USA
| | | | | | - Kathleen A. Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Kelowna, British Columbia, Canada
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Lai B, Bond K, Kim Y, Barstow B, Jovanov E, Bickel CS. Exploring the uptake and implementation of tele-monitored home-exercise programmes in adults with Parkinson's disease: A mixed-methods pilot study. J Telemed Telecare 2018; 26:53-63. [PMID: 30134777 DOI: 10.1177/1357633x18794315] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with Parkinson's disease experience numerous barriers to exercise participation at fitness facilities. Advances in tele-monitoring technologies create alternative channels for managing and supervising exercise programmes in the home. However, the success of these programmes will depend on participants' perceptions of using the technology and their exercise adherence. Thus, this pilot explored the uptake and implementation of two common methods of Internet-exercise training in Parkinson's disease. METHODS Twenty adults with Parkinson's disease were randomized into either: telecoach-assisted exercise (TAE) or self-regulated exercise (SRE) groups. Both groups received the same eight-week exercise prescription (combined strength and aerobic exercise) and telehealth system that streamed and recorded vital signs and exercise data. TAE participants exercised under a telecoach's supervision via videoconferencing. SRE participants independently managed their exercise training. Quantitative data were described and qualitative data underwent thematic analysis. RESULTS Quantitative results demonstrated that TAE participants achieved strong attendance (99.2%), whereas SRE participants demonstrated 35.9% lower attendance, 48% less total time exercising, and 74.5% less time exercising at moderate intensity. Qualitatively, TAE participants reported overtly favourable programme experiences and that assistance from a telecoach enhanced their exercise motivation. SRE participants noted several challenges that impeded adherence. CONCLUSION Findings demonstrate that adults with Parkinson's disease acknowledge benefits of exercising through a telehealth system and are open to utilizing this channel as a means of exercise. However, human-interactive support may be required to overcome unique impediments to participation. Study findings warrant validation in larger trials that can transfer the success of TAE towards more scalable methods of delivery.
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Affiliation(s)
- Byron Lai
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Kristina Bond
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Yumi Kim
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Beth Barstow
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Emil Jovanov
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - C Scott Bickel
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
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Moffat F, Paul L. Barriers and solutions to participation in exercise for moderately disabled people with multiple sclerosis not currently exercising: a consensus development study using nominal group technique. Disabil Rehabil 2018; 41:2775-2783. [DOI: 10.1080/09638288.2018.1479456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Fiona Moffat
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lorna Paul
- Nursing and Healthcare School, University of Glasgow, Glasgow, UK
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Crank H, Carter A, Humphreys L, Snowdon N, Daley A, Woodroofe N, Sharrack B, Petty J, Saxton JM. Qualitative Investigation of Exercise Perceptions and Experiences in People With Multiple Sclerosis Before, During, and After Participation in a Personally Tailored Exercise Program. Arch Phys Med Rehabil 2017. [DOI: 10.1016/j.apmr.2017.05.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Tallner A, Pfeifer K, Mäurer M. Web-based interventions in multiple sclerosis: the potential of tele-rehabilitation. Ther Adv Neurol Disord 2016; 9:327-35. [PMID: 27366240 DOI: 10.1177/1756285616640684] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The World Wide Web is increasingly used in therapeutic settings. In this regard, internet-based interventions have proven effective in ameliorating several health behaviors, amongst them physical activity behavior. Internet-delivered interventions have shown positive effects on physical activity and physical function in persons with MS (pwMS). In this review we give an overview on several online exercise programs for pwMS and discuss the advantages and drawbacks of web-based interventions. Although participants of online exercise programs reported a high acceptance and satisfaction with the intervention, decreasing compliance was a major issue. A possible remedy might be the implementation of game-design elements to increase compliance and long-term adherence to internet-delivered interventions. In addition we believe that the integration of social networks seems to be a promising strategy.
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Affiliation(s)
- Alexander Tallner
- Institut für Sportwissenschaft und Sport der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Pfeifer
- Institut für Sportwissenschaft und Sport der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Mathias Mäurer
- Deparment of Neurology, Caritas Krankenhaus Bad Mergentheim gGmbH, Uhlandstr. 7, 97980 Bad Mergentheim, Germany
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Perceptions of Participants in a Group, Community, Exercise Programme for People with Multiple Sclerosis. Rehabil Res Pract 2015; 2015:123494. [PMID: 26491567 PMCID: PMC4600491 DOI: 10.1155/2015/123494] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 08/30/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose. The purpose of this study was to explore the perceptions of people with multiple sclerosis of a community based, group exercise programme. Method. A pragmatic programme evaluation approach using qualitative research design was adopted. Focus groups were used to gather data from 14 participants who had taken part in a RCT of community based exercise interventions for PwMS who used at most a stick to walk outdoors. Data were transcribed verbatim and thematic analysis was used to first identify categories and then to group them into themes. Results. Three themes emerged, psychological benefits, physical benefits, and knowledge gained. The psychological benefits included the role of the group as a social and motivational factor, empowerment, confidence, hope, sense of achievement, and pride. Physical benefits were improved energy and reduced fatigue and improved ability and participation. Knowledge gained caused a shift from thoughts that exercise might do harm, to sufficient knowledge that would give participants confidence to exercise themselves. The role of the group was a key element in the positive outcomes. Conclusions. The qualitative analysis supports the findings of the main trial confirming positive effects of community exercise interventions by reducing the impact of MS and fatigue and improving participation.
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Learmonth YC, Motl RW. Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences. Disabil Rehabil 2015; 38:1227-42. [PMID: 26314587 DOI: 10.3109/09638288.2015.1077397] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE This systematic review was conducted to provide rich and deep evidence of the perceived determinants and consequences of physical activity and exercise based on qualitative research in multiple sclerosis (MS). METHOD Electronic databases and article reference lists were searched to identify qualitative studies of physical activity and exercise in MS. Studies were included if they were written in English and examined consequences/determinants of physical activity in persons with MS. Content analysis of perceived determinants and consequences of physical activity and exercise was undertaken using an inductive analysis guided by the Physical Activity for people with Disabilities framework and Social Cognitive Theory, respectively. RESULTS Nineteen articles were reviewed. The most commonly identified perceived barriers of physical activity and exercise were related to the environmental (i.e. minimal or no disabled facilities, and minimal or conflicting advice from healthcare professionals) and related to personal barriers (i.e. fatigue, and fear and apprehension). The most commonly identified perceived facilitators of physical activity were related to the environment (i.e. the type of exercise modality and peer support) and related to personal facilitators (i.e. appropriate exercise and feelings of accomplishment). The most commonly identified perceived beneficial consequences of physical activity and exercise were maintaining physical functions, increased social participation and feelings of self-management and control. The most commonly identified perceived adverse consequences were increased fatigue and feelings of frustration and lost control. CONCLUSIONS Results will inform future research on the perceived determinants and consequences of physical activity and exercise in those with MS and can be adopted for developing professional education and interventions for physical activity and exercise in MS. IMPLICATIONS FOR REHABILITATION Physical activity and exercise behaviour in people with multiple sclerosis (MS) is subject to a number of modifiable determinants. Healthcare professionals working to promote physical activity and exercise in those with MS should choose to endorse the positive benefits of participation. Future physical activity interventions for those with MS may be improved by incorporating behavioural management strategies.
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Affiliation(s)
- Yvonne C Learmonth
- a Department of Kinesiology and Community Health , University of Illinois at Urbana-Champaign , Urbana , IL , USA
| | - Robert W Motl
- a Department of Kinesiology and Community Health , University of Illinois at Urbana-Champaign , Urbana , IL , USA
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Gunn H, Cattaneo D, Finlayson M, Freeman J, Sosnoff JJ. Home or away? Choosing a setting for a falls-prevention program for people with multiple sclerosis. Int J MS Care 2014; 16:186-91. [PMID: 25694777 PMCID: PMC4321457 DOI: 10.7224/1537-2073.2014-058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Evidence suggests that choice of setting may be important in influencing the outcomes of rehabilitation programs, as well as optimizing participant satisfaction and adherence. This article aims to examine the factors that may inform the choice of setting for a falls-prevention program tailored to the needs of people with multiple sclerosis, including the influence of setting on program effectiveness, participant engagement, cost, and sustainability. Any new program should ensure that the choice of setting is informed by the intended program outcomes as well as an awareness of the opportunities and challenges presented by each type of setting. Evaluations of falls programs for older people suggest that immediate outcomes are similar regardless of setting; however, long-term outcomes may differ by setting, possibly owing to differential effects on adherence. Programs based away from home may offer benefits in terms of maintaining motivation, providing peer-support opportunities, and allowing regular access to facilitator input, while home-based programs offer unique opportunities for context-based practice and the integration of falls-prevention activities into real life. Additionally, home-based programs may address some of the long-term feasibility issues associated with programs away from home. A "mixed" program incorporating elements of home- and community-based activity may be the most sustainable and effective choice to achieve both long- and short-term goals within a falls-prevention program. However, currently there are significant gaps in knowledge relating to comparative program outcomes, cost, and long-term sustainability.
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Affiliation(s)
- Hilary Gunn
- School of Health Professionals, Plymouth University, Plymouth, UK (HG, JF); Don C. Gnocchi Foundation, Milan, Italy (DC); School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada (MF); and Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA (JJS)
| | - Davide Cattaneo
- School of Health Professionals, Plymouth University, Plymouth, UK (HG, JF); Don C. Gnocchi Foundation, Milan, Italy (DC); School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada (MF); and Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA (JJS)
| | - Marcia Finlayson
- School of Health Professionals, Plymouth University, Plymouth, UK (HG, JF); Don C. Gnocchi Foundation, Milan, Italy (DC); School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada (MF); and Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA (JJS)
| | - Jennifer Freeman
- School of Health Professionals, Plymouth University, Plymouth, UK (HG, JF); Don C. Gnocchi Foundation, Milan, Italy (DC); School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada (MF); and Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA (JJS)
| | - Jacob J Sosnoff
- School of Health Professionals, Plymouth University, Plymouth, UK (HG, JF); Don C. Gnocchi Foundation, Milan, Italy (DC); School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada (MF); and Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA (JJS)
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