Resident physician University of British Columbia Vancouver, British Columbia, Canada
Objectives: Explore and gain a deeper understanding of barriers, facilitators, and strategies to support exercise behaviours across the disease course from the perspectives of individuals living with multiple sclerosis (MS)
Design: This was a qualitative study using photo-elicitation and semi-structured interviews. The study took place in an urban community setting in Saskatchewan, Canada. Over a two-week period, participants with MS (n=7) captured photographs of situations, places, or things that they perceived to increase, decrease, or make physical activity more difficult. Participants were then instructed to choose and caption 6-9 photographs to share with the research team. Semi-structured one-on-one interviews, guided by the SHOWeD framework, were then conducted to discuss the content of the photographs and explore participants’ perceptions of managing their MS.
Results: Three main themes that influenced participants' exercise behaviour were identified. The themes were subdivided into several sub-themes. 1. Psychosocial: the self and the social: Social support, attitudes and attributes 2. Environmental: adapting and modifying the environment: adaptive and assistive equipment, adapted and individualized physical activity 3. Logistical: planning and preparedness: MS symptoms and overall health, the natural environment, accessibility and cost, physical activity program information
Communication and support from healthcare providers appeared to play a key role in each theme.
Conclusions: Barriers and facilitators to exercise among individuals with MS may be unique to the individual and influenced by personality, mindset, experiences, relationships, context, and environment. Interestingly, factors that act as a barrier to physical activity for one participant occasionally acted as a facilitator for another. Healthcare providers must realize their pivotal role in influencing exercise behaviours.
