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.

Abstract

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.