M. Smith1, B. Neibling1, G. Williams2, R. Barker1
1James Cook University, College of Healthcare Sciences, Townsville, Australia, 2University of Melbourne, Melbourne, Australia
Background: Exercise is essential for individuals with multiple sclerosis (MS), due to demonstrable benefits in strength, balance, mobility and fatigue. Despite the known benefits, individuals with MS engage in significantly less physical activity than those without the disease. Recent studies have explored behavioural interventions alongside exercise programs, to target change in exercise participation with some success. One such trial had commenced prior to the COVID-19 pandemic, where individuals with MS were engaging in a 12-week flexible exercise participation program (FEPP). The FEPP allows participants to engage in the exercise of their choice at a location of their choice, supported by weekly telephone coaching sessions from a physiotherapist. Behaviour change techniques known to assist with participation in exercise and sport were utilised in the coaching sessions. With the onset of the COVID-19 pandemic during the trial, opportunities, resources and support networks for exercise participation shifted for individuals with MS.
Purpose: The purpose of this study was to explore the impact of the COVID-19 pandemic on the ability of individuals with MS to participate in exercise.
Methods: A qualitative descriptive study utilizing two focus groups and one interview was conducted via videoconferencing technology. Open-ended questions were used to facilitate discussion of their experience of participating in exercise during the pandemic. Inductive thematic analysis was completed, and aided by NVivo software. Participants were individuals with minimal disability from MS (Expanded Disability Status Scale level of 0–3.5) enrolled in the 12-week FEPP during January-May 2020. Participants were residing in northern Queensland, Australia.
Results: Eight participants were recruited to the clinical trial with one drop out due to a change in social circumstances arising from the pandemic. The remaining seven participants were interviewed following completion of the FEPP. Three key themes were identified. “Disrupting Life” explained the change to exercise routine e.g. location, access to equipment and participation in team sports. “Changing Feelings” explored the uncertainty, fear and struggle of dealing with the pandemic and the restrictions. “Regaining Control” highlighted a need to create a new routine and new strategies to engage in exercise, with weekly telephone coaching providing both support and accountability to persevere with exercise.
Conclusion(s): The majority of participants successfully completed the trial despite the challenges imposed by physical restrictions and their subjective experience of the pandemic. Individuals with MS displayed resilience in finding new ways to exercise and new strategies to enable them to regain some control. Telephone coaching using behavioural change techniques enhanced participation in exercise during the pandemic.
Implications: Physiotherapists can use coaching involving behavioural change techniques to support individuals with MS to persevere with exercise during periods of significant disruption. Further research is required to explore the effects of behavioural change techniques on exercise for individuals with greater disability from MS and those who are not actively engaging in exercise.
Funding, acknowledgements: Supported by James Cook University, College of Healthcare Sciences.
Keywords: multiple sclerosis, exercise, COVID-19
Topic: Neurology: multiple sclerosis
Did this work require ethics approval? Yes
Institution: James Cook University
Committee: James Cook University Human Research Ethics Committee
Ethics number: H7956
All authors, affiliations and abstracts have been published as submitted.
